Since I am expecting the arrival of my baby any week (day?) now, I am way beyond the point where people are afraid to ask if I am pregnant or not. I am now at the point where complete strangers will come up to me on the subway and ask if they can touch “it”. Unsurprisingly, these strangers almost always also ask if it is a boy or a girl (it is a boy) and whether it is my first one or not (it is not).

Surprisingly, however, many will also ask me where I plan to deliver. When I say where I plan to deliver, some acutally look surprised or even make an expression of disgust. It turns out that in NYC, where you deliver says a lot about who you are and where you stand in society. Unfortunately, not everyone can rent out the entire labor and delivery floor at Lenox Hill. Next time.

Fortunately, even the most basic facility available to me here in NYC is infinitely better staffed and better equipped than essentially any public hospital available to people in most developing countries. If you are like me and track global health data, you might have noticed that Measure DHS project, the organization that helps with the collection and dissemination of the Demographic and Health Surveys recently began releasing for the first time a set of surveys known as the Service Provision Assessments (SPAs), which collects information on a nationally representative set of health facilities in small number of developing countries. So far these surveys have been under-exploited for research.

Using this data, a recently published paper in Health Policy and Planning by Renee Hsia, Naboth Mbembati, Sarah Macfarlane and Margaret Kruk paints a pretty grim picture of the status of emergency and surgical facilities in Sub-Saharan African hospitals. They find:

The percentage of hospitals with dependable running water and electricity ranged from 22% to 46%. In countries analysed, only 19–50% of hospitals had the ability to provide 24-hour emergency care. For storage of medication, only 18% to 41% of facilities had unexpired drugs and current inventories. Availability of supplies to control infection and safely dispose of hazardous waste was generally poor (less than 50%) across all facilities. As few as 14% of hospitals (and as high as 76%) among those surveyed had training and supervision in place.

They conclude that not a single surveyed hospital in the entire sample of 2000+ facilities had “enough infrastructure to follow minimum standards and practices that the World Health Organization has deemed essential for the provision of emergency and surgical care”. I’ll think twice about complaining about the hospital food this time around.

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22 Responses to “The state of emergency and surgical capacity in African hospitals”

  1. Karen Grepin says:

    The state of emergency and surgical capacity in African hospitals http://t.co/VBcOOYeQ #globalhealth

  2. The state of emergency and surgical capacity in African hospitals http://t.co/VBcOOYeQ #globalhealth

  3. Blake Parker says:

    RT @KarenGrepin: The state of emergency and surgical capacity in African hospitals http://t.co/PiM7Vwh1

  4. Kalkidan M says:

    @wambuiwaithaka >> RT @KarenGrepin The state of emergency and surgical capacity in African hospitals http://t.co/FGox1MGV #globalhealth

  5. RT @KarenGrepin The state of emergency and surgical capacity in African hospitals http://t.co/iWcm2jVc #globalhealth

  6. Hellen Otii says:

    "@KarenGrepin: The state of emergency and surgical capacity in African hospitals http://t.co/he66pjdZ #globalhealth" #africa

  7. Alex B. Hill says:

    The state of emergency and surgical capacity in African hospitals http://t.co/VBcOOYeQ #globalhealth

  8. AfricaHealth says:

    The state of emergency and surgical capacity in African hospitals http://t.co/VBcOOYeQ #globalhealth

  9. RT @KarenGrepin The state of emergency and surgical capacity in African hospitals http://t.co/iWcm2jVc #globalhealth

  10. April Harding says:

    Thanks for drawing my attention to the paper.
    I couldn’t agree more that the disastrous state of hospitals should get much more attention. In my experience, developing country policymakers often prioritize taking action on hospitals, but donors and development agencies are typically unwilling to provide support because you can’t show results wrt a specific disease (e.g. who did you save from malaria?) and because hospitals often serve more urban inhabitants, and fewer poor people. So strengthening hospitals loses out for not being “pro-poor” enough.
    I anticipated that hospitals might get more attention and support as the focus on maternal health grew the past couple of years. But I have yet to see signs of this. Well, besides your blog entry I mean.

  11. Nina says:

    The state of emergency and surgical capacity in African hospitals http://t.co/RnEslAFH

  12. PSI says:

    The state of emergency and surgical capacity in African hospitals via @karengrepin http://t.co/T3G3IGAb

  13. Tom Murphy says:

    The state of emergency and surgical capacity in African hospitals via @karengrepin http://t.co/aXFxWMUd

  14. The state of emergency and surgical capacity in African hospitals via @karengrepin http://t.co/aXFxWMUd

  15. Peter Larson says:

    Still pole surgical capacity in African hospitals http://t.co/eQXouyTS

  16. Olivia Reyes says:

    RT @KarenGrepin: The state of emergency and surgical capacity in African hospitals http://t.co/2jIync54

  17. Leila YaDt says:

    The state of emergency and surgical capacity in African hospitals http://t.co/Qd3RSYow #globalhealth via @KarenGrepin

  18. DrRomanzi says:

    The state of emergency and surgical capacity in African hospitals http://t.co/VBcOOYeQ #globalhealth

  19. Peter Singer says:

    The state of emergency and surgical capacity in African hospitals http://t.co/VBcOOYeQ #globalhealth

  20. NYU Wagner says:

    Here's prof. @KarenGrepin blog post "The state of emergency and surgical capacity in African hospitals" http://t.co/8KSy4g9h #NYUWnews

  21. Anna Bikakis says:

    Enjoyed your post!
    My organization, the American Society for Nutrition, is hosting a conference on food, health, and nutrition science in the Chicago area later this month. We have a limited number of free media passes available for bloggers. Please let me know if you’re interested in attending the event at no cost. The program features a keynote address by Dr. Dean Ornish on Friday, June 22; additional details: http://www.nutrition.org/meetings/clinical. Please email mktgintern@nutrition.org if you are interested in attending or have any questions.

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