Evaluation of needs and supply of emergency care in Kinshasa, Democratic Republic of Congo: a cross-sectional household survey
Objective Emergency care can address over half of deaths occurring each year in low-income countries. A baseline evaluation of the specific needs and gaps in the supply of emergency care at community level could help tailor suitable interventions in such settings. This study evaluates access to, uti...
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BMJ Publishing Group
2022-07-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/7/e060036.full |
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| author | Lee Wallis Peter Hodkinson Ken Diango John Yangongo Vera Sistenich Eric Mafuta |
| author_facet | Lee Wallis Peter Hodkinson Ken Diango John Yangongo Vera Sistenich Eric Mafuta |
| author_sort | Lee Wallis |
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| description | Objective Emergency care can address over half of deaths occurring each year in low-income countries. A baseline evaluation of the specific needs and gaps in the supply of emergency care at community level could help tailor suitable interventions in such settings. This study evaluates access to, utilisation of, and barriers to emergency care in the city of Kinshasa, Democratic Republic of Congo.Design A cross-sectional, community-based household survey.Setting 12 health zones in Kinshasa, Democratic Republic of Congo.Participants Three-stage randomised cluster sampling was used to identify approximately 100 households in each of the 12 clusters, for a total of 1217 households. The head of each household or an adult representative responded on behalf of the household. Additional 303 respondents randomly selected in the households were interviewed regarding their personal reasons for not accessing emergency care.Primary outcome Availability and utilisation of emergency care services.Results In August 2021, 1217 households encompassing 6560 individuals were surveyed (response rate of 96.2%). Most households were economically disadvantaged (70.0% lived with <US$100 per person per month) and had no health insurance (98.4%) in a country using a fee-for-service healthcare payment system. An emergency visit in the last 12 months was reported in 52.6% of households. Ambulance utilisation was almost non-existent (0.2%) and access to health facilities for emergencies was mostly by walking (60.6% and 56.7% by day and night, respectively). Death in the last 12 months was reported in 12.8% of households, of which 20.6% occurred out-of-hospital with no care received within 24 hours prior to death. Self-medication (71.3%) and the expected high cost of care (19.5%) were the main reasons for unmet emergency care needs.Conclusion There is a substantial gap in the supply of emergency care in Kinshasa, with several unmet needs and reasons for poor access identified. |
| format | Article |
| id | doaj-art-b8b35f1ccb4b4ffc90d8f91d8b9813c8 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-b8b35f1ccb4b4ffc90d8f91d8b9813c82025-01-31T01:55:10ZengBMJ Publishing GroupBMJ Open2044-60552022-07-0112710.1136/bmjopen-2021-060036Evaluation of needs and supply of emergency care in Kinshasa, Democratic Republic of Congo: a cross-sectional household surveyLee Wallis0Peter Hodkinson1Ken Diango2John Yangongo3Vera Sistenich4Eric Mafuta5Family, Community and Emergency Care, University of Cape Town Faculty of Health Sciences, Cape Town, South AfricaDivision of Emergency Medicine, University of Cape Town, Cape Town, South AfricaDivision of Emergency Medicine, University of Cape Town, Cape Town, South AfricaEcole de Santé Publique, Université de Kinshasa, Kinshasa, Democratic Republic of CongoDepartment of Emergency Medicine, St George Hospital, Sydney, New South Wales, AustraliaEcole de Santé Publique, Université de Kinshasa, Kinshasa, Democratic Republic of CongoObjective Emergency care can address over half of deaths occurring each year in low-income countries. A baseline evaluation of the specific needs and gaps in the supply of emergency care at community level could help tailor suitable interventions in such settings. This study evaluates access to, utilisation of, and barriers to emergency care in the city of Kinshasa, Democratic Republic of Congo.Design A cross-sectional, community-based household survey.Setting 12 health zones in Kinshasa, Democratic Republic of Congo.Participants Three-stage randomised cluster sampling was used to identify approximately 100 households in each of the 12 clusters, for a total of 1217 households. The head of each household or an adult representative responded on behalf of the household. Additional 303 respondents randomly selected in the households were interviewed regarding their personal reasons for not accessing emergency care.Primary outcome Availability and utilisation of emergency care services.Results In August 2021, 1217 households encompassing 6560 individuals were surveyed (response rate of 96.2%). Most households were economically disadvantaged (70.0% lived with <US$100 per person per month) and had no health insurance (98.4%) in a country using a fee-for-service healthcare payment system. An emergency visit in the last 12 months was reported in 52.6% of households. Ambulance utilisation was almost non-existent (0.2%) and access to health facilities for emergencies was mostly by walking (60.6% and 56.7% by day and night, respectively). Death in the last 12 months was reported in 12.8% of households, of which 20.6% occurred out-of-hospital with no care received within 24 hours prior to death. Self-medication (71.3%) and the expected high cost of care (19.5%) were the main reasons for unmet emergency care needs.Conclusion There is a substantial gap in the supply of emergency care in Kinshasa, with several unmet needs and reasons for poor access identified.https://bmjopen.bmj.com/content/12/7/e060036.full |
| spellingShingle | Lee Wallis Peter Hodkinson Ken Diango John Yangongo Vera Sistenich Eric Mafuta Evaluation of needs and supply of emergency care in Kinshasa, Democratic Republic of Congo: a cross-sectional household survey BMJ Open |
| title | Evaluation of needs and supply of emergency care in Kinshasa, Democratic Republic of Congo: a cross-sectional household survey |
| title_full | Evaluation of needs and supply of emergency care in Kinshasa, Democratic Republic of Congo: a cross-sectional household survey |
| title_fullStr | Evaluation of needs and supply of emergency care in Kinshasa, Democratic Republic of Congo: a cross-sectional household survey |
| title_full_unstemmed | Evaluation of needs and supply of emergency care in Kinshasa, Democratic Republic of Congo: a cross-sectional household survey |
| title_short | Evaluation of needs and supply of emergency care in Kinshasa, Democratic Republic of Congo: a cross-sectional household survey |
| title_sort | evaluation of needs and supply of emergency care in kinshasa democratic republic of congo a cross sectional household survey |
| url | https://bmjopen.bmj.com/content/12/7/e060036.full |
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