Medical Student Emory University School of Medicine Atlanta, Georgia, United States
Background: As healthcare becomes more global, it is increasingly important that we have shared definitions and understandings of words that are frequently used. “Pediatrics” is one word that lacks shared definitions globally, including in many low-and-middle income countries. Therefore, when healthcare professionals work together internationally and have conversations about pediatric care, research involving pediatric patients, or guidelines for pediatric care, they may not be intrinsically referring to the same population. Objective: To explore how physicians in East Africa define the term “pediatrics”, with a secondary aim of assessing how their definitions impact patient care. Design/Methods: We conducted a qualitative study using semi-structured interviews with physicians from Tanzania, Democratic Republic of the Congo, Ethiopia, Rwanda, and Uganda. Participants were identified through faculty partnerships and key community stakeholders. They were contacted via email, and the participant group was expanded via snowball method. After informed consent was obtained, interviews were conducted virtually or in-person, were audio-recorded, and notes were taken. Audio recordings were transcribed, de-identified, and checked for accuracy. Transcriptions were coded, a codebook was created, and themes were identified using an inductive, iterative approach. Interviews were conducted until thematic saturation was reached. Member checking/respondent validation was used to ensure the trustworthiness of the results. Results: 18 physicians completed interviews. Informants included 13 pediatricians, 4 emergency medicine physicians, and 1 anesthesiologist with a median of 5.5 yrs of practice (range: 2-15 yrs). Interviews averaged 21 min 19 sec in length. The following themes were identified: 1) There is no standard definition of “pediatrics”, and there is a lot of complexity surrounding the concept. 2) The transition from childhood/pediatric care to adulthood includes both mental and physical development, but there are also a variety of other considerations. 3) Specific settings use different definitions of pediatrics, and this directly impacts patient care. Illustrative quotes are shown in Table 1.
Conclusion(s): Our study shows that there is ambiguity in the term “pediatrics” in East Africa, not just between countries but also within countries. In fact, individual physicians reported using the term differently in varying contexts. No physician in our study could provide a standardized definition. There is a need to clearly define “pediatrics” when using this term clinically, in research, and in creating policy.
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