Purpose The challenges are immense when it comes to enhancing the development of pediatric surgery in low- and middleincome
countries in line with current recommendations for holistic and sustainable approaches. The Pediatric surgery
development plan in Burkina Faso was started in 2020. This paper reports on our unique experience, focusing on the main
actions and indicators monitored.
Methods The program was developed based on the core principles of the Global Initiative for Children's Surgery, employing
a comprehensive health system-strengthening strategy. Our approach aimed to address the pediatric surgical ecosystem
through partnerships, research, and interventions at all levels of the healthcare system.
Results Significant actions were implemented across various domains, including infrastructure, quality of care, workforce,
community awareness, research, and advocacy. These efforts have led to a substantial strengthening of the pediatric surgical
ecosystem in the country, achieving major milestones and outcomes in each of these areas.
Conclusion This program has not only helped to create a major impulse for the expansion of pediatric surgery in Burkina
Faso, but also enriched the community of interest with a robust implementation program to confirm the main challenge to
succeed: integrating this most essential discipline into the wider framework of global health.

Pediatric surgery · Low-to-middle income countries · Global surgery · Health system strengthening approach