Trauma care in Malawi: A call to action

Abstract

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.

Quality of Road Trauma Data in Malawi: The Case of Road Trauma Surveillance in Ntcheu District, Malawi.

“…The road safety situation in Malawi appears to be worsening with the passing of each year [38] [33]. Thacker (2007) [39] emphasized that what gets measured also gets done, and conversely that what is not measured is likely not to be done.…”

Physical Trauma and Its Consequences in Rural and Semi-Urban Regions of Low and Middle Income Countries

“…There is evidence that prehospital mortality can be reduced significantly by good emergency services following trauma which includes first aid and timely and safe transport to health facility [56]. In most LMICs reporting and life supporting systems to sustain the injured person and transportation to health facility are unreliable and indeterminate [3,57]. It is common for injured person in rural and semi-urban regions of LMICs to be handled haphazardly at the trauma scene and transported by laypersons to the health facility by any means possible.…”

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

“…The formulation of new and effective policies with regard to trauma, prevention, and care depends on a solid body of evidence on which to make decisions. 3 In highresource health settings, systematic collection of data about trauma cases, including cause, treatment provided, and outcome, is often captured through trauma registries, and is considered an essential element of a well-functioning trauma care system. 4 These registries can facilitate quality improvement processes, 5 injury prevention initiatives, injury-focused research, and policy development, by improving understanding of the epidemiology of trauma and the correlates of patient outcomes.…”

“…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.…”

“…7 However, there remains insufficient attention to trauma, and inadequate data for evidencebased policy action. 3,13 Additionally, there is no national initiative to scale up the use of trauma registries in Malawi.…”