abstract: 'Background: The burden of trauma in low and middle-income countries

  (LMICs) is disproportionately high: LMICs account for nearly 90\% of the

  global trauma deaths. Lack of trauma data has been identified as one of

  the major challenges in addressing the quality of trauma care and

  informing injury-preventing strategies in LMICs. This study aimed to

  explore the barriers and facilitators of current trauma documentation

  practices towards the development of a national trauma registry (TR).

  Methods: An exploratory qualitative study was conducted at five regional

  hospitals between August 2018 and December 2018. Five focus group

  discussions (FGDs) were conducted with 49 participants from five

  regional hospitals. Participants included specialists, medical doctors,

  assistant medical officers, clinical officers, nurses, health clerks and

  information communication and technology officers. Participants came

  from the emergency units, surgical and orthopaedic inpatient units, and

  they had permanent placement to work in these units as nonrotating

  staff. We analysed the gathered information using a hybrid thematic

  analysis.

  Results: Inconsistent documentation and archiving system, the disparity

  in knowledge and experience of trauma documentation, attitudes towards

  documentation and limitations of human and infrastructural resources in

  facilities we found as major barriers to the implementation of trauma

  registry. Health facilities commitment to standardising care, Ministry

  of Health and medicolegal data reporting requirements, and insurance

  reimbursements criteria of documentation were found as major

  facilitators to implementing trauma registry.

  Conclusions: Implementation of a trauma registry in regional hospitals

  is impacted by multiple barriers related to providers, the volume of

  documentation, resource availability for care, and facility care flow

  processes. However, financial, legal and administrative data reporting

  requirements exist as important facilitators in implementing the trauma

  registry at these hospitals. Capitalizing in the identified facilitators

  and investing to address the revealed barriers through contextualized

  interventions in Tanzania and other LMICs is recommended by this study.'
affiliation: 'Sawe, HR (Corresponding Author), Muhimbili Univ Hlth \& Allied Sci,
  Dept Emergency Med, Dar Es Salaam, Tanzania.

  Sawe, HR (Corresponding Author), Univ Cape Town, Div Emergency Med, Fac Hlth Sci,
  Cape Town, South Africa.

  Sawe, Hendry R., Muhimbili Univ Hlth \& Allied Sci, Dept Emergency Med, Dar Es Salaam,
  Tanzania.

  Sawe, Hendry R.; Wallis, Lee A.; Reynolds, Teri A., Univ Cape Town, Div Emergency
  Med, Fac Hlth Sci, Cape Town, South Africa.

  Sirili, Nathanael, Muhimbili Univ Hlth \& Allied Sci, Sch Publ Hlth \& Social Sci,
  Dept Dev Studies, Dar Es Salaam, Tanzania.

  Weber, Ellen, Univ Calif San Francisco, Emergency Dept, San Francisco, CA 94143
  USA.

  Coats, Timothy J., Univ Leicester, Dept Cardiovasc Sci, Leicester, Leics, England.

  Reynolds, Teri A., World Hlth Org WHO, Clin Serv \& Syst, Integrated Hlth Serv,
  Geneva, Switzerland.'
author: Sawe, Hendry R. and Sirili, Nathanael and Weber, Ellen and Coats, Timothy
  J. and Wallis, Lee A. and Reynolds, Teri A.
author-email: hsawe@muhas.ac.tz
author_list:
- family: Sawe
  given: Hendry R.
- family: Sirili
  given: Nathanael
- family: Weber
  given: Ellen
- family: Coats
  given: Timothy J.
- family: Wallis
  given: Lee A.
- family: Reynolds
  given: Teri A.
da: '2023-09-28'
doi: 10.1016/j.afjem.2020.06.003
eissn: 2211-4203
files: []
issn: 2211-419X
journal: AFRICAN JOURNAL OF EMERGENCY MEDICINE
keywords: 'Trauma registry; Tanzania; Barriers and facilitators; Trauma; Low- and

  middle-income countries'
keywords-plus: MAJOR TRAUMA; CARE; BURDEN; INJURY; NEEDS
language: English
number: 1, SI
number-of-cited-references: '44'
orcid-numbers: 'Coats, Timothy/0000-0003-2736-2784

  Wallis, Lee/0000-0003-2711-3139'
pages: S23-S28
papis_id: dee0692c1d6e6405f92c005f8d5bcd87
ref: Sawe2020barriersfacilitators
researcherid-numbers: 'Coats, Timothy/AAW-1254-2021

  Weber, Ellen/GRR-9967-2022

  '
times-cited: '8'
title: 'Barriers and facilitators to implementing trauma registries in low- and middle-income
  countries: Qualitative experiences from Tanzania'
type: article
unique-id: WOS:000598689700006
usage-count-last-180-days: '0'
usage-count-since-2013: '0'
volume: '10'
web-of-science-categories: Emergency Medicine
year: '2020'