{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:51:20Z","timestamp":1791420680412,"version":"4.3.3"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":86,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Health Serv Res"],"DOI":"10.1186\/s12913-026-15141-6","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T07:47:49Z","timestamp":1784015269000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessing barriers to musculoskeletal trauma care in Ethiopia: a national providers\u2019 survey"],"prefix":"10.1186","volume":"26","author":[{"given":"Samhita","family":"Kadiyala","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cameron Geoffrey","family":"Almeida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengistu G.","family":"Mengesha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ephrem G.","family":"Adem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Berwin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alpha Seifu","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Hailu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiran J.","family":"Agarwal-Harding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"15141_CR1","doi-asserted-by":"publisher","first-page":"1844","DOI":"10.2106\/JBJS.16.00323","volume":"98","author":"KJ Agarwal-Harding","year":"2016","unstructured":"Agarwal-Harding KJ, Von Keudell A, Zirkle LG, et al. Understanding and Addressing the Global Need for Orthopaedic Trauma Care. J Bone Joint Surg Am. 2016;98:1844\u201353. https:\/\/doi.org\/10.2106\/JBJS.16.00323.","journal-title":"J Bone Joint Surg Am"},{"key":"15141_CR2","doi-asserted-by":"publisher","first-page":"246","DOI":"10.2471\/BLT.08.052290","volume":"87","author":"RA Gosselin","year":"2009","unstructured":"Gosselin RA, Spiegel DA, Coughlin R, et al. Injuries: the neglected burden in developing countries. Bull World Health Organ. 2009;87:246. https:\/\/doi.org\/10.2471\/BLT.08.052290.","journal-title":"Bull World Health Organ"},{"key":"15141_CR3","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1007\/s40719-022-00229-1","volume":"8","author":"B Alayande","year":"2022","unstructured":"Alayande B, Chu KM, Jumbam DT, et al. Disparities in Access to Trauma Care in Sub-Saharan Africa: a Narrative Review. Curr Trauma Rep. 2022;8:66\u201394. https:\/\/doi.org\/10.1007\/s40719-022-00229-1.","journal-title":"Curr Trauma Rep"},{"key":"15141_CR4","doi-asserted-by":"publisher","first-page":"S3","DOI":"10.1016\/j.afjem.2019.01.013","volume":"9","author":"A Endalamaw","year":"2019","unstructured":"Endalamaw A, Birhanu Y, Alebel A, et al. The burden of road traffic injury among trauma patients in Ethiopia: A systematic review and meta-analysis. Afr J Emerg Med. 2019;9:S3\u20138. https:\/\/doi.org\/10.1016\/j.afjem.2019.01.013.","journal-title":"Afr J Emerg Med"},{"key":"15141_CR5","doi-asserted-by":"publisher","unstructured":"Misganaw A, Melaku YA, Tessema GA, et al. National disability-adjusted life years (DALYs) for 257 diseases and injuries in Ethiopia, 1990\u20132015: findings from the global burden of disease study 2015. Popul Health Metr. 2017;15. https:\/\/doi.org\/10.1186\/s12963-017-0146-0.","DOI":"10.1186\/s12963-017-0146-0"},{"key":"15141_CR6","doi-asserted-by":"publisher","first-page":"1990","DOI":"10.1016\/j.injury.2015.10.036","volume":"47","author":"L Chokotho","year":"2016","unstructured":"Chokotho L, Jacobsen KH, Burgess D, et al. A review of existing trauma and musculoskeletal impairment (TMSI) care capacity in East, Central, and Southern Africa. Injury. 