Estimating the health burden of road traffic injuries in Malawi using an individual based model

Smith, Robert M.; Cambiano, Valentina; Colbourn, Tim; Collins, Joseph H.; Graham, Matthew M.; Jewell, Britta L; Lin, Ines Li; Mangal, Tara; Manthalu, Gerald; Mfutso-Bengo, Joseph; Mnjowe, Emmanuel; Mohan, Sakshi; Ng’ambi, Wingston; Phillips, Andrew; Revill, Paul; She, Bingling; Sundet, Mads; Tamuri, Asif U.; Twea, Pakwanja; Hallet, Timothy B

doi:10.21203/rs.3.rs-1699741/v1

Cited by 2 publications

(2 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The source data for the study are provided by the Ministry of Health in Malawi in their publication (Detailed Annex for the Health Workforce Interventions of the Malawi Health Sector Strategic Plan (HSSP III) for 2023-2030 (32)) and health management information systems (https://dhis2.health.gov.mw) (33,34). Additional data underlying the publication were made available for this study by the Ministry of Health, Malawi.…”

Section: Supplementary Informationmentioning

confidence: 99%

Health workforce needs in Malawi: analysis of the Thanzi La Onse integrated epidemiological model of care

She,

Mangal,

Prust

et al. 2024

Preprint

View full text Add to dashboard Cite

Background: To make the best use of health resources, it is crucial to understand the healthcare needs of a population – including how needs will evolve and respond to changing epidemiological context and patient behaviour – and how this compares to the capabilities to deliver healthcare with the existing workforce. Existing approaches to planning either rely on using observed healthcare demand from a fixed historical period or using models to estimate healthcare needs within a narrow domain (e.g., a specific diease area or health programme). A new data-grounded modelling method is proposed by which healthcare needs and the capabilities of the healthcare workforce can be compared and analysed under a range of scenarios: in particular, when there is much greater propensity for healthcare seeking. Methods: A model representation of the healthcare workforce, one that formalises how the time of the different cadres is drawn into the provision of units of healthcare, was integrated with an individual-based epidemiological model - the Thanzi La Onse Model - that represents mechanistically the development of disease and ill-health and patients’ healthcare seeking behaviour. The model was applied in Malawi using routinely available data and the estimates of the volume of health service delivered were tested against officially recorded data. Model estimates of the “time needed” and “time available” for each cadre were compared under different assumptions for whether vacant (or established) posts are filled and healthcare seeking behaviour. Results: The model estimates of volume of each type of service delivered were in good agreement with the available data. The “time needed” for the healthcare workforce greatly exceeded the “time available” (overall by 1.82-fold), especially for pharmacists (6.37-fold) and clinicians (2.83-fold). This discrepancy would be largely mitigated if all vacant posts were filled, but the large discrepancy would remain for pharmacists (2.49-fold). However, if all of those becoming ill did seek care immediately, the “time needed” would increase dramatically and exceed “time supply” (2.11-fold for nurses and midwives, 5.60-fold for clinicians, 9.98-fold for pharmacists) even when there were no vacant positions. Conclusions: The results suggest that services are being delivered in less time on average than they should be, or that healthcare workers are working more time than contracted, or a combination of the two. Moreover, the analysis shows that the healthcare system could become overwhelmed if patients were more likely to seek care. It is not yet known what the health consequences of such changes would be but this new model provides – for the first time – a means to examine such questions.

show abstract

Section: Supplementary Informationmentioning

confidence: 99%

Health workforce needs in Malawi: analysis of the Thanzi La Onse integrated epidemiological model of care

She,

Mangal,

Prust

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…In Malawi, the average DALY loss due to RTCs was 180,000 per year between 2010 and 2020 6,7 . A substantial portion of fractures in Malawi, estimated at 66.5%, result from RTCs, while falls account for 16% 6 .…”

mentioning

confidence: 99%

An Assessment of Open Fracture Management in Hospitals in Malawi Before and Immediately After Implementing Open Fracture Guidelines

Sabawo,

Jaffry,

Chokotho

et al. 2024

JBJS Open Access

View full text Add to dashboard Cite

Background: Open fractures, a common consequence of road traffic collisions, are associated with a high risk of complications. The introduction of standard guidelines has been shown to improve patient care and reduce the risk of complications in several countries. In September 2021, the Malawi Orthopaedic Association/Arbeitsgemeinschaft für Osteosynthesefragen Alliance (MOA/AOA) guidelines and standards for open fracture management were introduced in Malawi. This study aimed to assess the management of open fractures in hospitals in Malawi, before and after implementing a training course on the MOA/AOA open fracture guidelines. Methods: This was a descriptive and quantitative, before-and-after study that reviewed the medical files of patients with open fractures at Zomba Central Hospital and Mulanje, Salima, and Mangochi district hospitals over two 3-month periods. Variables included initial assessment; antibiotic prophylaxis; place of debridement; type of anesthesia; treatment of the open fracture in the emergency department, operating room, and wards; and short-term complications requiring hospital treatment. Results: A total of 88 open-fracture case files were reviewed; 43 were prior and 45 were subsequent to the implementation of the open fracture guidelines. The overall median patient age was 36 years (interquartile range, 27 to 45 years), and 91% (80) were male. Limb neurovascular status assessment and documentation improved from 26% (11) of the patients before the guidelines to 62% (28) afterward (p = 0.0002). The percentage who underwent debridement in the operating room significantly increased from 19% (8) to 69% (31) (p = 0.01). The percentage who underwent debridement under general or spinal anesthesia significantly increased from 5% (2) to 38% (17) and from 12% (5) to 29% (13), respectively (p= 0.001). The wound infection rate decreased from 21% to 11%, but this was not significant, and there was no change in the overall complication rate (p = 0.152). Conclusions: This study suggests that training on the MOA/AOA open fracture management guidelines followed by their implementation can lead to at least temporary improvement in the management of open fractures. Nevertheless, additional studies need to be performed to understand the effect on long-term patient outcomes. Levels of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

show abstract

Estimating the health burden of road traffic injuries in Malawi using an individual based model

Cited by 2 publications

References 16 publications

Health workforce needs in Malawi: analysis of the Thanzi La Onse integrated epidemiological model of care

Health workforce needs in Malawi: analysis of the Thanzi La Onse integrated epidemiological model of care

An Assessment of Open Fracture Management in Hospitals in Malawi Before and Immediately After Implementing Open Fracture Guidelines

Contact Info

Product

Resources

About