ArticleBMJ open2014
Emergency and urgent care capacity in a resource-limited setting: an assessment of health facilities in western Kenya.
Article in BMJ open, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
47 citing papers in PubMed, 3 syntheses or guidelines pooled it, 84 citations in OpenAlex.
- Non-hospital healthcare center's preparedness assessment toolbar for providing basic emergency care: a sequential exploratory mixed-method study.BMC health services research · 2023Pooled it
- Assessing trauma care systems in low-income and middle-income countries: a systematic review and evidence synthesis mapping the Three Delays framework to injury health system assessments.BMJ global health · 2021Pooled it
- Uptake of the World Health Organization's trauma care guidelines: a systematic review.Bulletin of the World Health Organization · 2016Pooled it
- Trial
- Climate, geography and socioeconomic vulnerability and emergency care accessibility in Nepal, 2022: a high-resolution geospatial analysis of inequalities.BMJ global health · 2026Article
- Emergency and critical care services in Somalia: a cross-sectional nationwide hospital assessment using the WHO Hospital Emergency Unit assessment tool.BMC emergency medicine · 2025Article
- Needs assessment and Acceptability of a Community First Aid Responder programme to increase Out-of-hospital capacity in Kinshasa, Democratic Republic of Congo: A qualitative study.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2025Article
- Learning from the Kenyan experiment: key takeaways for implementing managed equipment services in developing countries.Frontiers in health services · 2025Article
- Are we ready? Emergency unit capacity at selected district level hospitals in Lusaka Province, Zambia: Barriers and facilitators for improving trauma care: a mixed methods approach.PLOS global public health · 2025Article
- Article
- The impact of scheduling ketamine as an internationally controlled substance on anaesthesia care in Sub-Saharan Africa: a case study and key informant interviews.BMC health services research · 2024Article
- Infectious Disease Management in Pediatric Emergency Departments in Low- and Middle-Income Countries: A Review of Diagnostic Tools, Treatment Protocols, and Preventive Measures.Global pediatric health · 2024Review
- Bedside critical care training: A quasi-experimental study in the paediatric emergency department of a referral hospital in Nigeria.The Southern African journal of critical care : the official journal of the Critical Care Society · 2024Article
- Development and delivery of a higher diploma in emergency medicine and critical care for clinical officers in Kenya.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2023Article
- Systemic emergency department performance in a low resource tertiary health facility in central Kenya: Micro level emergency care system evaluation.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2023Article
- Article
- Provider-identified barriers to performance at seven Nigerian accident & emergency units: A cross-sectional study.PLOS global public health · 2023Article
- Health-related reasons patients transfer from a clinic or health post to the Emergency Department in a District Hospital in Botswana.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2022Article
- Non-anaesthetist-administered ketamine for emergency caesarean section in Kenya: cost-effectiveness analysis.BMJ open · 2022Article
- Emergency Services Capacity of a Rural Community in Guatemala.The western journal of emergency medicine · 2022Article
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveInjuries, trauma and non-communicable diseases are responsible for a rising proportion of death and disability in low-income and middle-income countries. Delivering effective emergency and urgent healthcare for these and other conditions in resource-limited settings is challenging. In this study, we sought to examine and characterise emergency and urgent care capacity in a resource-limited setting.
methodsWe conducted an assessment within all 30 primary and secondary hospitals and within a stratified random sampling of 30 dispensaries and health centres in western Kenya. The key informants were the most senior facility healthcare provider and manager available. Emergency physician researchers utilised a semistructured assessment tool, and data were analysed using descriptive statistics and thematic coding.
resultsNo lower level facilities and 30% of higher level facilities reported having a defined, organised approach to trauma. 43% of higher level facilities had access to an anaesthetist. The majority of lower level facilities had suture and wound care supplies and gloves but typically lacked other basic trauma supplies. For cardiac care, 50% of higher level facilities had morphine, but a minority had functioning ECG, sublingual nitroglycerine or a defibrillator. Only 20% of lower level facilities had glucometers, and only 33% of higher level facilities could care for diabetic emergencies. No facilities had sepsis clinical guidelines.
conclusionsLarge gaps in essential emergency care capabilities were identified at all facility levels in western Kenya. There are great opportunities for a universally deployed basic emergency care package, an advanced emergency care package and facility designation scheme, and a reliable prehospital care transportation and communications system in resource-limited settings.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.