Emergency care capacity in Sierra Leone: A multicentre analysis
Dublin Core
Title
Emergency care capacity in Sierra Leone: A multicentre analysis
Subject
Emergency care systems
Facility assessment
Service delivery
Toolk
Facility assessment
Service delivery
Toolk
Description
Background: The Disease Control Priorities Project estimates that over 50 % of annual mortality in low- and
middle-income countries can be addressed by improved emergency care. Sierra Leone’s Ministry of Health and
Sanitation has highlighted emergency care as a national priority. We conducted the first multicentre analysis of
emergency care capacity in Sierra Leone, using the Hospital Emergency Unit Assessment Tool (HEAT) to analyse
14 government hospitals across the country.
Methods: HEAT is a standardised assessment that is recommended in the World Health Organisation Emergency
Care Toolkit. It has been used comparably elsewhere. To analyse Sierra Leone’s emergency care capacity with the
HEAT data, we created the HEAT-adjusted Emergency Care Capacity Score. Purposeful sampling was used to
select 14 government facilities nationwide. A multidisciplinary team was interviewed over a 2-day in-person visit
to each facility.
Results: Human Resources was the strongest parameter, scoring 49 %. All hospitals provided emergency cover
24/7. Emergency Diagnostic Services was the most severely limited parameter, scoring 29 %. 3 hospitals had no
access to basic radiography. Infrastructure scored 47 %. 2 hospitals had adequate electricity supply; 5 had
adequate clean, running water. No hospitals had adequate oxygen supply. Clinical services scored 39 %. 10
hospitals had no designated Emergency Unit, only 2 triaged to stratify severity. Signal functions scored 38 %. No
hospitals had reliable access to emergency drugs such as adrenaline. The total HEAT-adjusted Emergency Care
Capacity Score across all hospitals was 40 %.
Conclusions: These data identify gaps that have already led to local interventions, including focussing emergency
resources to a resuscitation area, and training multidisciplinary teams in emergency care skills. This facility-level
analysis could feed into wider assessment of Sierra Leone’s emergency care systems at every level, which may
help prioritise government strategy to target sustainable strengthening of national emergency care.
middle-income countries can be addressed by improved emergency care. Sierra Leone’s Ministry of Health and
Sanitation has highlighted emergency care as a national priority. We conducted the first multicentre analysis of
emergency care capacity in Sierra Leone, using the Hospital Emergency Unit Assessment Tool (HEAT) to analyse
14 government hospitals across the country.
Methods: HEAT is a standardised assessment that is recommended in the World Health Organisation Emergency
Care Toolkit. It has been used comparably elsewhere. To analyse Sierra Leone’s emergency care capacity with the
HEAT data, we created the HEAT-adjusted Emergency Care Capacity Score. Purposeful sampling was used to
select 14 government facilities nationwide. A multidisciplinary team was interviewed over a 2-day in-person visit
to each facility.
Results: Human Resources was the strongest parameter, scoring 49 %. All hospitals provided emergency cover
24/7. Emergency Diagnostic Services was the most severely limited parameter, scoring 29 %. 3 hospitals had no
access to basic radiography. Infrastructure scored 47 %. 2 hospitals had adequate electricity supply; 5 had
adequate clean, running water. No hospitals had adequate oxygen supply. Clinical services scored 39 %. 10
hospitals had no designated Emergency Unit, only 2 triaged to stratify severity. Signal functions scored 38 %. No
hospitals had reliable access to emergency drugs such as adrenaline. The total HEAT-adjusted Emergency Care
Capacity Score across all hospitals was 40 %.
Conclusions: These data identify gaps that have already led to local interventions, including focussing emergency
resources to a resuscitation area, and training multidisciplinary teams in emergency care skills. This facility-level
analysis could feed into wider assessment of Sierra Leone’s emergency care systems at every level, which may
help prioritise government strategy to target sustainable strengthening of national emergency care.
