Shayo Frida, Zaccheus Gregory Goodluck, Sakita Francis, Hernandes Thiago Rocha, Vissoci Joao Ricardo Nickenig, Gordee Alexander, Kuchibhatla Maragatha, Kiremeji Michael, Minja Linda, Mmbaga Blandina T, Staton Catherine A, Keating Elizabeth M, Joiner Anjni P
Kilimanjaro Christian Medical Center, Moshi, Tanzania.
Kilimanjaro Christian Medical University College, Moshi, Tanzania.
PLOS Glob Public Health. 2025 Jan 6;5(1):e0004032. doi: 10.1371/journal.pgph.0004032. eCollection 2025.
Emergency care systems are critical to improving care for time-sensitive emergency conditions. The growth and development of these systems in Sub-Saharan Africa is becoming a priority. Layperson knowledge and recognition of emergency symptoms and subsequent care-seeking behavior are key to achieving timely access to care and appropriate treatment. This study aimed to assess community knowledge of emergency conditions as well as barriers to accessing the emergency care system in Northern Tanzania.
This was a cross-sectional study of households in three districts in Kilimanjaro, Tanzania from June to September 2021. The primary outcome was an inappropriate response to any of five hypothetical emergency conditions. Secondary outcomes were the incidence of household emergencies and delay in care access for those with emergency conditions. Data were analyzed using descriptive statistics. Associations between the outcome of interest and select household characteristics were analyzed using Fisher's Exact tests for categorical measures and Wilcoxon rank-sum tests for continuous measures.
A total of 539 households were interviewed with 2,274 participants. The majority (46.8%) were from Moshi District Council. 73.7% used cash and/or had no insurance. The mean monthly household income was 226,107.6 Tanzanian Shillings. 76 (14.1%) households reported experiencing an emergency condition in the past year and 225 (41.7%) of respondents had an inappropriate response to at least one hypothetical emergency condition. A higher proportion of those with delayed access to healthcare paid with personal cash and a lower proportion had national health insurance. A higher proportion of those with inappropriate responses to hypothetical emergency conditions lived in rural districts, were uninsured, and had a lower mean income.
Community-dwelling adults in Northern Tanzania have significant gaps in understanding of emergency care conditions and delayed access to care for these conditions. Distance to the healthcare facilities, cost, and lack of insurance may contribute to care delays. Increasing insurance coverage and developing emergency medical services may improve access to care.
急救系统对于改善对时间敏感的紧急状况的救治至关重要。撒哈拉以南非洲地区这些系统的发展正成为一项优先事项。非专业人员对紧急症状的认知以及随后的就医行为是实现及时获得救治和恰当治疗的关键。本研究旨在评估坦桑尼亚北部社区对紧急状况的认知以及获取急救系统的障碍。
这是一项于2021年6月至9月对坦桑尼亚乞力马扎罗三个区的家庭进行的横断面研究。主要结局是对五种假设的紧急状况中任何一种的不恰当反应。次要结局是家庭紧急状况的发生率以及有紧急状况者获得救治的延迟情况。数据采用描述性统计进行分析。使用费舍尔精确检验对分类指标以及威尔科克森秩和检验对连续指标分析感兴趣的结局与选定家庭特征之间的关联。
共对539户家庭的2274名参与者进行了访谈。大多数（46.8%）来自莫希区议会。73.7%的家庭使用现金和/或没有保险。家庭月平均收入为226,107.6坦桑尼亚先令。76户（14.1%）家庭报告在过去一年中经历过紧急状况，225名（41.7%）受访者对至少一种假设的紧急状况有不恰当反应。获得医疗保健延迟的人群中，使用个人现金支付的比例较高，拥有国家医疗保险的比例较低。对假设紧急状况有不恰当反应的人群中，居住在农村地区、没有保险且平均收入较低的比例较高。
坦桑尼亚北部社区居住的成年人在对紧急护理状况的理解以及这些状况的救治延迟方面存在显著差距。到医疗设施的距离、费用以及缺乏保险可能导致救治延迟。增加保险覆盖范围和发展紧急医疗服务可能会改善救治的可及性。
