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

Background: Critical care is an essential component of universal healthcare, however, in low-middle income countries, its provision remains poorly understood. Zambia has expanded critical care services over the last 15 years, however, there is limited national evidence on workforce capacity, infrastructure and service provision.
Aim: To evaluate critical care workforce, service provision and patient case mix across Ministry of Health hospitals in Zambia.
Methods: data was collected via an e-survey questionnaire using a previously validated cross-sectional survey, 14 public hospitals with critical care units across Zambia representing all 10 Provinces. Descriptive statistical analysis was conducted using SPSS. Ethical approval was obtained prior to the study.
Results: All hospitals responded (n=14 / 100%). 131 critical care beds were identified. Only 28.6% of hospitals had 24-hour intensivist coverage, although 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 hospitals.
Conclusion: 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.
Relevance to Clinical Practice: 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 multi-disciplinary critical care workforce.