An assessment of emergency care capacity at three hospitals in the Harare metropol, Zimbabwe: A descriptive cross-sectional study using the WHO Hospital Emergency Assessment Tool (HEAT).

Introduction: Zimbabwe has experienced significant population growth, as well as a rise in noncommunicable diseases, impacting the demand for emergency care services. However, there is limited data on the state of Zimbabwe's emergency care systems to meet this growing need. This pilot study aimed to assess the capacity of Emergency Departments at three major referral hospitals in Harare, Zimbabwe. Methodology: A cross-sectional descriptive study was conducted using the World Health Organization's Hospital Emergency Assessment Tool (HEAT). Key participants from each hospital were interviewed in 2023 to gather data on facility characteristics, human resources, diagnostic services, and signal functions. Results: Three large hospitals offering round-the-clock emergency care services were included. A core of dedicated doctors and nurses manned the Emergency Department in all three facilities, yet none had specific training in emergency medicine. There were various significant challenges to the operation of emergency departments, including access to water for one, and two with limited capacity to perform emergency diagnostic tests as they lacked the necessary equipment and consumables. One hospital reported a sufficient set of emergency protocols and guidelines, while the other two hospitals exhibited varying levels of availability in these areas. Two facilities reported adequate capacity in performing >85 % of signal functions. Common challenges included the absence of emergency-trained staff, lack of a formal triage system, and equipment deficiencies, all of which constrained their ability to deliver certain signal functions. Conclusion: This assessment revealed a spectrum of service availabilities across the three hospitals, with common barriers identified. To strengthen the country's emergency care system, efforts should be focused on improving consumable supplies, prioritising training initiatives in emergency medicine to build a skilled workforce and implementing standardised protocols and triage systems across facilities. Continuous monitoring and evaluation of implemented interventions are necessary to ensure sustainable improvements in emergency care delivery.