Purpose: The challenges are immense when it comes to enhancing the development of pediatric surgery in low- and middle-income 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.