La inclusión digital a partir de la implementación del programa Conectar Igualdad en escuelas secundarias de Paraná. Una mirada de los procesos de apropiación de los jóvenes

El proyecto se presenta con el objetivo central de comprender los usos y sentidos que los jóvenes le otorgan a las netbook distribuidas a partir del Plan Conectar Igualdad. De este modo buscamos indagar en su implementación desde encargados del mismo en la provincia de Entre Ríos así como a directores, asesores pedagógicos y referentes técnicos de las dos escuelas secundarias que formaron parte del proyecto. Utilizando para ellos un instrumento cualitativo como es la entrevista en profundidad. Además, nos centramos fundamentalmente en las voces de los jóvenes del último año de estas escuelas secundarias, para lo cual realizamos encuestas anónimas, focus group y entrevistas en profundidad. Desde un primer momento quisimos analizar la categoría inclusión social e inclusión educativa para entender la forma en la cual el Programa se implementó en las escuelas, así como los aportes teóricos de autores que nos ayudaron a pensar la apropiación y la inclusión como categorías centrales que atraviesan todo el proyecto

Development of a National Food Composition Table to design food security policies and programs

INTRODUCCIÓN: El desarrollo de las Tablas de Composición de Alimentos tiene varios desafíos, por lo que es necesario formar equipos interdisciplinarios que trabajen de manera articulada. El objetivo fue desarrollar una Tabla Nacional de Composición de Alimentos actualizada y metodológicamente adecuada para responder a las necesidades de programas alimentarios y la formulación de nuevos alimentos saludables. MÉTODOS: Se realizó una búsqueda electrónica de la literatura publicada sobre composición de alimentos desde 2010 con el software Covidence. También se efectuó una búsqueda manual de publicaciones nacionales no indexadas. La inclusión de los datos se evaluó en términos de criterios analíticos. RESULTADOS: A partir de la búsqueda se identificaron 1647 referencias potencialmente elegibles, de las cuales 103 artículos e informes cumplieron los criterios de inclusión. Estos estudios proporcionaron información principalmente sobre valor energético, macronutrientes, ácidos grasos y, en menor proporción, sobre vitaminas y minerales para diversos alimentos individuales y de múltiples ingredientes. Se inició la inclusión de esta información en la Base Nacional de Datos de Alimentos mediante un software desarrollado a tal efecto, y se continúa trabajando en la compilación y generación de datos analíticos. DISCUSIÓN: Estos resultados contribuirán a la actualización continua y sistemática de la base de datos de composición de alimentos, que es de suma importancia para la salud pública.INTRODUCTION: The development of the Food Composition Tables has several challenges, so it is necessary to form interdisciplinary teams that work jointly. The aim was to develop a National Table of Food Composition updated and methodologically appropriate to respond to the needs of food programs and the formulation of new healthy foods. METHODS: An electronic search of the literature on food composition published since 2010 was carried out using Covidence online software. A manual search of non-indexed national publications was also performed. The inclusion of the data was evaluated in terms of analytical criteria. RESULTS: The search yielded 1647 potentially eligible references, of which 103 articles and reports met the inclusion criteria. These studies provided information primarily on energy value, macronutrients, fatty acids and, to a lesser extent, vitamins and minerals for various individual foods and multiple ingredients. The inclusion of this information in the National Food Database was initiated through a software developed for this purpose, and work continues on the compilation and generation of analytical data. DISCUSSION: These results will contribute to the continuous and systematic updating of the food composition database, which is of utmost importance for public health.Fil: Samman, Norma Cristina. Universidad Nacional de Jujuy. Centro Interdisciplinario de Investigaciones En Tecnologias y Desarrollo Social Para El Noa. - Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnologico Conicet - Saltajujuy. Centro Interdisciplinario de Investigaciones En Tecnologias y Desarrollo Social Para El Noa.; ArgentinaFil: Rossi, María Constanza. Universidad Nacional de Jujuy. Centro Interdisciplinario de Investigaciones En Tecnologias y Desarrollo Social Para El Noa. - Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnologico Conicet - Saltajujuy. Centro Interdisciplinario de Investigaciones En Tecnologias y Desarrollo Social Para El Noa.; ArgentinaFil: Rios, Francisco. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Instituto Superior de Investigaciones Biológicas. Universidad Nacional de Tucumán. Instituto Superior de Investigaciones Biológicas; ArgentinaFil: Romero, Iris Beatriz. Universidad Nacional de Jujuy. Centro Interdisciplinario de Investigaciones En Tecnologias y Desarrollo Social Para El Noa. - Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnologico Conicet - Saltajujuy. Centro Interdisciplinario de Investigaciones En Tecnologias y Desarrollo Social Para El Noa.; ArgentinaFil: Levy, Lorena Yanina. Universidad Nacional de Jujuy. Centro Interdisciplinario de Investigaciones En Tecnologias y Desarrollo Social Para El Noa. - Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnologico Conicet - Saltajujuy. Centro Interdisciplinario de Investigaciones En Tecnologias y Desarrollo Social Para El Noa.; ArgentinaFil: Tenisi, Mariela. Ministerio de Salud de la Nación; ArgentinaFil: Barrios, Romina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Instituto Superior de Investigaciones Biológicas. Universidad Nacional de Tucumán. Instituto Superior de Investigaciones Biológicas; Argentin

