Availability of ENT Surgical Procedures and Medication in Low-Income Nation Hospitals: Cause for Concern in Zambia. (24th March 2020) - Lukama, Lufunda
Abstract : Background . Ear, nose, and throat (ENT) diseases are an oft overlooked global health concern. Despite their high prevalence and associated morbidity and mortality, ENT diseases have remained neglected in health care delivery. In Zambia and many other low-income countries, ENT services are characterized by poor funding, unavailable surgical procedures, and erratic supply of essential drugs. Objective . To investigate ENT service provision in Zambia with regard to availability of surgical procedures and supply of essential drugs. Methods . A descriptive cross-sectional survey was conducted using a piloted structured questionnaire between 17 January 2017 and 2 January 2018. Included in the study were the 109 hospitals registered with the Ministry of Health (MoH) across the 10 provinces of Zambia. Results . Of the participating hospitals, only 5.9% (n = 1 ) and 40% (n = 2 ) of Second-Level Hospitals (SLH) and Third-Level Hospitals (TLH), respectively, carried out tympanoplasty, myringotomy, and grommet insertion (M+G). Frontal trephination and external ethmoidectomy were offered in 11.7% (n = 2 ) and 40% (n = 2 ) of SLH and TLH, respectively. While tracheostomy (39.3%, n = 24 ), tonsillectomy (27.9%, n = 17 ), and adenoidectomy (27.9%, n = 17 ) were the most widely performed head and neck procedures, laryngectomy was carried out by 1 hospital. Between 14.8% (n = 9 ) and 36.1% (n = 22 ) of hospitals lacked antibiotic and/or antiseptic ear drops. Despite 96.7% (n = 59 ) of the respondents acknowledging ENT as an important branch of clinical practice, only 15.3% (n = 4 ) of the hospitals had a budget for ENT. Also, 6.6% (n = 4 ) of the respondents thought the discipline of ENT had received enough attention. Conclusion . ENT service delivery in Zambia is limited with regard to performed surgical procedures and availability of essential drugs, necessitating urgent intervention. The findings from this study may be used to direct national policy on the improvement of provision of ENT services in Zambia.