Equitable access to quality trauma systems in low-income and middleincome countries: assessing gaps and developing priorities in Ghana, Rwanda and South Africa

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dc.contributor.authorThe Equi-Trauma Collaborative
dc.contributor.authorMaria Lisa Odland
dc.contributor.authorAbdul-Malik Abdul-Latif
dc.contributor.authorAgnieszka Ignatowicz
dc.contributor.authorBarnabas Alayande
dc.contributor.authorBernard Appia Ofori
dc.contributor.authorEvangelos Balanikas
dc.contributor.authorAbebe Bekele
dc.contributor.authorAntonio Belli
dc.contributor.authorKathryn Chu
dc.contributor.authorKaren Ferreira
dc.contributor.authorAnthony Howard
dc.contributor.authorPascal Nzasabimana
dc.contributor.authorEyitayo O Owolabi
dc.contributor.authorSamukelisiwe Nyamathe
dc.contributor.authorSheba Mary Pognaa Kunfah
dc.contributor.authorStephen Tabiri
dc.contributor.authorMustapha Yakubu
dc.contributor.authorJohn Whitaker
dc.contributor.authorJean Claude Byiringiro
dc.contributor.authorJustine I Davies
dc.date.accessioned2024-04-04T08:52:19Z
dc.date.available2024-04-04T08:52:19Z
dc.date.issued2021
dc.description.abstractInjuries in low-income and middle-income countries are prevalent and their number is expected to increase. Death and disability after injury can be reduced if people reach healthcare facilities in a timely manner. Knowledge of barriers to access to quality injury care is necessary to intervene to improve outcomes. We combined a four-delay framework with WHO Building Blocks and Institution of Medicine Quality Outcomes Frameworks to describe barriers to trauma care in three countries in sub-Saharan Africa: Ghana, South Africa and Rwanda. We used a parallel convergent mixed-methods research design, integrating the results to enable a holistic analysis of the barriers to access to quality injury care. Data were collected using surveys of patient experiences of injury care, interviews and focus group discussions with patients and community leaders, and a survey of policy-makers and healthcare leaders on the governance context for injury care. We identified 121 barriers across all three countries. Of these, 31 (25.6%) were shared across countries. More than half (18/31, 58%) were predominantly related to delay 3 (‘Delays to receiving quality care’). The majority of the barriers were captured using just one of the multiple methods, emphasising the need to use multiple methods to identify all barriers. Given there are many barriers to access to quality care for people who have been injured in Rwanda, Ghana and South Africa, but few of these are shared across countries, solutions to overcome these barriers may also be contextually dependent. This suggests the need for rigorous assessments of contexts using multiple data collection methods before developing interventions to improve access to quality care.
dc.description.librarianPM2023
dc.facultyFaculty of Health Sciences
dc.identifier.urihttps://hdl.handle.net/10539/38308
dc.language.isoen
dc.schoolPublic Health
dc.titleEquitable access to quality trauma systems in low-income and middleincome countries: assessing gaps and developing priorities in Ghana, Rwanda and South Africa
dc.typeArticle
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