Evidence map›Paper›PMID 38331742›Full record

ArticleBMC health services research2024

Hospital readiness for the provision of care to critically ill patients in Tanzania- an in-depth cross-sectional study.

Karima Khalid, Carl Otto Schell, Jacquie Oliwa, Mike English, Onesmus Onyango, Jacob Mcknight, Elibariki Mkumbo, Khamis Awadh, John Maiba, Tim Baker

Open access · goldAbstract read
In one paragraph

Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
3.3field-weighted citation impact, top 10% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 7 institutions in 4 countries.

Karima KhalidDepartment of Anaesthesia, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. karimakhalid@yahoo.com.
Carl Otto SchellDepartment of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Jacquie OliwaDepartment of Paediatrics, University of Nairobi, Nairobi, Kenya.
Mike EnglishHealth Services Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.
Onesmus OnyangoHealth Services Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.
Jacob McknightHealth Systems Collaborative, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
Elibariki MkumboIfakara Health Institute, Dar es Salaam, Tanzania.
Khamis AwadhIfakara Health Institute, Dar es Salaam, Tanzania.
John MaibaIfakara Health Institute, Dar es Salaam, Tanzania.
Tim BakerDepartment of Emergency Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Ifakara Health Institute · TZKenya Medical Research Institute · KEKarolinska Institutet · SEMuhimbili University of Health and Allied Sciences · TZUniversity of Nairobi · KEUniversity of Oxford · GBUppsala University · SE

Funding

Wellcome TrustWellcome Trust 221571/Z/20/Z
6 · The paper itself

Abstract

backgroundCritical illness is a state of ill health with vital organ dysfunction, a high risk of imminent death if care is not provided and potential for reversibility. The burden of critical illness is high, especially in low- and middle-income countries. Critical care can be provided as Essential Emergency and Critical Care (EECC)- the effective, low-cost, basic care that all critically ill patients should receive in all parts of all hospitals in the world- and advanced critical care- complex, resource-intensive care usually provided in an intensive care unit. The required resources may be available in the hospital and yet not be ready in the wards for immediate use for critically ill patients. The ward readiness of these resources, although harder to evaluate, is likely more important than their availability in the hospital. This study aimed to assess the ward readiness for EECC and the hospital availability of resources for EECC and for advanced critical care in hospitals in Tanzania.

methodsAn in-depth, cross-sectional study was conducted in five purposively selected hospitals by visiting all wards to collect data on all the required 66 EECC and 161 advanced critical care resources. We defined hospital-availability as a resource present in the hospital and ward-readiness as a resource available, functioning, and present in the right place, time and amounts for critically ill patient care in the wards. Data were analyzed to calculate availability and readiness scores as proportions of the resources that were available at hospital level, and ready at ward level respectively.

resultsAvailability of EECC resources in hospitals was 84% and readiness in the wards was 56%. District hospitals had lower readiness scores (less than 50%) than regional and tertiary hospitals. Equipment readiness was highest (65%) while that of guidelines lowest (3%). Availability of advanced critical care resources was 31%.

conclusionHospitals in Tanzania lack readiness for the provision of EECC- the low-cost, life-saving care for critically ill patients. The resources for EECC were available in hospitals, but were not ready for the immediate needs of critically ill patients in the wards. To provide effective EECC to all patients, improvements are needed around the essential, low-cost resources in hospital wards that are essential for decreasing preventable deaths.

Indexed as

Critical IllnessIntensive Care UnitsCross-Sectional StudiesHumansTanzaniaTertiary Care CentersCritical careCritical illnessEmergency careGlobal healthLMICsTanzania

Identifiers

PMID38331742
PMCPMC10854052
OpenAlexW4391637674

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.