Critical care capacity in Haiti: A nationwide cross-sectional survey

Critical illness affects health systems globally, but low- and middle-income countries (LMICs) bear a disproportionate burden. Due to a paucity of data, the capacity to care for critically ill patients in LMICs is largely unknown. Haiti has the lowest health indices in the Western Hemisphere. In thi...

Full description

Saved in:
Bibliographic Details
Published in:PloS one Vol. 14; no. 6; p. e0218141
Main Authors: Losonczy, Lia I., Barnes, Sean L., Liu, Shiping, Williams, Sarah R., McCurdy, Michael T., Lemos, Vivienne, Chandler, Jerry, Colas, L. Nathalie, Augustin, Marc E., Papali, Alfred
Format: Journal Article
Language:English
Published: United States Public Library of Science 13.06.2019
Public Library of Science (PLoS)
Subjects:
Adolescent
Capacity
Child
Child, Preschool
Consortia
Critical care
Critical Care - statistics & numerical data
Critical care medicine
Critical Illness
Cross-Sectional Studies
Education
Emergency medical care
Emergency medical services
Emergency Service, Hospital - statistics & numerical data
Engineering and Technology
Equipment and Supplies, Hospital - statistics & numerical data
Female
Global Health - statistics & numerical data
Haiti
Health care
Health care facilities
Health facilities
Health Facilities - statistics & numerical data
Hospital facilities
Hospitals
Hospitals - statistics & numerical data
Humans
Infant
Infant, Newborn
Intensive care
Intensive Care Units - statistics & numerical data
Internal medicine
Low income groups
Male
Medical personnel
Medicine
Medicine and Health Sciences
Nurses
Patients
Pediatrics
People and places
Physicians
Physicians - statistics & numerical data
Polls & surveys
Poverty - statistics & numerical data
Research and Analysis Methods
Sepsis
Streamlining
Supply and demand
Surveys
Surveys and Questionnaires
Training
Western Hemisphere
Haiti
North Carolina
United States > US
Port Au Prince Haiti
Uganda
Maryland
Baltimore Maryland
ISSN:1932-6203, 1932-6203
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Critical illness affects health systems globally, but low- and middle-income countries (LMICs) bear a disproportionate burden. Due to a paucity of data, the capacity to care for critically ill patients in LMICs is largely unknown. Haiti has the lowest health indices in the Western Hemisphere. In this study, we report results of the first known nationwide survey of critical care capacity in Haiti. Nationwide, cross-sectional survey of Haitian hospitals in 2017-2018. Haiti. All Haitian health facilities with at least six hospital beds. Electronic- and paper-based survey. Of 51 health facilities identified, 39 (76.5%) from all ten Haitian administrative departments completed the survey, reporting 124 reported ICU beds nationally. Of facilities without an ICU, 20 (83.3%) care for critically ill patients in the emergency department. There is capacity to ventilate 62 patients nationally within ICUs and six patients outside of the ICU. One-third of facilities with ICUs report formal critical care training for their physicians. Only five facilities met criteria for a Level 1 ICU as defined by the World Federation of Societies of Intensive and Critical Care Medicine. Self-identified barriers to providing more effective critical care services include lack of physical space for critically ill patients, lack of equipment, and few formally trained physicians and nurses. Despite a high demand for critical care services in Haiti, current capacity remains insufficient to meet need. A significant amount of critical care in Haiti is provided outside of the ICU, highlighting the important overlap between emergency and critical care medicine in LMICs. Many ICUs in Haiti lack basic components for critical care delivery. Streamlining critical care services through protocol development, education, and training may improve important clinical outcomes.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 14
content type line 23
Membership of the Research and Education consortium for Acute Care in Haiti (REACH) is provided in the acknowledgments.
Competing Interests: The authors have declared that no competing interests exist.
These authors are are co-senior authors on this work.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0218141