ArticleBMJ global health2022
Equitable access to quality trauma systems in low-income and middle-income countries: assessing gaps and developing priorities in Ghana, Rwanda and South Africa.
Article in BMJ global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- Access to quality trauma care after injury in Pakistan: a systematic review and narrative synthesis.BMJ open · 2025Pooled it
- Mitigating Financial Barriers to Trauma Care in Cameroon Through Locally Designed Quality Improvement.World journal of surgery · 2026Observational
- A systems approach to understanding injury care in LMICs using causal loop diagrams.BMJ global health · 2026Article
- Understanding Barriers to Effective Injury Care by Medical Trainees and Traffic Law Enforcement First Responders in Low-Income Contexts in Uganda (Motor Registry Project Part 2): Convergent Mixed Methods Analysis.JMIR human factors · 2026Article
- Delays in seeking and reaching care for injured patients in four low-income and middle-income countries: a cohort study.BMJ global health · 2026Article
- Enhancing Emergency Trauma Management Skills Through Simulation: A Quality Improvement Initiative in Ghana.Cureus · 2026Article
- Emergency, critical and operative care in Afghanistan: pathways to overcoming fragmentation and strengthening access in a post-conflict setting-a mixed-method study.BMJ public health · 2026Article
- Shock Index versus Systolic Blood Pressure for Mortality Prediction in Traumatic Hemorrhage: A Comparative Prognostic Evaluation in a Middle-Income Country.Open access emergency medicine : OAEM · 2026Article
- What Is the Need for and Access to Trauma Surgery in Low- and Middle-Income Countries? A Scoping Review.World journal of surgery · 2025Article
- Article
- Unintentional Injuries Requiring Medical Attention in Low-Income and Middle-Income Countries: Evidence from Nationally Representative surveys in 12 Countries.Journal of epidemiology and global health · 2025Article
- Article
- Health system governance for injury care in low- and middle-income countries: a survey of policymakers and policy implementors.BMJ global health · 2025Article
- The state of global surgery assessment and data collection tools: A scoping review.World journal of surgery · 2024Article
- Community perspectives on barriers to injury care in Northern Malawi: a three delays framed assessment using focus groups and photovoice.BMC health services research · 2024Article
- Article
- Mapping the processes and information flows of a prehospital emergency care system in Rwanda: a process mapping exercise.BMJ open · 2024Article
- Experiences of injured patients referred to higher levels of care after initial assessment and management at non-tertiary hospitals in Ghana.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2024Article
- Article
- Equitable access to quality injury care; Equi-Injury project protocol for prioritizing interventions in four low- or middle-income countries: a mixed method study.BMC health services research · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
21 authors at 12 institutions in 9 countries.
Funding
Abstract
Injuries in low-income and middle-income countries are prevalent and their number is expected to increase. Death and disability after injury can be reduced if people reach healthcare facilities in a timely manner. Knowledge of barriers to access to quality injury care is necessary to intervene to improve outcomes. We combined a four-delay framework with WHO Building Blocks and Institution of Medicine Quality Outcomes Frameworks to describe barriers to trauma care in three countries in sub-Saharan Africa: Ghana, South Africa and Rwanda. We used a parallel convergent mixed-methods research design, integrating the results to enable a holistic analysis of the barriers to access to quality injury care. Data were collected using surveys of patient experiences of injury care, interviews and focus group discussions with patients and community leaders, and a survey of policy-makers and healthcare leaders on the governance context for injury care. We identified 121 barriers across all three countries. Of these, 31 (25.6%) were shared across countries. More than half (18/31, 58%) were predominantly related to delay 3 ('Delays to receiving quality care'). The majority of the barriers were captured using just one of the multiple methods, emphasising the need to use multiple methods to identify all barriers. Given there are many barriers to access to quality care for people who have been injured in Rwanda, Ghana and South Africa, but few of these are shared across countries, solutions to overcome these barriers may also be contextually dependent. This suggests the need for rigorous assessments of contexts using multiple data collection methods before developing interventions to improve access to quality care.
Indexed as
Identifiers
What OpenQuestion holds
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.