Severe road traffic injuries in Kenya, quality of care and access.

BACKGROUND Road traffic injuries (RTI) are on increase in developing countries. Health care facilities are poorly equipped to provide the needed services. OBJECTIVE Determine access and quality of care for RTI casualties in Kenya. DESIGN Cross-sectional survey SETTING 53 large and medium size private, faith-based and public hospitals. PARTICIPANTS In-patient road traffic crash casualties and health personnel in the selected hospitals were interviewed on availability of emergency care and resources. Onsite verification of status was undertaken. RESULTS Out of 310 RTI casualties interviewed, 72.3%, 15.6% and 12.2% were in public, faith-based and private hospitals, respectively. Peak age of the injured was 15-49 years. First aid was availed to 16.0% of casualties. Unknown persons transported 76.5% of the injured. Police and ambulance vehicles transported 6.1% and 1.4%, respectively. 51.9% reached health facilities within 30 minutes of crash and medical care provided to 66.2% within one hour. 40.8% of recipient facilities were adequately prepared for RTI emergencies. CONCLUSIONS Most RTI casualties were young and from poor backgrounds. Training of motorists and general public in first aid should be considered in RTI control initiatives. Availability of basic trauma care medical supplies in public health facilities was highly deficient.