Optimum Ratio of Pediatric Surgery in Indonesia Based on Under Five Mortality Rate: Recent Evidence from Demographic Health Survey

Introduction: Children mortality was mostly dominated by deaths in the early life, some were attributed to congenital abnormalities. Access to pediatric surgical services, represented in the form of pediatric surgeon workforce density (PSWD), were expected to contribute to the reduction of the under-five mortality rate (U5MR). However, there still no established study that determine the ideal number of pediatric surgeons worldwide, especially in Indonesia. This study aims to calculate the optimal ratio of pediatric surgeon in Indonesia based on U5MR and PSWD. Method: This study was a quantitative study using cross-sectional design by processing secondary data from the Seventh Indonesian Demographic Health Survey (IDHS 7th). The research sample consists of 36,665 child mortality records that were collected using two-stage stratified cluster sampling technique. Variables used in this study were PSWD and U5MR, obtained from Indonesian Pediatric Surgery Association (PERBANI) and 7th IDHS, respectively. The data were analyzed using spearman and regression test. Result: The average U5MR and PSWD across 34 provinces in Indonesia were 32/8.89, 30/23.5, 31/7.98, 45/7.19, 47/3.25, and 80/6.36 for Sumatra, Java-Bali, Kalimantan, Sulawesi, Maluku-Nusa Tenggara, and Papua region respectively. PSWD strongly correlated with U5MR with Spearman coefficient -0.582 (p=0.000) and identified the value of PSWD by 51 as the threshold to reduce the U5MR optimally. Conclusion: The optimal ratio of pediatric surgeon in Indonesia based on children mortality rate was 1: 1,960. Currently, average of PSWD in Indonesia still inadequate to meet the criteria for reducing child mortality optimally. © 2024 Elsevier B.V., All rights reserved.