Trauma Surveillance and Registry Development in Mozambique: Results of a 1-Year Study and the First Phase of National Implementation

Fadi Hamadani, Tarek Razek, Ezio Massinga, Shailvi Gupta, Monica Muataco, Paloma Muripiha, Catarina Maguni, Vania Muripa, Ivandra Percina, Aassis Costa, Prem Yohannan, David Bracco, Evan Wong, Sam Harper, Dan L. Deckelbaum, Otilia Neves

Research output: Contribution to journalArticle

Abstract

Background: Mozambique has had no policy-driven trauma system and no hospital-based trauma registries, and injury was not a public health priority. In other low-income countries, trauma system implementation and trauma registries have helped to reduce mortality from injury by up to 35%. In 2014, we introduced a trauma registry in four hospitals in Maputo serving 18,000 patients yearly. The project has since expanded nationally. This study summarizes the challenges, results, and lessons learned from this large national undertaking. Methods: Between October 2014–September 2015, we implemented a trauma registry at four hospitals in Maputo. In October 2015, the project began to be expanded nationally. Physicians and allied health professionals at each hospital were trained to implement the registry, and each identified and trained data collectors. We conducted semi-structured interviews with the key stakeholders of this project to identify the challenges, results, and creative solutions implemented for the success of this project. Results: Most participants identified the importance of having a trauma registry and its usefulness in identifying gaps in trauma care. The registry identified that less than 5% of injured patients arrived by ambulance, which served as evidence for the need for a prehospital system, which the Ministry of Health had already begun implementing. Participants also highlighted how the registry has allowed for a structured clinical approach to patients, ensuring that severely injured patients are identified early. Challenges reported included the high rates of missing data, the difficulty in establishing a streamlined flow of trauma patients within each hospital, and the bureaucratic challenges faced when attempting to improve capacity for trauma care at each hospital by introducing a trauma bay and new technologies. Participants identified the need to improve data completeness, to disseminate the results of the project nationally and internationally, to improve inter-divisional cooperation, and to continue educating health providers on the importance of registries. Participants also identified political instabilities in the region as a potential source of challenge in expanding the project nationally; they also identified the lack of uniform resource allocation and low personnel in many areas, especially rural, as a major burden that would need to be overcome. Conclusion: Introduction of a trauma registry system in Mozambique is feasible and necessary. Initial findings provide insight into the nature of traumas seen in Maputo hospitals, but also underscore future challenges, especially in minimizing missing data, utilizing data to develop evidence-based trauma prevention policies, and ensuring the sustainability of these efforts by ensuring continued governmental support, education, and resource allocation. Many of these measures are being undertaken.

Original languageEnglish (US)
JournalWorld journal of surgery
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

Fingerprint

Mozambique
Registries
Wounds and Injuries
Resource Allocation
Health Priorities
Allied Health Personnel
Ambulances

ASJC Scopus subject areas

  • Surgery

Cite this

Trauma Surveillance and Registry Development in Mozambique : Results of a 1-Year Study and the First Phase of National Implementation. / Hamadani, Fadi; Razek, Tarek; Massinga, Ezio; Gupta, Shailvi; Muataco, Monica; Muripiha, Paloma; Maguni, Catarina; Muripa, Vania; Percina, Ivandra; Costa, Aassis; Yohannan, Prem; Bracco, David; Wong, Evan; Harper, Sam; Deckelbaum, Dan L.; Neves, Otilia.

In: World journal of surgery, 01.01.2019.

