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.Share on Facebook