{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T13:39:31Z","timestamp":1759412371932},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,11,19]],"date-time":"2014-11-19T00:00:00Z","timestamp":1416355200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Consortium for National Health Research (Kenya)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate services in hospitals providing internship training to graduate doctors in <jats:styled-content style=\"fixed-case\">K<\/jats:styled-content>enya.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A survey of 22 internship training hospitals was conducted. Availability of key resources spanning infrastructure, personnel, equipment and drugs was assessed by observation. Outcomes and process of care for pre\u2010specified priority conditions (head injury, chest injury, fractures, burns and acute abdomen) were evaluated by auditing case records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Each hospital had at least one consultant surgeon. Scheduled surgical outpatient clinics, major ward rounds and elective (half day) theatre lists were provided once per week in 91%, 55% and 9%, respectively. In all other hospitals, these were conducted twice weekly. Basic drugs were not always available (e.g. gentamicin, morphine and pethidine in 50%, injectable antistaphylococcal penicillins in 5% hospitals). Fewer than half of hospitals had all resources needed to provide oxygen. One hundred and forty\u2010five of 956 cases evaluated underwent operations under general or spinal anaesthesia. We found operation notes for 99% and anaesthetic records for 72%. Pre\u2010operatively measured vital signs were recorded in 80% of cases, and evidence of consent to operation was found in 78%. Blood loss was documented in only one case and sponge and instrument counts in 7%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Evaluation of surgical services would be improved by development and dissemination of clear standards of care. This survey suggests that internship hospitals may be poorly equipped and documented care suggests inadequacies in quality and training.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.12422","type":"journal-article","created":{"date-parts":[[2014,10,28]],"date-time":"2014-10-28T08:17:15Z","timestamp":1414484235000},"page":"240-249","source":"Crossref","is-referenced-by-count":7,"title":["Quality of surgical care in hospitals providing internship training in <scp>K<\/scp>enya: a cross sectional survey."],"prefix":"10.1111","volume":"20","author":[{"given":"Stephen","family":"Mwinga","sequence":"first","affiliation":[{"name":"KEMRI\u2010Wellcome Trust Research Programme Nairobi Kenya"},{"name":"Ministry of Health Government of Kenya Nairobi Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colette","family":"Kulohoma","sequence":"additional","affiliation":[{"name":"KEMRI\u2010Wellcome Trust Research Programme Nairobi Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Mwaniki","sequence":"additional","affiliation":[{"name":"KEMRI\u2010Wellcome Trust Research Programme Nairobi Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Idowu","sequence":"additional","affiliation":[{"name":"Vanderbilt Institute for Global Health Vanderbilt School of Medicine Nashville TN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Masasabi","sequence":"additional","affiliation":[{"name":"Ministry of Health Government of Kenya Nairobi Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mike","family":"English","sequence":"additional","affiliation":[{"name":"KEMRI\u2010Wellcome Trust Research Programme Nairobi Kenya"},{"name":"Nuffield Department of Medicine University of Oxford Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the SIRCLE Collaboration","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,11,19]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001018"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.417400"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60593-0"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16408-8"},{"key":"e_1_2_6_6_1","first-page":"1211","volume-title":"Disease Control Priorities in Developing Countries","author":"English M","year":"2006"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-6-124"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61081-2"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001264"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.3402\/gha.v7.24859"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)62162-X"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2008.540"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2010.05.002"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61728-0"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2013-002223"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-7292(03)00072-9"},{"volume-title":"Clinical Guidelines for Level 4 and 5 Facilities","year":"2009","author":"Ministry of Health Republic of Kenya","key":"e_1_2_6_18_1"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)03542-X"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-011-1125-4"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b220"},{"volume-title":"\u201cHospitals and Health for All.\u201d Report of the WHO Expert Committee on the Role of Hospitals at the First Referral Level","year":"1987","author":"WHO","key":"e_1_2_6_22_1"},{"volume-title":"Surgical Care at the District Hospital","year":"2003","author":"WHO","key":"e_1_2_6_23_1"},{"volume-title":"Planning Tool for Emergency and Essential Care Surgical Services","year":"2013","author":"WHO","key":"e_1_2_6_24_1"}],"container-title":["Tropical Medicine &amp; 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