Improving hospital-based trauma care for road traffic injuries in Malawi

Chokotho, Linda; Mulwafu, Wakisa; Singini, Isaac; Njalale, Yasin; Jacobsen, Kathryn H.

doi:10.5847/wjem.j.1920-8642.2017.02.001

Cited by 17 publications

(28 citation statements)

References 20 publications

(19 reference statements)

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“…Furthermore, in-hospital care of injured persons is often sub-optimal at hospitals due to a lack of appropriate infrastructure, adequate numbers of trained personnel, and the necessary equipment and supplies to provide life-saving and disability-preventing treatment. 11 These conditions are common across sub-Saharan Africa. 12 , 13 …”

Section: Injuries and Trauma Care In Malawimentioning

confidence: 99%

“…Lack of appropriate infrastructure, trained personnel, and adequate equipment and supplies in most district and central hospitals has resulted in suboptimal care of injured cases. 11 , 34 The greatest strides in improving injury survival and recovery rates will likely be achieved if each health facility treating trauma patients has a dedicated accident and emergency (A&E) unit which is well equipped. This can be done in a phased approach starting with hospitals along M1 road that is the country's main highway and extends from the northern border of the country all the way to the southern border.…”

Section: In-hospital Carementioning

confidence: 99%

“…Most district and central hospitals have staffing and equipment shortages, and there is lack of trauma care training for clinical staff at central and district hospitals. 11 However, most clinicians at all levels of care—physicians and surgeons, clinical officers, nurses, and others—are eager for opportunities to learn new skills that will let them better serve their patients. Opportunities for advanced training are likely to be welcomed and appreciated as well as effective at improving patient care.…”

Section: In-hospital Carementioning

confidence: 99%

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Trauma care in Malawi: A call to action

Mulwafu¹,

Chokotho²,

Mkandawire³

et al. 2017

Mal. Med. J

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Injuries are a global public health concern because most are preventable yet they continue to be a major cause of death and disability, especially among children, adolescents, and young adults. This enormous loss of human potential has numerous negative social and economic consequences. Malawi has no formal system of prehospital trauma care, and there is limited access to hospital-based trauma care, orthopaedic surgery, and rehabilitation. While some hospitals and research teams have established local trauma registries and quantified the burden of injuries in parts of Malawi, there is no national injury surveillance database compiling the data needed in order to develop and implement evidence-based prevention initiatives and guidelines to improve the quality of clinical care. Studies in other low- and middle-income countries (LMICs) have demonstrated cost-effective methods for enhancing prehospital, in-hospital, and post-discharge care of trauma patients. We encourage health sectors leaders from across Malawi to take action to improve trauma care and reduce the burden from injury in this country.

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Section: Injuries and Trauma Care In Malawimentioning

confidence: 99%

Section: In-hospital Carementioning

confidence: 99%

Section: In-hospital Carementioning

confidence: 99%

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Trauma care in Malawi: A call to action

Mulwafu¹,

Chokotho²,

Mkandawire³

et al. 2017

Mal. Med. J

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“…Injuries are an important contributor to the burden of disease in Malawi, contributing to 6% of all deaths. 3 In addition, road accidents are a rapidly growing subcategory of trauma, with the number of accidents increasing from 7390 in 2013-14 to 8194 in 2015- 16. 14 Yet despite this burden, there is currently no nation-wide trauma data collection or registry in the country.…”

Section: Introductionmentioning

confidence: 99%

“…For example, an assessment of trauma care in Malawi in July 2013 to 2014 found that in addition to gaps in equipment, supplies and training for trauma care, only two out of 12 hospitals were capturing systematic trauma data through a registry. 16 The objective of this paper is to describe the implementation of a trauma registry in 10 hospitals in Malawi and to highlight challenges and lessons learned with respect to stakeholder engagement, implementation of digital data collection, and other measures that contributed to the continuous improvement of data quality over the first year of the initiative.…”

Section: Introductionmentioning

confidence: 99%

Implementation of a multi‐center digital trauma registry: Experience in district and central hospitals in Malawi

Croke

Chokotho

Milusheva

et al. 2020

Health Planning & Management

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Background Trauma is a rapidly growing component of the burden of disease in developing countries; yet systematic data collection about trauma in such contexts is relatively rare. Methods This paper describes the implementation of a trauma registry in 10 government‐run hospitals in Malawi, with a focus on implementation logistics, stakeholder engagement strategies, and data quality procedures. Results 51 337 trauma cases were recorded over the first 14 months of registry operations. The number of cases per month, data accuracy, and the geographic coverage of the registry improved over time as data quality measures were implemented. Conclusions Multi‐center digital trauma registries are feasible in low‐resource settings. Stakeholder engagement, periodic in‐person and frequent digital follow up with data teams, and regular channeling of findings back to data collection teams help to improve data quality and completeness over a 14 month period. Financial and staffing constraints remain challenges for sustainability over time, but this experience demonstrates the feasibility of large‐scale registry operations.

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