De las aulas a los ambientes naturales... Conservamos nuestro patrimonio natural

El presente trabajo es resultado del proyecto de extensión UNNE res. 109/18 C.S., en el cual participaron integrantes de la FaCENA (UNNE), EBCo (MACN- CONICET), docentes y estudiantes de distintos niveles educativos de la provincia de Corrientes, guardaparques del Parque Pcial San Cayetano (PPSC, San Cayetano, Corrientes) y guías del Aluseo de Ciencias Naturales Amado Bonpland y de Casa Iberá (Corrientes, Corrientes). El objetivo principal fue fortalecer valores ambientales relacionados a temas de biodiversidad y conservación, principalmente mamíferos y sus ambientes naturales. Entre ellos, se trató aquellas especies bajo protección como los monumentos naturales de la provincia (aguará guazú, lobito de río, ciervo de los pantanos, venados de las pampas y oso hormiguero), y otras de importancia ecológica, cultural y/o económica como monos carayá, guazunchos, zorros, carpinchos y tatiíes. Esta experiencia fue un punto de partida para la integración didáctica entre los conocimientos científicos generados en la EBCo y la UNNE y los contenidos del Diseño Curricular de Corrientes, siendo la metodología talleres de educación no formal en las aulas y visitas guiadas al PPSC, Museo de Cs. Naturales Bonpland y/o Casa Iberá. Esta interacción permitió a la comunidad involucrada, el desarrollo de habilidades, actitudes y conocimientos en espacios generados para favorecer el reconocimiento, la reflexión, la valoración, el respeto de su Patrimonio Natural como un elemento clave hacia una mejor calidad de vida a futuro.Fil: Romero, Verónica Lorena. Universidad Nacional del Nordeste; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Kowalewski, Miguel Martin. Universidad Nacional del Nordeste; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales "Bernardino Rivadavia". Estación Biológica de Usos Múltiples (Sede Corrientes); ArgentinaFil: Cespedez, Jorge Abel. Universidad Nacional del Nordeste; ArgentinaFil: Godoy, Angelina M.. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales "Bernardino Rivadavia". Estación Biológica de Usos Múltiples (Sede Corrientes); ArgentinaFil: Obregon, Cesar A.. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales "Bernardino Rivadavia". Estación Biológica de Usos Múltiples (Sede Corrientes); ArgentinaFil: Romero, Barbara G.. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales "Bernardino Rivadavia". Estación Biológica de Usos Múltiples (Sede Corrientes); ArgentinaFil: Fernandez, Patricia M.. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales "Bernardino Rivadavia". Estación Biológica de Usos Múltiples (Sede Corrientes); ArgentinaFil: Alegre, Rocío A.. Universidad Nacional del Nordeste. Facultad de Ciencias Exactas y Naturales y Agrimensura; ArgentinaFil: Bay, Rodrigo. Universidad Nacional del Nordeste. Facultad de Ciencias Exactas y Naturales y Agrimensura; ArgentinaFil: Landi, Mauricio A.. Universidad Nacional del Nordeste. Facultad de Ciencias Exactas y Naturales y Agrimensura; ArgentinaFil: Mayer, Joaquin. Universidad Nacional del Nordeste. Facultad de Ciencias Exactas y Naturales y Agrimensura; ArgentinaFil: Pucheta, Daniela. Universidad Nacional del Nordeste. Facultad de Ciencias Exactas y Naturales y Agrimensura; ArgentinaFil: Quijano, Romina Florencia. Universidad Nacional del Nordeste. Facultad de Ciencias Exactas y Naturales y Agrimensura; ArgentinaFil: Romero, Marta I. G.. Universidad Nacional del Nordeste. Facultad de Ciencias Exactas y Naturales y Agrimensura; Argentin

