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Emergency and critical care services in Malawi: Findings from a nationwide survey of health facilities
journal contributionposted on 2023-02-15, 22:25 authored by RK Kayambankadzanja, A Likaka, SK Mndolo, GM Chatsika, E Umar, Tim BakerTim Baker
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.
JournalMalawi Medical Journal
Publication classificationC1.1 Refereed article in a scholarly journal
PublisherAfrican Journals Online (AJOL)
Critical IllnessEmergency careHealth ServicesMalawiCritical CareEmergency Service, HospitalHealth Care SurveysHealth FacilitiesHealth ResourcesHealth Services AccessibilityHumansQuality of Health CareSurveys and QuestionnairesClinical Research8.1 Organisation and delivery of services8 Health and social care services researchGeneric health relevance3 Good Health and Well Being