2016;47:1990\u20135. https:\/\/doi.org\/10.1016\/j.injury.2015.10.036.","journal-title":"Injury"},{"key":"15141_CR7","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.3233\/HAB-190363","volume":"27","author":"AA Gebru","year":"2019","unstructured":"Gebru AA, Mosadeghrad AM, Sari AA, et al. Prevalence, pattern, magnitude and associated factors of trauma in the Emergency Department at Health Institutes in Ethiopia: A systematic review. Hum Antibodies. 2019;27:S1\u201310. https:\/\/doi.org\/10.3233\/HAB-190363.","journal-title":"Hum Antibodies"},{"key":"15141_CR8","doi-asserted-by":"publisher","first-page":"926","DOI":"10.1186\/s12889-020-08944-7","volume":"20","author":"A Anteneh","year":"2020","unstructured":"Anteneh A, Endris BS. Injury related adult deaths in Addis Ababa, Ethiopia: analysis of data from verbal autopsy. BMC Public Health. 2020;20:926. https:\/\/doi.org\/10.1186\/s12889-020-08944-7.","journal-title":"BMC Public Health"},{"key":"15141_CR9","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1016\/j.afjem.2020.01.001","volume":"10","author":"AD Laytin","year":"2020","unstructured":"Laytin AD, Seyoum N, Kassa S, et al. Patterns of injury at an Ethiopian referral hospital: Using an institutional trauma registry to inform injury prevention and systems strengthening. Afr J Emerg Med. 2020;10:58. https:\/\/doi.org\/10.1016\/j.afjem.2020.01.001.","journal-title":"Afr J Emerg Med"},{"key":"15141_CR10","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1016\/j.aogh.2016.04.044","volume":"82","author":"S Carpenter","year":"2016","unstructured":"Carpenter S, Chin R, Felipe N, et al. Assessing barriers to accessing surgical care in Ethiopia: a provider perspective. Ann Glob Health. 2016;82:345. https:\/\/doi.org\/10.1016\/j.aogh.2016.04.044.","journal-title":"Ann Glob Health"},{"key":"15141_CR11","doi-asserted-by":"publisher","first-page":"1007308","DOI":"10.3389\/fpubh.2022.1007308","volume":"10","author":"HE Hareru","year":"2022","unstructured":"Hareru HE, Negassa B, Kassa Abebe R, et al. The epidemiology of road traffic accidents and associated factors among drivers in Dilla Town, Southern Ethiopia. Front Public Health. 2022;10:1007308. https:\/\/doi.org\/10.3389\/fpubh.2022.1007308.","journal-title":"Front Public Health"},{"key":"15141_CR12","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.surge.2021.10.001","volume":"20","author":"T Quene","year":"2022","unstructured":"Quene T, Mac, Bust L, Louw J, et al. Global surgery is an essential component of global health. Surgeon. 2022;20:9\u201315. https:\/\/doi.org\/10.1016\/j.surge.2021.10.001.","journal-title":"Surgeon"},{"key":"15141_CR13","unstructured":"Federal Ministry of Health. Ethiopia National Health Accounts Report 2019\/20."},{"key":"15141_CR14","doi-asserted-by":"publisher","first-page":"e001453","DOI":"10.1136\/tsaco-2024-001453","volume":"9","author":"N Starr","year":"2024","unstructured":"Starr N, Ayehu M, Zhuang A, et al. Review of a large trauma registry in Addis Ababa, Ethiopia: insights into prehospital care and provider training for trauma quality improvement. Trauma Surg Acute Care Open. 2024;9:e001453. https:\/\/doi.org\/10.1136\/tsaco-2024-001453.","journal-title":"Trauma Surg Acute Care Open"},{"key":"15141_CR15","doi-asserted-by":"publisher","first-page":"185","DOI":"10.4314\/mmj.v36i3.5","volume":"36","author":"KJ Agarwal-Harding","year":"2024","unstructured":"Agarwal-Harding KJ, Mody K, Amlani L, et al. Technical Priorities for Orthopaedic Trauma Care Development in Malawi. Malawi Med J. 2024;36:185\u2013207. https:\/\/doi.org\/10.4314\/mmj.v36i3.5.","journal-title":"Malawi Med J"},{"key":"15141_CR16","doi-asserted-by":"publisher","unstructured":"Levac D, Colquhoun H, O'Brien KK. Scoping studies: advancing the methodology. Implement Sci. 2010;5. https:\/\/doi.org\/10.1186\/1748-5908-5-69.","DOI":"10.1186\/1748-5908-5-69"},{"key":"15141_CR17","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1080\/1364557032000119616","volume":"8","author":"H Arksey","year":"2005","unstructured":"Arksey H, O\u2019Malley L. Scoping studies: Towards a methodological framework. Int J Social Res Methodology: Theory Pract. 