Centinelas: un proyecto de integración y acción ciudadana

Este proyecto es una tarea de extensión desde el ámbito de la investigación de monos aulladores negros y dorados (Alouatta caraya) y de zorros (Cerdocyon thous, Lycalopex gymnocercus) que habitan en las zonas de interfase urbano-rural de la Estación Biológica Corrientes (EBCo, CCT, CONICET) y un proyecto de UNNE+ SALUD 2019. Los objetivos generales incluyeron proponer acciones para la detección temprana de ciertas enfermedades en la comunidad desde la participaciónciudadana. Se efectuaron una serie de encuentros con ciudadanos/as de las localidades de la ciudad de Corrientes y Mburucuyá sobre el conocimiento de la ecología y epidemiología de estas especies centinelas. La meta es impulsar una red integrada por ciudadanos/as locales motivados/as por la búsqueda personal y colectiva de soluciones a problemáticas ambientales y epidemiológicas.Fil: Romero, Verónica Lorena. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales "Bernardino Rivadavia". Estación Biológica de Usos Múltiples (Sede Corrientes); ArgentinaFil: Raño, Mariana. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales "Bernardino Rivadavia". Estación Biológica de Usos Múltiples (Sede Corrientes); ArgentinaFil: Natalini, María Belén. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales "Bernardino Rivadavia". Estación Biológica de Usos Múltiples (Sede Corrientes); ArgentinaFil: Godoy, Angelina M.. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales "Bernardino Rivadavia". Estación Biológica de Usos Múltiples (Sede Corrientes); ArgentinaFil: Quijano, Romina Florencia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales "Bernardino Rivadavia". Estación Biológica de Usos Múltiples (Sede Corrientes); ArgentinaFil: Sanchez, Martin. Universidad Nacional del Nordeste. Facultad de Ciencias Exactas y Naturales y Agrimensura; ArgentinaFil: Bay Jouliá, Rodrigo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales "Bernardino Rivadavia". Estación Biológica de Usos Múltiples (Sede Corrientes); ArgentinaFil: Pucheta, Daniela. Universidad Nacional del Nordeste. Facultad de Ciencias Exactas y Naturales y Agrimensura; ArgentinaFil: Gilles, Débora R.. Universidad Nacional del Nordeste. Facultad de Ciencias Exactas y Naturales y Agrimensura; ArgentinaFil: Romero, Barbara G.. Universidad Nacional del Nordeste. Facultad de Ciencias Exactas y Naturales y Agrimensura; ArgentinaFil: Alegre, Rocio. Universidad Nacional del Nordeste. Facultad de Ciencias Exactas y Naturales y Agrimensura; ArgentinaFil: Mayer, Joaquín. Universidad Nacional del Nordeste. Facultad de Ciencias Exactas y Naturales y Agrimensura; ArgentinaFil: Landi, Mauricio. Universidad Nacional del Nordeste. Facultad de Ciencias Exactas y Naturales y Agrimensura; ArgentinaFil: Kowalewski, Miguel Martin. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales "Bernardino Rivadavia". Estación Biológica de Usos Múltiples (Sede Corrientes); Argentin

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030