title: Strategic assessment of the availability of pediatric trauma care equipment, technology and supplies in Ghana.
abstract: BACKGROUND
  This study aimed to assess the availability of pediatric trauma care items (i.e. equipment, supplies, technology) and factors contributing to deficiencies in Ghana.
  
  
  METHODS
  Ten universal and 9 pediatric-sized items were selected from the World Health Organization's Guidelines for Essential Trauma Care. Direct inspection and structured interviews with administrative, clinical and biomedical engineering staff were used to assess item availability at 40 purposively sampled district, regional and tertiary hospitals in Ghana.
  
  
  RESULTS
  Hospital assessments demonstrated marked deficiencies for a number of essential items (e.g. basic airway supplies, chest tubes, blood pressure cuffs, electrolyte determination, portable X-ray). Lack of pediatric-sized items resulting from equipment absence, lack of training, frequent stock-outs and technology breakage were common. Pediatric items were consistently less available than adult-sized items at each hospital level.
  
  
  CONCLUSIONS
  This study identified several successes and problems with pediatric trauma care item availability in Ghana. Item availability could be improved, both affordably and reliably, by better organization and planning (e.g. regular assessment of demand and inventory, reliable financing for essential trauma care items). In addition, technology items were often broken. Developing local service and biomedical engineering capability was highlighted as a priority to avoid long periods of equipment breakage.
authors.affiliation: Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: James
authors.initials: J
authors.lastname: Ankomah
authors.affiliation: Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana; Department of Surgery, University of Washington, Seattle, WA, USA; School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. Electronic address: stewarb@uw.edu.
authors.forename: Barclay T
authors.initials: BT
authors.lastname: Stewart
authors.affiliation: Department of Anesthesia, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: Victor
authors.initials: V
authors.lastname: Oppong-Nketia
authors.affiliation: Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: Adofo
authors.initials: A
authors.lastname: Koranteng
authors.affiliation: Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana; School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
authors.forename: Adam
authors.initials: A
authors.lastname: Gyedu
authors.affiliation: Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana; School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
authors.forename: Robert
authors.initials: R
authors.lastname: Quansah
authors.affiliation: Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana; School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
authors.forename: Peter
authors.initials: P
authors.lastname: Donkor
authors.affiliation: Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana; School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
authors.forename: Francis
authors.initials: F
authors.lastname: Abantanga
authors.affiliation: Department of Surgery, University of Washington, Seattle, WA, USA; Harborview Injury Prevention & Research Center, Seattle, WA, USA; Department of Global Health, University of Washington, Seattle, WA, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Mock
mesh_terms: D015505:Chest Tubes / Q000600:supply & distribution; D002648:Child; D004865:Equipment and Supplies, Hospital / Q000600:supply & distribution*; D005869:Ghana; D006801:Humans; D011859:Radiography / Q000295:instrumentation; D019722:Sphygmomanometers / Q000600:supply & distribution; D062606:Tertiary Care Centers; D014194:Traumatology / Q000295:instrumentation*; D014944:World Health Organization
keywords: Capacity; Developing country; Global surgery; Operations management; Pediatric; Trauma
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