4.4 Article

Strategic assessment of the availability of pediatric trauma care equipment, technology and supplies in Ghana

Journal

JOURNAL OF PEDIATRIC SURGERY
Volume 50, Issue 11, Pages 1922-1927

Publisher

W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.jpedsurg.2015.03.047

Keywords

Trauma; Pediatric; Capacity; Operations management; Developing country; Global surgery

Funding

  1. University of Washington Department of Surgery Research Reinvestment Fund
  2. Fogarty International Center, US National Institutes of Health [R25TW009345, D43-TW007267]

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Background: This study aimed to assess the availability of pediatric trauma care items (i.e. equipment, supplies, technology) and factors contributing to deficiencies in Ghana. Methods: Ten universal and 9 pediatric-sized items were selected from the World Health Organization's Guidelines for Essential Trauma Care. Direct inspection and structured interviews with administrative, clinical and biomedical engineering staff were used to assess item availability at 40 purposively sampled district, regional and tertiary hospitals in Ghana. Results: Hospital assessments demonstrated marked deficiencies for a number of essential items (e.g. basic airway supplies, chest tubes, blood pressure cuffs, electrolyte determination, portable X-ray). Lack of pediatric-sized items resulting from equipment absence, lack of training, frequent stock-outs and technology breakage were common. Pediatric items were consistently less available than adult-sized items at each hospital level. Conclusion: This study identified several successes and problems with pediatric trauma care item availability in Ghana. Item availability could be improved, both affordably and reliably, by better organization and planning (e.g. regular assessment of demand and inventory, reliable financing for essential trauma care items). In addition, technology items were often broken. Developing local service and biomedical engineering capability was highlighted as a priority to avoid long periods of equipment breakage. (C) 2015 Elsevier Inc. All rights reserved.

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