Research output: Contribution to journalArticle

Hamadani, F, Razek, T, Massinga, E, Gupta, S, Muataco, M, Muripiha, P, Maguni, C, Muripa, V, Percina, I, Costa, A, Yohannan, P, Bracco, D, Wong, E, Harper, S, Deckelbaum, DL & Neves, O 2019, 'Trauma Surveillance and Registry Development in Mozambique: Results of a 1-Year Study and the First Phase of National Implementation', World journal of surgery. https://doi.org/10.1007/s00268-019-04947-7
Hamadani, Fadi ; Razek, Tarek ; Massinga, Ezio ; Gupta, Shailvi ; Muataco, Monica ; Muripiha, Paloma ; Maguni, Catarina ; Muripa, Vania ; Percina, Ivandra ; Costa, Aassis ; Yohannan, Prem ; Bracco, David ; Wong, Evan ; Harper, Sam ; Deckelbaum, Dan L. ; Neves, Otilia. / Trauma Surveillance and Registry Development in Mozambique : Results of a 1-Year Study and the First Phase of National Implementation. In: World journal of surgery. 2019.
@article{859b710e6a7f4e9bbf74bb9f7446bd64,
title = "Trauma Surveillance and Registry Development in Mozambique: Results of a 1-Year Study and the First Phase of National Implementation",
abstract = "Background: Mozambique has had no policy-driven trauma system and no hospital-based trauma registries, and injury was not a public health priority. In other low-income countries, trauma system implementation and trauma registries have helped to reduce mortality from injury by up to 35{\%}. In 2014, we introduced a trauma registry in four hospitals in Maputo serving 18,000 patients yearly. The project has since expanded nationally. This study summarizes the challenges, results, and lessons learned from this large national undertaking. Methods: Between October 2014–September 2015, we implemented a trauma registry at four hospitals in Maputo. In October 2015, the project began to be expanded nationally. Physicians and allied health professionals at each hospital were trained to implement the registry, and each identified and trained data collectors. We conducted semi-structured interviews with the key stakeholders of this project to identify the challenges, results, and creative solutions implemented for the success of this project. Results: Most participants identified the importance of having a trauma registry and its usefulness in identifying gaps in trauma care. The registry identified that less than 5{\%} of injured patients arrived by ambulance, which served as evidence for the need for a prehospital system, which the Ministry of Health had already begun implementing. Participants also highlighted how the registry has allowed for a structured clinical approach to patients, ensuring that severely injured patients are identified early. Challenges reported included the high rates of missing data, the difficulty in establishing a streamlined flow of trauma patients within each hospital, and the bureaucratic challenges faced when attempting to improve capacity for trauma care at each hospital by introducing a trauma bay and new technologies. Participants identified the need to improve data completeness, to disseminate the results of the project nationally and internationally, to improve inter-divisional cooperation, and to continue educating health providers on the importance of registries. Participants also identified political instabilities in the region as a potential source of challenge in expanding the project nationally; they also identified the lack of uniform resource allocation and low personnel in many areas, especially rural, as a major burden that would need to be overcome. Conclusion: Introduction of a trauma registry system in Mozambique is feasible and necessary. Initial findings provide insight into the nature of traumas seen in Maputo hospitals, but also underscore future challenges, especially in minimizing missing data, utilizing data to develop evidence-based trauma prevention policies, and ensuring the sustainability of these efforts by ensuring continued governmental support, education, and resource allocation. Many of these measures are being undertaken.",
author = "Fadi Hamadani and Tarek Razek and Ezio Massinga and Shailvi Gupta and Monica Muataco and Paloma Muripiha and Catarina Maguni and Vania Muripa and Ivandra Percina and Aassis Costa and Prem Yohannan and David Bracco and Evan Wong and Sam Harper and Deckelbaum, {Dan L.} and Otilia Neves",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s00268-019-04947-7",
language = "English (US)",
journal = "World Journal of Surgery",
issn = "0364-2313",
publisher = "Springer New York",

}

TY - JOUR

T1 - Trauma Surveillance and Registry Development in Mozambique

T2 - Results of a 1-Year Study and the First Phase of National Implementation

AU - Hamadani, Fadi

AU - Razek, Tarek

AU - Massinga, Ezio

AU - Gupta, Shailvi

AU - Muataco, Monica

AU - Muripiha, Paloma

AU - Maguni, Catarina

AU - Muripa, Vania

AU - Percina, Ivandra

AU - Costa, Aassis

AU - Yohannan, Prem

AU - Bracco, David

AU - Wong, Evan

AU - Harper, Sam

AU - Deckelbaum, Dan L.

