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Critical care capacity in Haiti: A nationwide cross-sectional survey

Author

Listed:
  • Lia I Losonczy
  • Sean L Barnes
  • Shiping Liu
  • Sarah R Williams
  • Michael T McCurdy
  • Vivienne Lemos
  • Jerry Chandler
  • L Nathalie Colas
  • Marc E Augustin
  • Alfred Papali
  • for the Research and Education consortium for Acute Care in Haiti (REACH) Study Group

Abstract

Objective: Critical illness affects health systems globally, but low- and middle-income countries (LMICs) bear a disproportionate burden. Due to a paucity of data, the capacity to care for critically ill patients in LMICs is largely unknown. Haiti has the lowest health indices in the Western Hemisphere. In this study, we report results of the first known nationwide survey of critical care capacity in Haiti. Design: Nationwide, cross-sectional survey of Haitian hospitals in 2017–2018. Setting: Haiti. Subjects: All Haitian health facilities with at least six hospital beds. Interventions: Electronic- and paper-based survey. Results: Of 51 health facilities identified, 39 (76.5%) from all ten Haitian administrative departments completed the survey, reporting 124 reported ICU beds nationally. Of facilities without an ICU, 20 (83.3%) care for critically ill patients in the emergency department. There is capacity to ventilate 62 patients nationally within ICUs and six patients outside of the ICU. One-third of facilities with ICUs report formal critical care training for their physicians. Only five facilities met criteria for a Level 1 ICU as defined by the World Federation of Societies of Intensive and Critical Care Medicine. Self-identified barriers to providing more effective critical care services include lack of physical space for critically ill patients, lack of equipment, and few formally trained physicians and nurses. Conclusions: Despite a high demand for critical care services in Haiti, current capacity remains insufficient to meet need. A significant amount of critical care in Haiti is provided outside of the ICU, highlighting the important overlap between emergency and critical care medicine in LMICs. Many ICUs in Haiti lack basic components for critical care delivery. Streamlining critical care services through protocol development, education, and training may improve important clinical outcomes.

Suggested Citation

  • Lia I Losonczy & Sean L Barnes & Shiping Liu & Sarah R Williams & Michael T McCurdy & Vivienne Lemos & Jerry Chandler & L Nathalie Colas & Marc E Augustin & Alfred Papali & for the Research and Educat, 2019. "Critical care capacity in Haiti: A nationwide cross-sectional survey," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-12, June.
  • Handle: RePEc:plo:pone00:0218141
    DOI: 10.1371/journal.pone.0218141
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    References listed on IDEAS

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    1. Tim Baker & Carl Otto Schell & Edwin Lugazia & Jonas Blixt & Moses Mulungu & Markus Castegren & Jaran Eriksen & David Konrad, 2015. "Vital Signs Directed Therapy: Improving Care in an Intensive Care Unit in a Low-Income Country," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-15, December.
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    Cited by:

    1. Conțiu Tiberiu Șoitu & Silviu-Petru Grecu & Romeo Asiminei, 2022. "Health Security, Quality of Life and Democracy during the COVID-19 Pandemic: Comparative Approach in the EU-27 Countries," IJERPH, MDPI, vol. 19(21), pages 1-26, November.
    2. Bardosh, Kevin & Jean, Lorence & Desir, Luccene & Yoss, Sarah & Poovey, Brianna & Beau de Rochars, Madsen Valerie & Noland, Gregory S., 2023. "Was lockdown worth it? community perspectives and experiences of the Covid-19 pandemic in remote southwestern Haiti," Social Science & Medicine, Elsevier, vol. 331(C).

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