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Background: Barriers to surgical care for children in low and middle income countries (LMICs) remain poorly defined. In this study, we used two consumer decision analysis tools to measure how families view the importance of different barriers to pediatric surgical care in Guatemala. Methods: Our subject population was a convenience sample of parents or guardians of children receiving surgical care at a single non-governmental organization in Guatemala City. Respondents performed rating and ranking surveys to determine the relative importance of eight barriers to surgical care using a structured questionnaire. Results: We included 46 respondents in this study. By rating analysis, the most significant barriers to care were the cost of surgery, perceived quality of care, and transportation issues. By ranking analysis, the most significant barriers to care were the cost of surgery, waiting time for surgery, and perceived quality of care. Conclusions: Based on rating and ranking analyses, the cost of care is the most significant barrier to pediatric surgical care in Guatemala, although perceived quality of care is also important for families. Using complementary analysis tools provided enhanced insight into how families view the importance of different barriers to care, and should help policy makers develop programs to enhance surgical access for children.

Ranking and Rating Analyses of Barriers to Surgical Care for Children in Guatemala