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Building Critical Care Capacity in a Low-Income Country
Critical Care Clinics
Intensive care units Capacity building Low-income country Uganda COVID KEY POINTS Uganda, like many other other low income countries, has very limited critical care capacity. The COVID 19 pandemic spurred governtments efforts to improve critical care capacity not just for COVID but also for the post pandemic era. This paper describes the process of building a low income country's critical care capacity in the pandemic era.
National estimates of critical care capacity in 54 African countries
2020
The COVID-19 pandemic is an emerging threat across the African continent where critical care capacity is underdeveloped or unknown. In this paper, we describe national critical care capacity including number of ICU beds, number of ventilators, and number of physician and non-physician anesthesia providers for 54 African countries. Data was compiled from a variety of resources including World Bank databases, local and international news media, government reports, local healthcare workers, and published scientific literature. Overall, data on number of physicians, hospital beds, and ICU beds were available for over 90% of countries. Data on number of ventilators, number of physician anesthesia providers (PAP) and non-PAP were available for 46 (85%), 47 (87%) and 37 (69%) countries, respectively. Across all 54 countries included in the analysis, there was an average of 3.10 ICU beds and 0.97 ventilators per 100,000 people, and an average of 2.42 total (physician and non-physician) anes...
BMJ Open, 2021
IntroductionCritical care in low-income and low-middle income countries (LLMICs) is an underdeveloped component of the healthcare system. Given the increasing growth in demand for critical care services in LLMICs, understanding the current capacity to provide critical care is imperative to inform policy on service expansion. Thus, our aim is to describe the provision of critical care in LLMICs with respect to patients, providers, location of care and services and interventions delivered.Methods and analysisWe will search PubMed/MEDLINE, Web of Science and EMBASE for full-text original research articles available in English describing critical care services that specify the location of service delivery and describe patients and interventions. We will restrict our review to populations from LLMICs (using 2016 World Bank classifications) and published from 1 January 2008 to 1 January 2020. Two-reviewer agreement will be required for both title/abstract and full text review stages, and ...
Critical Care, 2008
World health care expenditures exceed US 4trillion.However,thereismarkedvariationinglobalhealthcarespending,fromupwardsofUS4 trillion. However, there is marked variation in global health care spending, from upwards of US 4trillion.However,thereismarkedvariationinglobalhealthcarespending,fromupwardsofUS7,000 per capita in the US to under US $25 per capita in most of sub-Saharan Africa. In developed countries, care of the critically ill comprises a large proportion of health care spending; however, in developing countries, with a greater burden of both illness and critical illness, there is little infrastructure to provide care for these patients. There is sparse research to inform the needs of critically ill patients, but often basic requirements such as trained personnel, medications, oxygen, diagnostic and therapeutic equipment, reliable power supply, and safe transportation are unavailable. Why should this be a focus of intensivists of the developed world? Nearly all of those dying in developing countries would be our patients without the accident of latitude. Tailored to the needs of the region, the provision of critical care has a role, even in the context of limited preventive and primary care. Internationally and locally driven solutions are needed. We can help by recognizing the '10/90 gap' that is pervasive within global health care and our profession by educating ourselves of needs, contacting and collaborating with colleagues in the developing world, and advocating that our professional societies and funding agencies consider an increasingly global perspective in education and research.
An assessment of critical care capacity in the Gambia
Journal of Critical Care, 2018
Purpose: Critical illnesses are a major cause of morbidity and mortality in The Gambia, yet national data on critical care capacity is lacking. Materials and Methods: We surveyed eight of the eleven government-owned health facilities providing secondary and tertiary care in The Gambia's public health sector. At each hospital, a designated respondent completed a questionnaire reporting information on the presence of an intensive care unit, the number of critical care beds where available, monitoring equipment, and the ability to provide basic critical care services at their respective hospitals. Results: The response rate was 88% (7/8 hospitals). Only one hospital had a dedicated intensive care unit with eight ICU beds, resulting in an estimated 0.4 ICU beds/100,000 population in the country. All hospitals reported treating more than 50 critically ill patients a month, with trauma, obstetric emergencies, hypertensive emergencies and stroke accounting for the leading causes of admission respectively. The country lacks any trained specialists and resources to diagnose and treat critically ill patients. Conclusions: The Gambia has a very low ICU bed capacity and lacks the human resources and equipment necessary to diagnose and treat the large number of critically ill patients admitted to public hospitals in the country.
National intensive care unit bed capacity and ICU patient characteristics in a low income country
BMC Research Notes, 2012
Background: Primary health care delivery in the developing world faces many challenges. Priority setting favours HIV, TB and malaria interventions. Little is known about the challenges faced in this setting with regard to critical care medicine. The aim of this study was to analyse and categorise the diagnosis and outcomes of 1,774 patients admitted to a hospital intensive care unit (ICU) in a low-income country over a 7-year period. We also assessed the country's ICU bed capacity and described the challenges faced in dealing with critically ill patients in this setting.