Qualitative Health Research
May 2015; 25 (5)
http://qhr.sagepub.com/content/current

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Trauma Systems in Kenya
A Qualitative Analysis at the District Level
Hadley K. H. Wesson1,2, Kent A. Stevens1,3, Abdulgafoor M. Bachani1, Stephen Mogere4
Daniel Akungah5. Jackim Nyamari5, John Masasabi Wekesa6, Adnan A. Hyder1
1Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
2Virginia Commonwealth University Medical Center, Richmond, Virginia, USA
3Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
4Roless Media Management Institute, Nairobi, Kenya
5Kenyatta University, Nairobi, Kenya
6Ministry of Medical Services, Nairobi, Kenya
Abstract
Injury is a leading cause of death and disability in low- and middle-income countries. Kenya has a particularly high burden of injuries, accounting for 88.4 deaths per 100,000 population. Despite recent attempts to prioritize injury prevention in Kenya, trauma care systems have not been assessed. We assessed perceptions of formal and informal district-level trauma systems through 25 qualitative semi-structured interviews and 16 focus group discussions with Ministry of Health officials, district hospital administrators, health care providers, police, and community members. We used the principles of theoretical analysis to identify common themes of prehospital and hospital trauma care. We found prehospital care relied primarily on “good Samaritans” and police. We described hospital care in terms of human resources, infrastructure, and definitive care. The interviewers repeatedly emphasized the lack of hospital infrastructure. We showed the need to develop prehospital care systems and strengthen hospital trauma care services.