2005;8:19\u201332. https:\/\/doi.org\/10.1080\/1364557032000119616.","journal-title":"Int J Social Res Methodology: Theory Pract"},{"key":"15141_CR18","doi-asserted-by":"publisher","first-page":"3038","DOI":"10.1007\/s00268-017-4271-5","volume":"41","author":"D Burssa","year":"2017","unstructured":"Burssa D, Teshome A, Iverson K, et al. Safe Surgery for All: Early Lessons from Implementing a National Government-Driven Surgical Plan in Ethiopia. World J Surg. 2017;41:3038\u201345. https:\/\/doi.org\/10.1007\/s00268-017-4271-5.","journal-title":"World J Surg"},{"key":"15141_CR19","unstructured":"Health m. of national surgical care strategic plan: saving lives through safe surgery II (SaLTS II) 2021\u20132025. Published Online First: 2022."},{"key":"15141_CR20","unstructured":"Ministry of Health, Health Service Quality Directorate; Armauer Hansen Research Institute. Evaluation of the Five-Year National Safe Surgical Care Strategy and the Saving Lives Through Safe Surgery (SaLTS I) Program in Ethiopia (2016\u20132020): A Nationwide Evaluation. Addis Ababa (Ethiopia): Ministry of Health; 2021."},{"key":"15141_CR21","doi-asserted-by":"publisher","first-page":"S50","DOI":"10.1016\/j.afjem.2020.09.006","volume":"10","author":"T Firew","year":"2020","unstructured":"Firew T, Gebreyesus A, Woldeyohannes L, et al. Human resources for emergency care systems in Ethiopia: Challenges and triumphs. Afr J Emerg Med. 2020;10:S50. https:\/\/doi.org\/10.1016\/j.afjem.2020.09.006.","journal-title":"Afr J Emerg Med"},{"key":"15141_CR22","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1186\/s12913-025-12611-1","volume":"25","author":"EM Goshu","year":"2025","unstructured":"Goshu EM, Manyisa ZM. Trauma team members\u2019 perceptions of the effectiveness of the current trauma care system in Addis Ababa, Ethiopia: a phenomenological study. BMC Health Serv Res. 2025;25:472. https:\/\/doi.org\/10.1186\/s12913-025-12611-1.","journal-title":"BMC Health Serv Res"},{"key":"15141_CR23","doi-asserted-by":"publisher","first-page":"3195","DOI":"10.1016\/j.injury.2022.06.047","volume":"53","author":"S Hailu","year":"2022","unstructured":"Hailu S, Gebre H, Alemayehu G. Orthopaedic injury patterns at a tertiary referral hospital in Ethiopia: a prospective observational study. Injury. 2022;53:3195\u2013200. https:\/\/doi.org\/10.1016\/j.injury.2022.06.047.","journal-title":"Injury"},{"key":"15141_CR24","unstructured":"Hailu S, Gebreyohanes M. Prevalence of delayed presentation of open long bone fracture patients at two Ethiopian tertiary hospitals. Ethiop Med J. 2020. https:\/\/emjema.org\/index.php\/EMJ\/article\/view\/1806\/670 (accessed 24 March 2026)."},{"key":"15141_CR25","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1016\/S0140-6736(15)60160-X","volume":"386","author":"JG Meara","year":"2015","unstructured":"Meara JG, Leather AJM, Hagander L, et al. