Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom.
School of Life Course and Population Sciences, King's College London, London, United Kingdom.
PLoS One. 2024 Sep 12;19(9):e0308525. doi: 10.1371/journal.pone.0308525. eCollection 2024.
The burden of injuries globally and in Malawi is substantial. Optimising both access to, and quality of, care in health systems requires attention. We aimed to establish how health facility staff in Karonga, Malawi, perceive barriers to seeking (delay 1), reaching (delay 2) and receiving (delay 3) injury care.
We conducted a cross-sectional survey of health facility staff who treat patients with injuries in all health facilities serving the Karonga Demographic Surveillance Site population. The primary outcome was participant perceptions of the importance of delays 1 to 3 following injury. Secondary outcomes were the barriers within each of these delays considered most important and which were considered the most important across all delays stages.
228 staff completed the survey: 36.8% (84/228) were female and 61.4% (140/228) reported being involved in caring for an injured person at least weekly. Delay 3 was most frequently considered the most important delay 35.1% (80/228), with 19.3% (44/228) and 16.6% (38/228) reporting delays 1 and 2 as the most important respectively; 28.9% (66/228) of respondents either did not know or answer. For delay 1 the barrier, "the perceived financial costs associated with seeking care are too great", was considered most important. For delay 2, the barrier "lack of timely affordable emergency transport (formal or informal)" was considered most important. For delay 3, the barrier, "lack of reliably available necessary physical resources (infrastructure, equipment and consumable material)" was considered most important. When considering the most important overall barrier across all delays, the delay 3 barrier, "lack of reliably available necessary physical resources" received the most nominations (41.7% [95/228]).
Given the awareness of health facility staff of the issues facing their patients, these findings should assist in informing health system planning.
全球和马拉维的受伤负担都很沉重。优化医疗系统中获取和护理质量都需要重视。我们旨在确定马拉维卡龙加的卫生机构工作人员如何看待寻求（延迟 1）、到达（延迟 2）和接受（延迟 3）伤害护理的障碍。
我们对所有为卡龙加人口监测点服务的卫生机构中治疗受伤患者的卫生机构工作人员进行了横断面调查。主要结果是参与者对受伤后延迟 1 至 3 重要性的看法。次要结果是这些延迟中的每个延迟中最重要的障碍，以及在所有延迟阶段中最重要的障碍。
228 名工作人员完成了调查：36.8%（84/228）为女性，61.4%（140/228）报告每周至少参与照顾受伤人员。延迟 3 被认为是最重要的延迟，占 35.1%（80/228），分别有 19.3%（44/228）和 16.6%（38/228）报告延迟 1 和 2 是最重要的；28.9%（66/228）的受访者不知道或未回答。对于延迟 1，最重要的障碍是“寻求护理的相关经济费用过高”。对于延迟 2，最重要的障碍是“缺乏及时、负担得起的紧急交通（正式或非正式）”。对于延迟 3，最重要的障碍是“缺乏可靠的必要物理资源（基础设施、设备和消耗性材料）”。在考虑所有延迟中最重要的总体障碍时，延迟 3 的障碍“缺乏可靠的必要物理资源”获得了最多提名（41.7%[95/228]）。
鉴于卫生机构工作人员对患者面临问题的认识，这些发现应该有助于为卫生系统规划提供信息。
