Availability of basic emergency care services in conflict-affected and resource-limited settings: A facility-based assessment of secondary health facilities in Borno state, Nigeria

Abstract

Objective: Basic Emergency Care (BEC) services are critical for reducing preventable morbidity and mortality. However, there has been no prior empirical assessment that specifically evaluated BEC capacity in secondary facilities in Borno State. This study assesses the availability of BEC services in secondary healthcare facilities amid ongoing insurgencies.

Methods: A facility-based cross-sectional descriptive assessment was conducted in 20 secondary health facilities across Borno State using a multi-stage sampling technique. A validated researcher-constructed checklist assessed infrastructure, guidelines/protocols, medications/supplies, diagnostic services, consulting services, ancillary services, and human resources. Data were collected via Google Forms, verified through direct observations, and analysed using descriptive statistics in IBM SPSS version 27.

Results: Critical gaps were identified in human resources, with 55% of facilities having low nurse staffing and 65% low doctor staffing per shift. Only 15% of facilities provided 24-hour coverage. Diagnostic services were limited, with basic imaging available in only 20% of facilities. Ancillary services were fully available in only 28% of the hospitals assessed. However, consulting services (90.5%), medications (74%), and infrastructure (75%) were fully or partially available.

Conclusion: Persistent shortages in human resources, diagnostics, and ancillary services hinder effective BEC delivery in Borno State. Intentional and innovative investments in workforce recruitment and retention, diagnostic equipment, and ancillary support, alongside technology-driven solutions, are needed to strengthen emergency care in this conflict-affected region.