ArticleBMC health services research2026
Assessing barriers to musculoskeletal trauma care in Ethiopia: a national providers' survey.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMusculoskeletal trauma represents a major burden in Ethiopia, yet system level barriers to effective care remain poorly studied. This study aimed to identify evidence-based, expert-informed priorities for national orthopaedic capacity building in Ethiopia.
methodsA scoping literature review guided the development of essential goals and challenges to musculoskeletal trauma care delivery in Ethiopia. These domains were refined through in-depth interviews with orthopaedic surgeons at tertiary hospitals. A structured survey was then distributed to providers and public health workers nationally through professional networks. Descriptive statistics were used to summarize responses and regional comparisons were performed.
resultsA total of 128 providers responded, primarily orthopaedic surgeons (n = 110) representing 8 of 14 regions. Most respondents reported managing tibiofibular fracture (92%), femoral shaft fracture (87%), and chronic bone infections (67%) on a weekly basis. Inadequate diagnosis (77%), treatment (83%), and rehabilitation (90%) were widely reported, with no significant regional variation (p > 0.05). In the prehospital setting, inadequate first aid (99%) and delayed triage and referral (96%) were the leading barriers. At primary and secondary hospitals, > 70% reported inadequate triage and referral. Access to slings and plaster for immobilization was inadequate (79%) in primary hospitals; surgical implants/instruments (89%) and blood products (67%) were lacking at secondary hospitals. Though > 70% of respondents reported appropriate and safe operative care delivery at tertiary centers, inadequate implants/instruments (76%), fluoroscopy (69%), and resources for managing bone (67%) and soft tissue defects (51%) were commonly reported. Negative Pressure Wound Therapy was frequently unavailable at secondary (81%) and tertiary (78%) hospitals. Insufficient trauma training was reported across all levels, most notably at primary (91%), and secondary (78%) hospitals.
conclusionsOur study suggests significant gaps in musculoskeletal trauma care delivery in Ethiopia. Key priorities should include strengthening prehospital care and triage/referral systems, improving access to essential surgical resources, and expanding system-wide trauma training. These findings provide actionable evidence to guide policy priorities and national strategies in orthopaedic trauma systems development.
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