Creator
Zosia Bredow a,*
, Zoe Corbett a
, Moses Mohamed Tarawally a,b
, Lucy Jackson a
,
Foday Tejan Mansaray a,c
, Santigie Sesay d,1
, Andrew Leather a,
, Zoe Corbett a
, Moses Mohamed Tarawally a,b
, Lucy Jackson a
,
Foday Tejan Mansaray a,c
, Santigie Sesay d,1
, Andrew Leather a,
Source
https://pdf.sciencedirectassets.com/280685/1-s2.0-S2211419X23X00056/1-s2.0-S2211419X2400003X/main.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEKD%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEaCXVzLWVhc3QtMSJGMEQCIH4TT8jNan5CUjxGrMI2guOH5FDHphtnQD9U8VbpU%2BOKAiAdwWNsKg1YsY7JbMSCmS3S5kyMqCELVaumDpwxp98Okiq8BQiJ%2F%2F%2F%2F%2F%2F%2F%2F%2F%2F8BEAUaDDA1OTAwMzU0Njg2NSIMbddR7Dnw6xdZZrpxKpAFYUuFIpHvADM1TpPqAEgKbxYWaVX8pgj%2Fq3KKm8%2Fz8dC%2FG4DI46SUHpwIZmF955%2F2R9HTrH2Dgm0stMLH%2B4KKtaamrcmSCYSq9hgUkk6QsGHW45wrLXQp9527uyykDGSnpXWU%2BHov6YgcGNMZHZtf0kmBorugkPk9P2E%2Fcf8Ct9TAVUnEmU6qesoXMOKwtXp9HruYGYSusIIHGFR2wWVV2EQ%2BP%2BI39OfPvsjbncCgjY%2FdrHoB1gubx5aCy05AjdW1YzcaRrLzgSWhof85PZbBCx1%2FIDy%2Fzw2GiJ%2BnBezKkBfGPpDE2eubcTypCh7mnhpXRXquKNorjiDAwgtjomniLS1BUxKb7hiL27hNfwvEYCiCWCOrQd4ue%2BIG2%2FxmrMSw7pFfG9SXwckByzXN59pzV%2BmD449M5e45gaK4C05o1RPQvuKvtvl%2FeqAwQd48LSYiKMK0UhDGfDbVnYl%2FGvTs19F1R9RQcBWNizFdXCcLMq2OU0DXxzY0%2BWv9KKQ2d2bVmrXKDWa%2B3Lk9OqbMAqeIuUzMwJtvDV6Xt8nKVu91pfNm1qNpR%2Fy6DysxrLX6y%2BxLdD56t%2B7vGJuPr10MECaYFuMGg203i1T48W3DwL4d0orDfWb%2B1WWqT%2Bl6VyNdJWAsIcPRC%2FL0xaYnPn6OuYD67n%2BPtV0%2FX4%2FYEa%2BC0%2BqSCLJyxRlFz4b6GKheXd%2Fz8%2B6cZTbT%2BDE%2FFGMHrv2XXCoysLnOIcFTgF9QBlLRmIlI7hPIRVtdIr1IT5xPNa0ZlvWKDta5dsyF4XN11ehTkEccsBYAd7zcFiyAKfx4o1RGbTGDl20Db%2BXixXnKYN9qEKVzhN%2BJsnlnv5Jcs1uDSQFO7cEyy%2BIxre30b7q6p1rR73AwptTJwgY6sgH0O9s6DcSovMqU85%2Fosq8oAE%2Fr7U8i1v365QJkTunWJ3pxJfQum0tTWTRM7oRTLo0F6Lz6%2FnZiSHQt8xTOfF0VyUUL%2Bf%2FqPGUZ6ZbQrTrgeW6EuZeL0GDvbjKkZzhhgNbHo0%2F60LKTE%2FGksiAbpQN%2FLPPJ2hmh7TicdvUfebE9nX38WbetXfW%2BwBFj9suw66stFQhYAm1oBFNMJ83PxZH0wLNGLv%2BhFp8XzqdhQYl%2FZimD&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250618T083340Z&X-Amz-SignedHeaders=host&X-Amz-Expires=300&X-Amz-Credential=ASIAQ3PHCVTYVOWZ3FSD%2F20250618%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Signature=82b93346756a6bb0a86c417923bbc1642396ef4a09c582b31cb079f37c2435c9&hash=af0b81c9060f8eef3c4f0197e944f48773c576cf00cac419536d7367a312a134&host=68042c943591013ac2b2430a89b270f6af2c76d8dfd086a07176afe7c76c2c61&pii=S2211419X2400003X&tid=spdf-28f16769-bde4-47ce-8c1f-d077ec1a8dda&sid=14b8a1eb7498d34787591540b87a02ee8336gxrqb&type=client&tsoh=d3d3LnNjaWVuY2VkaXJlY3QuY29t&rh=d3d3LnNjaWVuY2VkaXJlY3QuY29t&ua=13025d5355595055555051&rr=951971702aa4aa34&cc=id
Publisher
a King’s Global Health Partnerships, School of Life Course and Population Sciences, King’s College London, London, UK b Kenema Government Hospital, Kenema, Sierra Leone c Connaught Hospital, Freetown, Sierra Leone d Ministry of Health and Sanitation, Freetown, Sierra Leone
Date
20 january 2024
Contributor
Fajar Bagus w
Format
PDF
Language
English
Type
Text
Files
Citation
Zosia Bredow a,*
, Zoe Corbett a
, Moses Mohamed Tarawally a,b
, Lucy Jackson a
,
Foday Tejan Mansaray a,c
, Santigie Sesay d,1
, Andrew Leather a,, “Emergency care capacity in Sierra Leone: A multicentre analysis,” Repository Horizon University Indonesia, accessed June 20, 2025, https://repository.horizon.ac.id/items/show/9555.