A scoping review exploring the health impact and sustainability of collaborative paediatric heart disease treatment programmes in developing countries.

INTRODUCTION: The global burden of paediatric heart disease is increasing with widening disparities between developed countries and developing economies. In the last two decades, mortality and morbidity rates have markedly improved in developed nations, however they continue to rise in developing countries. Collaborative treatment programmes are crucial for bridging this gap where the necessary healthcare infrastructure is lacking. This scoping review aims to map the health impact, economic outcomes, and capacity building initiatives of collaborative paediatric heath disease treatment programmes in developing countries. METHODS: A comprehensive search was conducted across MEDLINE, Embase and Global Health from inception to May 5th, 2024. Studies were screened by title and abstract, followed by full-text review, applying predefined inclusion and exclusion criteria. Data on patient and programme characteristics, mortality rates, economic impact and capacity-building initiatives were extracted and analysed. RESULTS: The review included 35 studies. Thirty studies reported on mortality rates which ranged from 0% to 12.4%. Nine studies reported on mortality pre and post programme with a 4% to 41% reduction in mortality. Many studies included capacity building initiatives within their programmes. This included: Training and Education (n = 26); Infrastructure Development (n = 13); and Systems Strengthening (n = 18). Long-term programmes placed more than double the emphasis on systems strengthening approaches compared to short-term missions. CONCLUSION: Our review extensively maps the various characteristics and approaches of collaborative paediatric heart disease programmes. Overall, the findings suggests that these initiatives have the potential to provide favourable clinical outcomes and if setup appropriately they can support development of local expertise, improve healthcare infrastructure, and promote self-sustaining services in developing countries. A multi-faceted approach is required to improve paediatric cardiac care globally. Evidence evaluating long term impact and sustainability remains limited and further research is required to better understand how collaborative models can be optimised to support equitable and sustainable paediatric cardiac care globally.