An OxPLORE Initiative Evaluating Children’s Surgery Resources Worldwide: A Cross-sectional Implementation of the OReCS Document

Krupa Ravi, Annabel Killen, Angus Alexander, Frances Bell-Davies, James Biganiro Sebintu, Aurelia Brazeal, Jean Marie Vianney Butoyi, Fabio Edgardo Diaz, Romeo Drabile, Marvin Fanny, Lucila Fernie, Shannon Gunawardana, Emma Hartley, Yolisa N. Hawu, Holly Hendron, Stephanie Alcine Joseph, Ananda Lamahewage, Ruwantha Mahagedera, Emery Manirambona, Benjamin Kitambala MorishoPatrick Muchunu, Alliance Niyukuri, Edmond Ntaganda, Francisco Orliacq, Josefina Orliacq, Adili Wobenjo, Pablo Young, Kokila Lakhoo, Kathryn Ford*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Background: The Global Initiative for Children's Surgery (GICS) group produced the Optimal Resources for Children’s Surgery (OReCS) document in 2019, listing standards of children’s surgical care by level of healthcare facilities within low resource settings. We have previously created and piloted an audit tool based on the OReCS criteria in a high-income setting. In this study, we aimed to validate its use in identifying gaps in children’s surgery provision worldwide. Methods: Our OReCS audit tool was implemented in 10 hospitals providing children’s surgery across eight countries. Collaborators were recruited via the Oxford Paediatrics Linking Our Research with Electives (OxPLORE) international network of medical students and trainees. The audit tool measured a hospital’s current capacity for children’s surgery. Data were analysed firstly to express the percentage of ‘essential’ criteria met for each specialty. Secondly, the ‘OxPLORE method’ was used to allocate each hospital specialty a level based on procedures performed and resources available. A User Evaluation Tool (UET) was developed to obtain feedback on the ease of use of the tool. Results: The percentage of essential criteria met within each category varied widely between hospitals. The level given to hospitals for subspecialties based on OReCS criteria often did not reflect their self-defined level. The UET indicated the audit tool was practicable across multiple settings. Conclusions: We recommend the use of the OReCS criteria to identify areas for local hospital improvement and inform national children’s surgical plans. We have made informed suggestions to increase usability of the OReCS audit tool.

Original languageEnglish
Pages (from-to)476-485
Number of pages10
JournalWorld Journal of Surgery
Issue number3
Publication statusPublished - Mar 2022
Externally publishedYes


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