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Emergency and critical care services in Malawi: Findings from a nationwide survey of health facilities

BACKGROUND: Globally, critical illness causes up to 45 million deaths every year. The burden is highest in low-income countries such as Malawi. Critically ill patients require good quality, essential care in emergency departments and in hospital wards to avoid negative outcomes such as death. Little...

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Autores principales: Kayambankadzanja, Raphael Kazidule, Likaka, Andrew, Mndolo, Samson Kwazizira, Chatsika, Grace Mayamiko, Umar, Eric, Baker, Tim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Medical Association Of Malawi 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7366165/
https://www.ncbi.nlm.nih.gov/pubmed/32733655
http://dx.doi.org/10.4314/mmj.v32i1.5
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author Kayambankadzanja, Raphael Kazidule
Likaka, Andrew
Mndolo, Samson Kwazizira
Chatsika, Grace Mayamiko
Umar, Eric
Baker, Tim
author_facet Kayambankadzanja, Raphael Kazidule
Likaka, Andrew
Mndolo, Samson Kwazizira
Chatsika, Grace Mayamiko
Umar, Eric
Baker, Tim
author_sort Kayambankadzanja, Raphael Kazidule
collection PubMed
description BACKGROUND: Globally, critical illness causes up to 45 million deaths every year. The burden is highest in low-income countries such as Malawi. Critically ill patients require good quality, essential care in emergency departments and in hospital wards to avoid negative outcomes such as death. Little is known about the quality of care or the availability of necessary resources for emergency and critical care in Malawi. The aim of this study was to assess the availability of resources for emergency and critical care in Malawi using data from the Service Provision Assessment (SPA). METHODS: We conducted a secondary data analysis of the SPA — a nationwide survey of all health facilities. We assessed the availability of resources for emergency and critical care using previously developed standards for hospitals in low-income countries. Each health facility received an availability score, calculated as the proportion of resources that were present. Resource availability was sub-divided into the seven a-priori defined categories of drugs, equipment, support services, emergency guidelines, infrastructure, training and routines. RESULTS: Of the 254 indicators in the standards necessary for assessing the quality of emergency and critical care, SPA collected data for 102 (40.6%). Hospitals had a median resource availability score of 51.6% IQR (42.2–67.2) and smaller health facilities had a median of 37.5% (IQR 28.1–45.3). For the category of drugs, the hospitals' median score was 62.0% IQR (52.4–81.0), for equipment 51.9% IQR (40.7–66.7), support services 33.3% IQR (22.2–77.8) and emergency guidelines 33.3% IQR (0–66.7). SPA did not collect any data for resources in the categories of infrastructure, training or routines. CONCLUSION: Hospitals in Malawi lack resources for providing emergency and critical care. Increasing data about the availability of resources for emergency and critical care and improving the hospital systems for the care of critically ill patients in Malawi should be prioritized.
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spelling pubmed-73661652020-07-29 Emergency and critical care services in Malawi: Findings from a nationwide survey of health facilities Kayambankadzanja, Raphael Kazidule Likaka, Andrew Mndolo, Samson Kwazizira Chatsika, Grace Mayamiko Umar, Eric Baker, Tim Malawi Med J Original Research BACKGROUND: Globally, critical illness causes up to 45 million deaths every year. The burden is highest in low-income countries such as Malawi. Critically ill patients require good quality, essential care in emergency departments and in hospital wards to avoid negative outcomes such as death. Little is known about the quality of care or the availability of necessary resources for emergency and critical care in Malawi. The aim of this study was to assess the availability of resources for emergency and critical care in Malawi using data from the Service Provision Assessment (SPA). METHODS: We conducted a secondary data analysis of the SPA — a nationwide survey of all health facilities. We assessed the availability of resources for emergency and critical care using previously developed standards for hospitals in low-income countries. Each health facility received an availability score, calculated as the proportion of resources that were present. Resource availability was sub-divided into the seven a-priori defined categories of drugs, equipment, support services, emergency guidelines, infrastructure, training and routines. RESULTS: Of the 254 indicators in the standards necessary for assessing the quality of emergency and critical care, SPA collected data for 102 (40.6%). Hospitals had a median resource availability score of 51.6% IQR (42.2–67.2) and smaller health facilities had a median of 37.5% (IQR 28.1–45.3). For the category of drugs, the hospitals' median score was 62.0% IQR (52.4–81.0), for equipment 51.9% IQR (40.7–66.7), support services 33.3% IQR (22.2–77.8) and emergency guidelines 33.3% IQR (0–66.7). SPA did not collect any data for resources in the categories of infrastructure, training or routines. CONCLUSION: Hospitals in Malawi lack resources for providing emergency and critical care. Increasing data about the availability of resources for emergency and critical care and improving the hospital systems for the care of critically ill patients in Malawi should be prioritized. The Medical Association Of Malawi 2020-03 /pmc/articles/PMC7366165/ /pubmed/32733655 http://dx.doi.org/10.4314/mmj.v32i1.5 Text en © 2020 The College of Medicine and the Medical Association of Malawi. This work is licensed under the Creative Commons Attribution 4.0 International License. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle Original Research
Kayambankadzanja, Raphael Kazidule
Likaka, Andrew
Mndolo, Samson Kwazizira
Chatsika, Grace Mayamiko
Umar, Eric
Baker, Tim
Emergency and critical care services in Malawi: Findings from a nationwide survey of health facilities
title Emergency and critical care services in Malawi: Findings from a nationwide survey of health facilities
title_full Emergency and critical care services in Malawi: Findings from a nationwide survey of health facilities
title_fullStr Emergency and critical care services in Malawi: Findings from a nationwide survey of health facilities
title_full_unstemmed Emergency and critical care services in Malawi: Findings from a nationwide survey of health facilities
title_short Emergency and critical care services in Malawi: Findings from a nationwide survey of health facilities
title_sort emergency and critical care services in malawi: findings from a nationwide survey of health facilities
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7366165/
https://www.ncbi.nlm.nih.gov/pubmed/32733655
http://dx.doi.org/10.4314/mmj.v32i1.5
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