Africa\u2019s challenged ENT services: highlighting challenges in Zambia

Lufunda Lukama,Colleen Aldous,Chester Kalinda

doi:10.1186/s12913-019-4267-y

Lufunda Lukama, Colleen Aldous + Show 1 more

Open Access

https://doi.org/10.1186/s12913-019-4267-y

Copy DOI

Abstract

BackgroundDiseases of the ear, nose and throat (ENT) are common and are a major cause of morbidity and mortality. In many low income countries like Zambia, the high ENT disease burden has not received the required resources for treatment. We investigated ENT service provision in hospitals in Zambia by documenting the profile of hospitals offering ENT services and examining the country’s ENT services with regards to human resource, infrastructure and availability of equipment based on the levels of care of various hospitals.MethodsThe study was a cross-sectional descriptive survey conducted using a structured and piloted questionnaire which was administered to the 109 Ministry of Health (MoH) registered hospitals across the country. Ethical clearance was granted by University of KwaZulu-Natal and the Zambia National Health Research Authority. Participation in the study was voluntary and all respondents signed informed consent. Descriptive statistics were used to analyse the data.ResultsOf the 109 hospitals approached to participate in the study, 61 (55.9%) hospitals responded. This represented 83.3% (n = 5) of Third Level Hospitals (TLH), 89.5% (n = 17) of Second Level Hospitals (SLH) and 41.7% (n = 35) of First Level Hospitals (FLH) countrywide. Of the participating hospitals, 6.6% (n = 4) were unclassified. Within this sample, 8.6% (n = 3) FLH, 11.8% (n = 2) SLH and 60.0% (n = 3) TLH had an ENT examination room. Only 2.9% (n = 4) hospitals had an audiology booth and 1.6% (n = 1) had a speech therapy room. Of the second and third level hospitals, 9.1% (n = 2) had flexible rhinolaryngoscopes, 18.2% (n = 4) had operating microscopes and 68.2% (n = 15) adenotonsillectomy sets. The data revealed that there were 4 ENT surgeons, 1 Audiologist and no Speech Therapists across the country.ConclusionZambia’s ENT services were deficient at all levels of hospital care. There were deficiencies in infrastructure, human resource and equipment in hospitals. With the current burden of disease, critical intervention is required. These findings should be used to direct national policy on the improvement of ENT service provision in Zambia.

Highlights

Diseases of the ear, nose and throat (ENT) are common and are a major cause of morbidity and mortality
This study determined the current status of ENT service provision in hospitals in Zambia by documenting the profile of hospitals offering ENT services and examining the ENT service with regards to human resource, infrastructure and availability of equipment based on the levels of care of the various hospitals
Information regarding human resource was provided by the hospital’s Human Resource Officers (HROs) and validated with data obtained from the Health Professions

Summary

Introduction

Nose and throat (ENT) are common and are a major cause of morbidity and mortality. In many low income countries like Zambia, the high ENT disease burden has not received the required resources for treatment. Nose and throat (ENT) are universally a major public health concern [1,2,3]. The Global Burden of Disease (GBD), including ENT conditions, has uniformly been reported to be proportional to resource deprivation [4, 5]. Even though developed countries are not exempt from the high ENT disease burden [6], low income African and Asian countries are most affected [7,8,9]. In the majority of places, individuals with communication difficulties are not prioritized in health care systems as governments focus on saving lives as opposed to improving quality of life [12]

Methods

Results

Discussion

Conclusion