Trauma & Critical Care

Biography

Biography: Barclay Stewart

Abstract

This study aimed to compare the availability of trauma care services and the resources necessary to provide them in Ghana between assessments in 2004 and 2014. By doing so, the effects of a decade of change in the trauma care landscape can be assessed and recommendations for potential interventions can be made. Trauma care capacity assessments of district and regional hospitals in Ghana were performed using the World Health Organization’s Guidelines for Essential Trauma Care. Trauma care item availability ratings were compared; Wilcoxon signed ranks test was used to determine if there was a difference in item availability ratings between the two assessments and within each hospital level. There were significant improvements in mean trauma care item ratings between 2004 and 2014 assessments at district and regional level hospitals (p=0.002 and p=0.01, respectively). However, a number of critical deficiencies remain (e.g. chest tubes, mechanical ventilators, cardiac monitors, diagnostics and essential orthopaedic and neurosurgical care). Most deficiencies were related to stock outs, having never been present at a facility or a lack of training; latter two were most often reported for items that did not have improved availability in 2014 compared to 2004. Re-assessment of trauma care item availability in Ghana demonstrated significant improvement over the past decade. However, important deficiencies remain, some for low-cost items. Serial capacity assessment is a valuable tool for monitoring the effect of efforts to strengthen trauma care systems in LMICs.