AU - Neves, Otilia

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Mozambique has had no policy-driven trauma system and no hospital-based trauma registries, and injury was not a public health priority. In other low-income countries, trauma system implementation and trauma registries have helped to reduce mortality from injury by up to 35%. In 2014, we introduced a trauma registry in four hospitals in Maputo serving 18,000 patients yearly. The project has since expanded nationally. This study summarizes the challenges, results, and lessons learned from this large national undertaking. Methods: Between October 2014–September 2015, we implemented a trauma registry at four hospitals in Maputo. In October 2015, the project began to be expanded nationally. Physicians and allied health professionals at each hospital were trained to implement the registry, and each identified and trained data collectors. We conducted semi-structured interviews with the key stakeholders of this project to identify the challenges, results, and creative solutions implemented for the success of this project. Results: Most participants identified the importance of having a trauma registry and its usefulness in identifying gaps in trauma care. The registry identified that less than 5% of injured patients arrived by ambulance, which served as evidence for the need for a prehospital system, which the Ministry of Health had already begun implementing. Participants also highlighted how the registry has allowed for a structured clinical approach to patients, ensuring that severely injured patients are identified early. Challenges reported included the high rates of missing data, the difficulty in establishing a streamlined flow of trauma patients within each hospital, and the bureaucratic challenges faced when attempting to improve capacity for trauma care at each hospital by introducing a trauma bay and new technologies. Participants identified the need to improve data completeness, to disseminate the results of the project nationally and internationally, to improve inter-divisional cooperation, and to continue educating health providers on the importance of registries. Participants also identified political instabilities in the region as a potential source of challenge in expanding the project nationally; they also identified the lack of uniform resource allocation and low personnel in many areas, especially rural, as a major burden that would need to be overcome. Conclusion: Introduction of a trauma registry system in Mozambique is feasible and necessary. Initial findings provide insight into the nature of traumas seen in Maputo hospitals, but also underscore future challenges, especially in minimizing missing data, utilizing data to develop evidence-based trauma prevention policies, and ensuring the sustainability of these efforts by ensuring continued governmental support, education, and resource allocation. Many of these measures are being undertaken.

AB - Background: Mozambique has had no policy-driven trauma system and no hospital-based trauma registries, and injury was not a public health priority. In other low-income countries, trauma system implementation and trauma registries have helped to reduce mortality from injury by up to 35%. In 2014, we introduced a trauma registry in four hospitals in Maputo serving 18,000 patients yearly. The project has since expanded nationally. This study summarizes the challenges, results, and lessons learned from this large national undertaking. Methods: Between October 2014–September 2015, we implemented a trauma registry at four hospitals in Maputo. In October 2015, the project began to be expanded nationally. Physicians and allied health professionals at each hospital were trained to implement the registry, and each identified and trained data collectors. We conducted semi-structured interviews with the key stakeholders of this project to identify the challenges, results, and creative solutions implemented for the success of this project. Results: Most participants identified the importance of having a trauma registry and its usefulness in identifying gaps in trauma care. The registry identified that less than 5% of injured patients arrived by ambulance, which served as evidence for the need for a prehospital system, which the Ministry of Health had already begun implementing. Participants also highlighted how the registry has allowed for a structured clinical approach to patients, ensuring that severely injured patients are identified early. Challenges reported included the high rates of missing data, the difficulty in establishing a streamlined flow of trauma patients within each hospital, and the bureaucratic challenges faced when attempting to improve capacity for trauma care at each hospital by introducing a trauma bay and new technologies. Participants identified the need to improve data completeness, to disseminate the results of the project nationally and internationally, to improve inter-divisional cooperation, and to continue educating health providers on the importance of registries. Participants also identified political instabilities in the region as a potential source of challenge in expanding the project nationally; they also identified the lack of uniform resource allocation and low personnel in many areas, especially rural, as a major burden that would need to be overcome. Conclusion: Introduction of a trauma registry system in Mozambique is feasible and necessary. Initial findings provide insight into the nature of traumas seen in Maputo hospitals, but also underscore future challenges, especially in minimizing missing data, utilizing data to develop evidence-based trauma prevention policies, and ensuring the sustainability of these efforts by ensuring continued governmental support, education, and resource allocation. Many of these measures are being undertaken.

UR - http://www.scopus.com/inward/record.url?scp=85064669099&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85064669099&partnerID=8YFLogxK

U2 - 10.1007/s00268-019-04947-7

DO - 10.1007/s00268-019-04947-7

M3 - Article

C2 - 31004208

AN - SCOPUS:85064669099

JO - World Journal of Surgery

JF - World Journal of Surgery

SN - 0364-2313

ER -