Management varies widely in SSA. In HICs most centres undertake air enema reduction (AER) as primary management in cases without peritonitis, perforation or non-responsive shock. This has been shown to be 1.48 times more effective than hydrostatic reduction (61% and 44% respectively). Centres in SSA with access to AER report good success rates; in a study in Ghana AER was successful in 59-67% cases and their mortality rate was 2%. They note that AER costs 20% of the fee for surgical management. A study from Nigeria reports offering hydrostatic reduction to 40% of cases, where it is successful in 64%. They also highlight the significant cost savings.