The operational setup of intensive care units in a low income country in East Africa

Abstract

Background: Intensive care medicine is a medical specialty which focuses on management of critically ill patients. The majority of critically ill patients in less developed countries, harboring two thirds of world populations do not have access to intensive care.
Objectives: Evaluate the current status of Intensive Care Unit setups and facilities in Kenya.
Design: An observational cross sectional survey.
Setting: The study was carried out in referral hospitals, provincial level 5 hospitals, mission hospitals and private hospitals with intensive care units.
Results: A total of 21 hospitals were surveyed in the republic with a bed capacity of 6,551. The bed capacity of ICUs was 130. Availability and serviceability of ICU equipment, availability of essential drugs and diagnostic support services used in care of critically ill patients ranged from > 95% in private and mission hospitals to 60-80% in the other hospitals. There were 414 nurses working in the ICUs of which 204 had specialty training. Anaesthesiologists were the most common primary care clinicians in 47% of ICUs surveyed. Over a one year period, post-operative surgical cases at 1086 (30%) and trauma at 909 (26%) cases were the leading causes of ICU admissions.
Conclusion: There is a low bed capacity in ICUs compounded by a universal deficit in human resource capacity and support infrastructure for the critical care services. Regionalisation, increased funding and more training opportunities for critical  are
services by the regional and central governments will go a long way in alleviating these challenges.