A cross-sectional survey of emergency and essential surgical care capacity among hospitals with high trauma burden in a Central African country.
A cross-sectional survey of emergency and essential surgical care capacity among hospitals with high trauma burden in a Central African country.
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DOI：
10.1186/s12913-015-1147-y
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发表时间：
2015-10-23
影响因子：
2.8
通讯作者：
Ekeke-Monono M
中科院分区：
文献类型：
--
作者：
Kouo-Ngamby M;Dissak-Delon FN;Feldhaus I;Juillard C;Stevens KA;Ekeke-Monono M
随着伤害和疾病带来的巨大手术负担不断增加，对低收入和中等收入国家的影响尤为严重，因此充足的手术和创伤护理系统至关重要。然而，人们对许多非洲国家设施的紧急和基本外科护理 (EESC) 能力知之甚少。本研究的目的是评估喀麦隆不同类型医院的 EESC 能力。这项横断面调查使用了世卫组织的环境分析工具来评估 EESC，调查了四个关键领域：基础设施、人力资源、干预措施以及设备和用品。 2009 年 8 月至 9 月期间对 12 家医院进行了调查。根据喀麦隆四个地区与道路交通的接近程度以及所服务人口的社会人口构成，对设施进行了方便的抽样。为了完成调查，调查人员采访了设施负责人、医疗顾问和护理人员，并查阅了每个设施的医院记录和统计数据。七家地区医院、两家地区医院、两家综合医院和一家教会医院完成了调查。 EESC 的基础设施普遍不足，在氧气浓缩器供应、现场血库和疼痛缓解管理指南方面存在最大差距。人力资源稀缺，地区、地区和教会医院总共只有六名合格的外科医生、七名合格的妇产科医生，而且没有麻醉师。在 35 例手术干预中，有 16 例由所有医院提供。地区医院报告转诊患者接受了 22 项干预措施。所有医院始终为所有患者提供 67 台设备中的 9 台。本次调查强调的严重短缺表明，喀麦隆医院在提供 EESC 和有效解决日益增加的疾病和伤害手术负担方面存在巨大差距。这些数据为围绕适当分配和提供国家充足的 EESC 资源的循证决策奠定了基础。
As the overwhelming surgical burden of injury and disease steadily increases, disproportionately affecting low- and middle-income countries, adequate surgical and trauma care systems are essential. Yet, little is known about the emergency and essential surgical care (EESC) capacity of facilities in many African countries. The objective of this study was to assess the EESC capacity in different types of hospitals across Cameroon. This cross-sectional survey used the WHO Tool for Situational Analysis to Assess EESC, investigating four key areas: infrastructure, human resources, interventions, and equipment and supplies. Twelve hospitals were surveyed between August and September 2009. Facilities were conveniently sampled based on proximity to road traffic and sociodemographic composition of population served in four regions of Cameroon. To complete the survey, investigators interviewed heads of facilities, medical advisors, and nursing officers and consulted hospital records and statistics at each facility. Seven district hospitals, two regional hospitals, two general hospitals, and one missionary hospital completed the survey. Infrastructure for EESC was generally inadequate with the largest gaps in availability of oxygen concentrator supply, an on-site blood bank, and pain relief management guidelines. Human resources were scarce with a combined total of six qualified surgeons, seven qualified obstetrician/gynecologists, and no anesthesiologists at district, regional, and missionary hospitals. Of 35 surgical interventions, 16 were provided by all hospitals. District hospitals reported referring patients for 22 interventions. Only nine of the 67 pieces of equipment were available at all hospitals for all patients all of the time. Severe shortages highlighted by this survey demonstrate the significant gaps in capacity of hospitals to deliver EESC and effectively address the increasing surgical burden of disease and injury in Cameroon. This data provides a foundation for evidence-based decision-making surrounding appropriate allocation and provision of resources for adequate EESC in the country.