Emergency departments in Yaoundé : A situational analysis

Aude Laetitia Ndoadoumgue (naudelaetitia@yahoo.com)
Surgery and specialties, University of Yaoundé I
June, 2016


Emergency departments play an important role in a country’s health care system by immediately responding to health conditions which may be life threatening regardless of their ultimate cause thereby supporting progress towards strong health. The proper management of patients in an emergency department determines good outcome. This management takes into account the availability of resources. There is a rise in health care needs with the growing population. It is therefore important to provide a full picture of emergency departments in Yaoundé so as to ensure that the needs of the population are met. Hence we sought out to evaluate the ability of emergency departments in Yaoundé to provide adequate emergency care.
We carried out a descriptive cross-sectional study in the emergency departments of the category 1, 2 and 4 hospitals in Yaoundé from November 2015 to April 2016. In the study were included all emergency departments from which we received authorisations and who had the information we sought in their records. The sampling was consecutive. Data was collected using pre-established forms. The variables we studies were information on the emergency departments’ infrastructures, equipment, organisation and human resources using an adapted WHO tool as well as disease profile and patient outcome. Data was analysed using the statistical software Epi Info and results were presented in the form of counts, percentages and means.
Ten emergency departments were included of which two category 1, four category 2, and four category 4. The required infrastructures in emergency departments were present in 75% of first category hospitals, 58.3% of the second category and 41.7% of the fourth category. With respect to the equipment sought in those emergency departments, it was mostly present at 80% in the hospitals of the first category, 60% in the second category and 55% in the fourth category. There were 129 beds in the emergency departments with an average of 10.8 beds/emergency department. Guidelines to ease organisation in emergency departments were mostly present in 60% of first category, 53.3% of second category and 15% of fourth category hospitals. Three hundred and forty eight health personnel were present in the 10 emergency departments of which 78 physicians and 270 nurses giving us an average of 34.8 health personnel / emergency department. During our study period there were 6738 emergency department visits of which 5711 were included in our study. Category 2 emergency departments had 49.8% of all visits. Pathologies most represented were of infectious origin (23.2%), followed by trauma (14.2%), and digestive disorders (13.6%). These were mainly malaria (40.4%), road traffic accidents (63%), and gastroenteritis (19.7%) respectively. Regarding outcome 51.8% patients were discharged home after consultations, 44.4% were admitted in the emergency department or transferred to an inpatient unit, and 1.9% were referred to another facility. The overall mortality in emergency departments was 1.6%.
Substantial care is provided in Yaoundé emergency departments despite the staring shortcomings. These shortcomings depend on the category of the hospital. They were greater in hospitals in fourth category. The disease profile of Yaoundé emergency departments is mostly made of infectious diseases. Most emergency department consultations were not real emergencies.