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Africa's challenged ENT services: highlighting challenges in Zambia.

ABSTRACT: BACKGROUND:Diseases of the ear, nose and throat (ENT) are common and are a major cause of morbidity and mortality. In many low income countries like Zambia, the high ENT disease burden has not received the required resources for treatment. We investigated ENT service provision in hospitals in Zambia by documenting the profile of hospitals offering ENT services and examining the country's ENT services with regards to human resource, infrastructure and availability of equipment based on the levels of care of various hospitals. METHODS:The study was a cross-sectional descriptive survey conducted using a structured and piloted questionnaire which was administered to the 109 Ministry of Health (MoH) registered hospitals across the country. Ethical clearance was granted by University of KwaZulu-Natal and the Zambia National Health Research Authority. Participation in the study was voluntary and all respondents signed informed consent. Descriptive statistics were used to analyse the data. RESULTS:Of the 109 hospitals approached to participate in the study, 61 (55.9%) hospitals responded. This represented 83.3% (n =?5) of Third Level Hospitals (TLH), 89.5% (n =?17) of Second Level Hospitals (SLH) and 41.7% (n =?35) of First Level Hospitals (FLH) countrywide. Of the participating hospitals, 6.6% (n =?4) were unclassified. Within this sample, 8.6% (n =?3) FLH, 11.8% (n =?2) SLH and 60.0% (n =?3) TLH had an ENT examination room. Only 2.9% (n =?4) hospitals had an audiology booth and 1.6% (n =?1) had a speech therapy room. Of the second and third level hospitals, 9.1% (n =?2) had flexible rhinolaryngoscopes, 18.2% (n =?4) had operating microscopes and 68.2% (n =?15) adenotonsillectomy sets. The data revealed that there were 4 ENT surgeons, 1 Audiologist and no Speech Therapists across the country. CONCLUSION:Zambia's ENT services were deficient at all levels of hospital care. There were deficiencies in infrastructure, human resource and equipment in hospitals. With the current burden of disease, critical intervention is required. These findings should be used to direct national policy on the improvement of ENT service provision in Zambia.

SUBMITTER: Lukama L

PROVIDER: S-EPMC6604437 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Africa's challenged ENT services: highlighting challenges in Zambia.

Lukama Lufunda L Kalinda Chester C Aldous Colleen C

BMC health services research 20190702 1

<h4>Background</h4>Diseases of the ear, nose and throat (ENT) are common and are a major cause of morbidity and mortality. In many low income countries like Zambia, the high ENT disease burden has not received the required resources for treatment. We investigated ENT service provision in hospitals in Zambia by documenting the profile of hospitals offering ENT services and examining the country's ENT services with regards to human resource, infrastructure and availability of equipment based on th ...[more]

PMID: 31266482

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Project description:BackgroundHuman African Trypanosomiasis is one of the Neglected Tropical Diseases that is targeted for elimination by the World Health Organization. Strong health delivery system in endemic countries is required for a control program to eliminate this disease. In Zambia, Human African Trypanosomiasis is lowly endemic in the northeastern part of the country.FindingsWe conducted a cross-sectional survey of health institutions in Mpika district in Northern Province of Zambia from 9th to 23rd November 2011. The aim of this study was to assess current health delivery system in the management of Human African Trypanosomiasis cases in Mpika district, Northern Province of Zambia. Ten health institutions were covered in the survey. Two structured questionnaires targeting health workers were used to collect the data on general knowledge on HAT and state of health care facilities in relation to HAT management from the surveyed health institution.Only 46% of the 28 respondents scored more than 50% from the questionnaire on general knowledge about Human African Trypanosomiasis disease. None of the respondents knew how to differentiate the two clinical stages of Human African Trypanosomiasis disease. There were only three medical doctors to attend to all Human African Trypanosomiasis cases and other diseases at the only diagnostic and treatment hospital in Mpika district. The supply of antitrypanosomal drugs to the only treatment centre was erratic. Only one refresher course on Human African Trypanosomiasis case diagnosis and management for health staff in the district had been organized by the Ministry of Health in conjunction with the World Health Organization in the district in 2009. The referral system for suspected Human African Trypanosomiasis cases from Rural Health Centres (RHCs) to the diagnostic/treatment centre was inefficient.ConclusionsThere are a number of challenges that have been identified and need to be addressed if Human African Trypanosomiasis is to be eliminated in a lowly endemic country such as Zambia. These include shortage of trained health workers, inadequate diagnostic and treatment centres, lack of more sensitive laboratory diagnostic techniques, shortage of trypanosomicides among others discussed in detail here.

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Africa's challenged ENT services: highlighting challenges in Zambia.

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Africa's challenged ENT services: highlighting challenges in Zambia.

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