A health systems approach to critical care delivery in low-resource settings: a narrative review

Faustina, Adipa, Baker, Tim, Crawford, Ana Maria, Dark, Paul, Dula, Dingase, Gordon, Stephen ORCID: https://orcid.org/0000-0001-6576-1116, Hamilton, David Oliver, Huluka, Dawit Kebede, Khalid, Karima, Sulaiman, Lakoh, Limbani, Felix, Morton, Ben ORCID: https://orcid.org/0000-0002-6164-2854, Rylance, Jamie ORCID: https://orcid.org/0000-0002-2323-3611, Sawe, Hendry, Simiyu, Ibrahim, Spencer, Stephen ORCID: https://orcid.org/0000-0001-8451-7514, Waweru-Siika, Wangari and Worrall, Eve ORCID: https://orcid.org/0000-0001-9147-3388 (2023) 'A health systems approach to critical care delivery in low-resource settings: a narrative review'. Intensive Care Medicine, Vol 49, pp. 772-784.

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Abstract

There is a high burden of critical illness in low-income countries (LICs), adding pressure to already strained health systems. Over the next decade, the need for critical care is expected to grow due to ageing populations with increasing medical complexity; limited access to primary care; climate change; natural disasters; and conflict, adding pressure to the already strained health systems. In 2019, the 72nd World Health Assembly emphasised that an essential part of universal health coverage is improved access to effective emergency and critical care and to “ensure the timely and effective delivery of life-saving health care services to those in need”. In this narrative review we examine critical care capacity building in LICs from a health systems perspective. We conducted a systematic literature search, using the WHO health systems framework to structure findings within six core components or “building blocks”: 1) service delivery; 2) health workforce; 3) health information systems; 4) access to essential medicines and equipment; 5) financing; and 6) leadership and governance. We provide recommendations using this framework, derived from literature identified in our review. These recommendations are useful for policy makers, health service researchers and healthcare workers to inform critical care capacity building in low resource settings.

Item Type:	Article
Subjects:	WA Public Health > WA 100 General works
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1007/s00134-023-07136-2
Depositing User:	Christy Littlejohn
Date Deposited:	11 Jul 2023 14:11
Last Modified:	10 Oct 2023 13:35
URI:	https://archive.lstmed.ac.uk/id/eprint/22632

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