635 - Healthcare provider perspective on barriers and successes in the care of pediatric injury patients at a tertiary hospital in Northern Tanzania
Sunday, April 30, 2023
3:30 PM – 6:00 PM ET
Poster Number: 635 Publication Number: 635.316
Elizabeth M. Keating, University of Utah, Salt Lake City, UT, United States; Francis Sakita, Kilimanjaro Christian medical Centre, Moshi, Kilimanjaro, Tanzania; Kajsa Vlasic, University of Utah School of Medicine, Salt Lake City, UT, United States; Getrude Melkizedeck. Nkini, Duke Collaboration, Moshi Town, Kilimanjaro, Tanzania; Ismail Amiri, Duke University, Durham, NC, United States; Bryan Young, University of Utab, Salt Lake City, UT, United States; Jenna P. Birchall, University of Utah School of Medicine, Encinitas, CA, United States; Melissa Watt, University of Utah, Department of Population Health Sciences, Salt Lake City, UT, United States; Catherine A. Staton, Duke University School of Medicine, Durham, NC, United States; Blandina T. Mmbaga, Kilimanjaro Christian Medical University College, Moshi, Kilimanjaro, Tanzania
Assistant Professor University of Utah Salt Lake City, Utah, United States
Background: Pediatric injuries are a leading cause of morbidity and mortality in low- and middle-income countries (LMICs). The recovery of injured children in LMICs is often impeded by barriers in accessing and receiving timely and quality care at healthcare facilities. Objective: The purpose of this study was to identify the barriers and the successes in pediatric injury care at Kilimanjaro Christian Medical Center (KCMC), a tertiary zonal referral hospital in Northern Tanzania. Design/Methods: In this study, focus group discussions (FGDs) were conducted by trained interviewers who were fluent in English and Swahili in order to examine the barriers and successes in pediatric injury care. Five FGDs were completed from February 2021 to July 2021 and composed of 30 healthcare providers from the emergency department, burn ward, two surgical wards, and pediatric ward. De-identified transcripts were analyzed through a team-based, thematic approach informed by applied thematic analysis with qualitative memo writing. Results: Barriers that impeded care included delays in presenting for care, personnel shortages, lack of pediatric training among healthcare providers, absence of locally-relevant pediatric-specific injury care guidelines, limitations in resources such as medications or equipment, delays in transferring between wards, and cultural and financial barriers of the patient’s caregivers which limited the providers’ ability to provide timely and quality care. Successes were found in the strong teamwork of the healthcare providers, more resources available at KCMC than other health facilities in the region, and prioritizing injured children when they arrive at KCMC.
Conclusion(s): These FGDs were able to highlight barriers and successes that could lead to interventions to improve the care of pediatric injury patients in Northern Tanzania such as increasing personnel trained in pediatric injury, the development of pediatric injury care guidelines, and focusing on improving access to at home and follow-up care.
