Browsing by Author "Jayaraman, Sudha"

Now showing 1 - 4 of 4

Building Research Capacity in Africa: Equity and Global Health Collaborations
(Public Library Science, 1160 Battery Street, Ste 100, San Francisco, Usa, Ca, 94111, 2014) Chu, Kathryn M; Jayaraman, Sudha; Kyamanywa, Patrick; Ntakiyiruta, Georges
Global health has increased the number of high-income country (HIC) investigators conducting research in low- and middle-income countries (LMICs). N Partnerships with local collaborators rather than extractive research are needed. N LMICs have to take an active role in leading or directing these research collaborations in order to maximize the benefits and minimize the harm of inherently inequitable relationships. N This essay explores lessons from effective and equitable relationships that exist between African countries and HICs.
Building trauma and EMS systems capacity in Rwanda: lessons and recommendations
(Ubiquity Press Ltd , Unit 3.22, East London Works, 65-75 Whitechapel Road, London, England, E1 1du, 2021) Jayaraman, Sudha; Ntirenganya, Faustin; Nkeshimana, Menelas; Rosenberg, Ashley; Dushime, Theophile; Kabagema, Ignace; Uwitonze, Jean Marie; Uwitonize, Eric; Nyinawankusi, Jeanne d'Arc; Riviello, Robert; Bagahirwa, Irene; Williams, Kenneth L; Krebs, Elizabeth; Maine, Rebecca; Banguti, Paulin; Rulisa, Stephen; Kyamanywa, Patrick; Byiringiro, Jean Claude
Background: Surgical capacity building has gained substantial momentum. However, care at the hospital level depends on improved access to emergency services. There is no established model for facilitating trauma and EMS system capacity in LMIC settings. This manuscript describes our model for multi-disciplinary collaboration to advance trauma and EMS capacity in Rwanda, along with our lessons and recommendations. Methods: After high-level meetings at the Ministry of Health in Rwanda (MOH), in 2016, a capacity building plan focusing on improved clinical services, quality improvement/ research and leadership capacity across prehospital and emergency settings. The main themes for the collaborative model included for empowerment of staff, improving clinical service delivery, and investing in systems and infrastructure. Funding was sought and incorporated into the Sector Wide Approaches to Planning process at the Ministry of Health of Rwanda. Findings: A shared mental model was created through a fully funded immersion program for Rwandese leaders from emergency medicine, nursing, prehospital care, and injury policy. Prehospital care delivery was standardized within Kigali through a train-thetrainers program with four new context-appropriate short courses in trauma, medical, obstetric/neonatal, and pediatric emergencies and expanded across the country to reach >600 staff at district and provincial hospitals. Forty-two protocols and checklists were implemented to standardize prehospital care across specialties. The WHO Trauma Registry was instituted across four major referral centers in the country capturing over 5,000 injured patients. Long-term research capacity development included Masters’ Degree support for 11 staff. Conclusions and Recommendations: This collaboration was highly productive in empowering staff and leadership, standardizing clinical service delivery in EMS, and investing in systems and infrastructure. This can be a useful model for trauma and EMS system capacity development in other LMICs.
Epidemiology of Child Injuries in Uganda: Challenges for Health Policy
(Page Press Publ, 2011-03-01) Hsia, Y Renee; Ozgediz, Doruk; Jayaraman, Sudha; Kyamanywa, Patrick; Mutto, Milton; Kobusingye, C Olive
Globally, 90%ofroad crash deaths occurin the developing world. Children in Africa bear the major part of this burden, with the highest unintentional injury rates in the world. Our study aims to better understand injury patterns among children living in Kampala, Uganda and provide evidence that injuries are significant in child health. Trauma registry records of injured children seen at Mulago Hospital in Kampala were analysed. Data were collected when patients were seen initially and included patient condition, demographics, clinical variables, cause, severity, as measured by the Kampala trauma score, and location of injury. Outcomes were captured on discharge from the casualty department and at two weeks for admitted patients. From August 2004 to August 2005, 872 injuryvisitsforchildren <18 years old were recorded. The mean age was 11 years (95% CI 10.9-11.6); 68% (95% CI 65-72%) were males; 64% were treated in casualty and discharged; 35% were admitted. The most common causes were traffic crashes (34%), falls (18%) and violence (15%). Most children (87%) were mildly injured; 1% severely injured. By two weeks, 6% of the patients admitted for injuries had died and, of these morbidities, 16% had severe injuries, 63% had moderate injuries and 21% had mild injuries. We concluded that, in Kampala,children bear a large burden of injury from preventable causes. Deaths in low severity patients highlight the need for improvements in facility based care. Further studies are necessary to capture overall child injury mortality and to measure chronic morbidity owing to sequelae of injuries.
Epidemiology of Injuries Presenting to the National Hospital in Kampala, Uganda: Implications for Research and Policy
(BMC , Campus, 4 Crinan St, London, England, N1 9XW, 2010-07-20) Hsia, Renee Y.; Ozgediz, Doruk; Mutto, Milton; Jayaraman, Sudha; Kyamanywa, Patrick; Kobusingye, Olive C.
Background Despite the growing burden of injuries in LMICs, there are still limited primary epidemiologic data to guide health policy and health system development. Understanding the epidemiology of injury in developing countries can help identify risk factors for injury and target interventions for prevention and treatment to decrease disability and mortality. Aim To estimate the epidemiology of the injury seen in patients presenting to the government hospital in Kampala, the capital city of Uganda. Methods A secondary analysis of a prospectively collected database collected by the Injury Control Centre-Uganda at the Mulago National Referral Hospital, Kampala, Uganda, 2004-2005. Results From 1 August 2004 to 12 August 2005, a total of 3,750 injury-related visits were recorded; a final sample of 3,481 records were analyzed. The majority of patients (62%) were treated in the casualty department and then discharged; 38% were admitted. Road traffic injuries (RTIs) were the most common causes of injury for all age groups in this sample, except for those under 5 years old, and accounted for 49% of total injuries. RTIs were also the most common cause of mortality in trauma patients. Within traffic injuries, more passengers (44%) and pedestrians (30%) were injured than drivers (27%). Other causes of trauma included blunt/penetrating injuries (25% of injuries) and falls (10%). Less than 5% of all patients arriving to the emergency department for injuries arrived by ambulance. Conclusions Road traffic injuries are by far the largest cause of both morbidity and mortality in Kampala. They are the most common cause of injury for all ages, except those younger than 5, and school-aged children comprise a large proportion of victims from these incidents. The integration of injury control programs with ongoing health initiatives is an urgent priority for health and development.