| Autor: |
Emily White Johansson, Cecilia Lindsjö, Daniel J. Weiss, Humphreys Nsona, Katarina Ekholm Selling, Norman Lufesi, Helena Hildenwall |
| Jazyk: |
angličtina |
| Rok vydání: |
2020 |
| Předmět: |
|
| Zdroj: |
BMC Public Health, Vol 20, Iss 1, Pp 1-11 (2020) |
| Druh dokumentu: |
article |
| ISSN: |
1471-2458 |
| DOI: |
10.1186/s12889-020-09043-3 |
| Popis: |
Abstract Background Emergency care is among the weakest parts of health systems in low-income countries with both quality and accessibility constraints. Previous studies estimated accessibility to surgical or emergency care based on population travel times to nearest hospital with no assessment of hospital readiness to provide such care. We analysed a Malawi national facility census with comprehensive inventory audits and geocoded facility locations to identify hospitals equipped to provide basic paediatric emergency care with estimated travel times to these hospitals from non-equipped facilities and in relation to Malawi’s population distribution. Methods We analysed a Malawi national facility census in 2013–2014 to identify hospitals equipped to manage critically ill children according to an extended version of WHO Emergency Triage, Assessment and Treatment (ETAT) guidelines. These guidelines include 25 components including staff, transport, equipment, diagnostics, medications, fluids, feeds and consumables that defined an emergency-equipped hospital in our study. We estimated travel times to emergency-equipped hospitals from non-equipped facilities and relative to population distributions using geocoded facility locations and an established accessibility mapping approach using global road network datasets from OpenStreetMap and Google. Results Four (3.5, 95% CI: 1.3–8.9) of 116 Malawi hospitals were emergency-equipped. Least available items were nasogastric tubes in 34.5% of hospitals (95% CI: 26.4–43.6), blood typing services (40.4, 95% CI: 31.9–49.6), micro nebulizers (50.9, 95% CI: 41.9–60.0), and radiology (54.2, 95% CI: 45.1–63.0). Nationally, the median travel time from non-equipped facilities to the nearest emergency-equipped hospital was 73 min (95% CI: 67–77) ranging 1–507 min. Approximately one-quarter (27%) of Malawians lived over 120 min from an emergency-equipped hospital with significantly better accessibility in Central than North and South regions (16% vs. 38 and 35%, p |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
|
|
Nepřihlášeným uživatelům se plný text nezobrazuje |
K zobrazení výsledku je třeba se přihlásit.
|
