Cross-Sectional Survey of Critical Care Provision in Ministry of Health Hospitals in Zambia

Critical care is an essential component of universal health care; however, its provision in low- and middle-income countries remains poorly understood. Although Zambia has expanded critical care services over the last 15 years, national evidence regarding workforce capacity, infrastructure and service provision remains limited.

To evaluate critical care workforce, service provision and patient case mix across Ministry of Health hospitals in Zambia.

A cross-sectional survey was administered across 14 public hospitals with critical care units across Zambia, representing all 10 provinces. Data were collected via an e-survey questionnaire instrument. Descriptive statistical analysis was conducted using SPSS. Ethics approval was obtained prior to the study.

All hospitals responded (n = 14/14, 100% response rate), accounting for a capacity of 131 critical care beds. Only 28.6% of hospitals had 24-h intensivist coverage, whereas all had registered critical care nurses. Equipment availability varied, with universal access to ventilators and monitors but limited access to syringe pumps and inconsistent availability of functional CT scanners. Over a 7-day period, 121 admissions were recorded, predominantly medical (29%), surgical (24.8%) and trauma-related (19.8%). Paediatric cases accounted for 40% of admissions. Formal admission and discharge protocols were present in fewer than half of the hospitals.

The study provides the first national overview of public critical care provision in Zambia and provides a snapshot of current provision. The findings highlight urgent areas for capacity strengthening.

Findings are similar to other studies within the sub-Saharan region and highlight the need to strengthen workforce training, particularly in critical and paediatric care, improve access to essential equipment and standardise care protocols to enhance patient safety and outcomes. The study demonstrates the importance of strengthening the multidisciplinary critical care workforce.