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. 2020 Dec:60:273-278.
doi: 10.1016/j.jcrc.2020.08.017. Epub 2020 Aug 21.

A national survey of critical care services in hospitals accredited for training in a lower-middle income country: Pakistan

Madiha Hashmi  1 , Arshad Taqi  2 , Muhammad I Memon  3 , Syed Muneeb Ali  3 , Saleh Khaskheli  4 , Muhammad Sheharyar  5 , Muhammad Hayat  6 , Mohiuddin Shiekh  7 , Chamira Kodippily  8 , Dilanthi Gamage  8 , Arjen M Dondorp  9 , Rashan Haniffa  10 , Abi Beane  11
Affiliations

A national survey of critical care services in hospitals accredited for training in a lower-middle income country: Pakistan

Madiha Hashmi et al. J Crit Care. 2020 Dec.

Abstract

Purpose: To describe the extent and variation of critical care services in Pakistan.

Materials and methods: A cross-sectional survey was conducted in all intensive care units (ICUs) recognised for postgraduate training to determine administration, infrastructure, equipment, staffing, and training.

Results: There were 151 hospitals recognised for training, providing 2166 ICU beds and 1473 ventilators. Regional distribution of ICU beds per 100,000 population ranged from 1.0 in Sindh to none in Gilgit Baltistan (median 0.7). A senior clinician trained in critical care was available in 19 (12.1%) of units. One-to-one nurse-to-bed ratio during the day was available in 84 (53.5%) of units, dropping to 75 (47.8%) at night. Availability of 1:1 nursing also varied between provinces, ranging from 56.5% in Punjab compared to 0% in Azad Jamu Kashmir. Similarly, there was disparity in the availability of ventilators between provinces. All ICUs had basic infrastructure (electricity, running water, piped oxygen) and basic equipment (electronic monitoring and infusion pumps).

Conclusion: Pakistan, a lower middle-income country, has an established network of critical care facilities with access to basic equipment, but inequalities in its distribution. Investment in critical care training for doctors and nurses is needed.

Keywords: Critical care resources; Critical care services; Critical care staffing; Lower middle-income country.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of recruitment and participation in survey.
Fig. 2
Fig. 2
Top: Heat map of Pakistan, showing density of ICU beds per population at a regional level. Bottom: Heat map of Pakistan, showing population density.
See this image and copyright information in PMC

References

    1. Murthy S., Leligdowicz A., Adhikari N.K.J. Intensive care unit capacity in low-income countries: a systematic review. PLoS One. 2015;10:1):1–12. doi: 10.1371/journal.pone.0116949. - DOI - PMC - PubMed
    1. Hirshon J.M., Risko N., Calvello E.J.B., De Ramirez S.S., Narayan M., Theodosis C. Health systems and services: the role of acute care. Bull World Health Organ. 2013;91(5):386–388. doi: 10.2471/blt.12.112664. - DOI - PMC - PubMed
    1. Hashmi M., Beane A., Taqi A., Memon M.I., Athapattu P., Khan Z. Pakistan registry of intensive CarE (PRICE): expanding a lower middle-income, clinician-designed critical care registry in South Asia. Pediatr Crit Care Med. 2019;20(3):190–195. doi: 10.1177/1751143718814126. - DOI - PMC - PubMed
    1. Central Intelligence Agency. Pakistan The World Factbook. 2020. https://www.cia.gov/library/publications/the-world-factbook/geos/pk.html (accessed April 2, 2020)
    1. Haniffa R., De Silva A.P., Iddagoda S., Batawalage H., De Silva S.T.G.R., Mahipala P.G. A cross-sectional survey of critical care services in Sri Lanka: a lower middle-income country. J Crit Care. 2014;29(5):764–768. doi: 10.1016/j.jcrc.2014.04.021. - DOI - PubMed

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