Abstract
Survival dominates current pediatric global health priorities. Diseases of poverty largely contribute to overall mortality in children under 5 years of age. Infectious diseases and injuries account for 75% of cause-specific mortality among children ages 5-14 years. Twenty percent of the world's population lives in extreme poverty (income below US $1.25/day). Within this population, essential services and basic needs are not met, including clean water, sanitation, adequate nutrition, shelter, access to health care, medicines and education. In this context, musculoskeletal disease comprises 0.1% of all-cause mortality in children ages 5-14 years. Worldwide morbidity from musculoskeletal disease remains generally unknown in the pediatric age group. This epidemiologic data is not routinely surveyed by international agencies, including the World Health Organization. The prevalence of pediatric rheumatic diseases based on data from developed nations is in the range of 2,500 - 3,000 cases per million children. Developing countries' needs for musculoskeletal morbidity are undergoing an epidemiologic shift to chronic conditions, as leading causes of pediatric mortality are slowly quelled.A global crisis of health care providers and human resources stems from insufficient workforce production, inability to retain workers in areas of greatest need, distribution disparity and poor management of both health care systems and health workforce. Internationally, the pediatric rheumatology workforce will also be in very short supply for the foreseeable future relative to projected demand. Physician extenders are an essential resource to meet this demand in underserved regions. They can be trained in common aspects of musculoskeletal medicine and rheumatic conditions. Innovative strategies have been introduced in the United Kingdom to address musculoskeletal medicine educational deficiencies. Telemedicine offers an important capacity to improve access to care despite distance. Regulatory flexibility may allow realignment of clinical responsibilities through existing and future governmental or non-governmental credentialing organizations. This review explores a variety of creative approaches which hold promise to improve patient access to care.
Highlights
Survival dominates current pediatric global health priorities
For children under 5 years of age, 83-84% of global mortality can be attributed to neonatal disorders, pneumonia, diarrhea, malaria, measles, human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), and injuries (Table 1) [1,2]
Since 2008, the defined international poverty line is income below United States (US) $1.25/day based on 2005 purchasing power parity [4]
Summary
Million children [8,9,10], there are approximately 6-7 million children afflicted worldwide with rheumatic disease. The total international PR workforce supply is 12% of this demand; the US possesses 40% of this total supply The needs of these children are understandably eclipsed by the leading causes of pediatric mortality. Other European countries lack formalized certification of PR fellowship training Both PR and internist rheumatologist physician resources in Canada are “inadequate” to fulfill requisite clinical care demands. UK PRs endure frustrations with inadequate MSK medicine education at UK medical schools, delays in referral and a workforce shortage Their educational policy approach involves promoting inclusion of pediatric MSK clinical skills and knowledge in their Competency Framework for Postgraduate General Paediatrics. While approximately one half of the global population lives in rural locations (defined by the OECD as communities with a population density below 150 inhabitants/km2), these areas are served by less than a quarter of the total physician workforce [25].
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