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet. 2015;386:569\u2013624. https:\/\/doi.org\/10.1016\/S0140-6736(15)60160-X.","journal-title":"Lancet"},{"key":"15141_CR26","doi-asserted-by":"publisher","first-page":"26","DOI":"10.29245\/2767-5130\/2024\/2.1200","volume":"5","author":"A Misganaw","year":"2024","unstructured":"Misganaw A, Belay W, Hailu G, et al. Prevalence and Associated Factors of Nonunion in Open Tibial Shaft Fracture among Patients Treated with External Fixation in Tibebe Ghion Specialized Hospital. J Orthop Orthop Surg. 2024;5:26\u201333.","journal-title":"J Orthop Orthop Surg"},{"key":"15141_CR27","doi-asserted-by":"publisher","first-page":"4","DOI":"10.4314\/ecajs.v28i1.2","volume":"28","author":"MR Askew","year":"2024","unstructured":"Askew MR, Hinchman C, Rayel IM, et al. The continued role of traditional bonesetters in East and West Africa: An expert consensus statement. East Cent Afr J Surg. 2024;28:4\u20139. https:\/\/doi.org\/10.4314\/ecajs.v28i1.2.","journal-title":"East Cent Afr J Surg"},{"key":"15141_CR28","doi-asserted-by":"publisher","first-page":"205031212311611","DOI":"10.1177\/20503121231161191","volume":"11","author":"B Mulualem","year":"2023","unstructured":"Mulualem B, Belay G, Bogale EK. Magnitude of chronic osteomyelitis and its associated factors in children as diagnosed on X-ray visiting at Felege Hiwot Comprehensive Specialized Hospital, Northwest Ethiopia: A cross-sectional study. SAGE Open Med. 2023;11:20503121231161190. https:\/\/doi.org\/10.1177\/20503121231161191.","journal-title":"SAGE Open Med"},{"key":"15141_CR29","unstructured":"Biruk WL, Wubshet K. Chronic osteomyelitis at Tikur Anbessa Hospital, Addis Ababa University, Ethiopia. East Cent Afr J Surg. 2007."},{"key":"15141_CR30","doi-asserted-by":"publisher","unstructured":"Abayneh HB, Danielsen SO, Halvorsen K, Engebretsen S. Injury characteristics and mortality in an emergency department in Ethiopia: a single-center observational study. BMC Emerg Med. 2024;24. https:\/\/doi.org\/10.1186\/S12873-024-01017-7.","DOI":"10.1186\/S12873-024-01017-7"},{"key":"15141_CR31","doi-asserted-by":"publisher","first-page":"e031525","DOI":"10.1136\/BMJOPEN-2019-031525","volume":"9","author":"N Starr","year":"2019","unstructured":"Starr N, Carpenter S, Carvalho M, et al. Diagnosis and management of surgical disease at Ethiopian health centres: cross-sectional survey of resources and barriers to care. BMJ Open. 2019;9:e031525. https:\/\/doi.org\/10.1136\/BMJOPEN-2019-031525.","journal-title":"BMJ Open"},{"key":"15141_CR32","doi-asserted-by":"publisher","unstructured":"Mengesha MG, Vella C, Adem EG, et al. Use of a trauma registry to drive improvement in the regional trauma network systems in Hawassa, Ethiopia. Eur J Orthop Surg Traumatol. 2023;33(3):541-546. https:\/\/doi.org\/10.1007\/s00590-022-03410-z.","DOI":"10.1007\/s00590-022-03410-z"},{"key":"15141_CR33","doi-asserted-by":"publisher","unstructured":"Meshesha BR, Sibhatu MK, Beshir HM, et al. Access to surgical care in Ethiopia: a cross-sectional retrospective data review. BMC Health Serv Res. 2022;22:973. https:\/\/doi.org\/10.1186\/s12913-022-08357-9.","DOI":"10.1186\/s12913-022-08357-9"},{"key":"15141_CR34","doi-asserted-by":"publisher","first-page":"e217","DOI":"10.1097\/BOT.0000000000000826","volume":"31","author":"PS Whiting","year":"2017","unstructured":"Whiting PS, Anderson DR, Galat DD, et al. State of Pelvic and Acetabular Surgery in the Developing World: A Global Survey of Orthopaedic Surgeons at Surgical Implant Generation Network (SIGN) Hospitals. J Orthop Trauma. 2017;31:e217\u201323. https:\/\/doi.org\/10.1097\/BOT.0000000000000826.","journal-title":"J Orthop Trauma"},{"key":"15141_CR35","unstructured":"C-arm for better operative fracture care in Hawassa, Ethiopia, Alliance AO. https:\/\/ao-alliance.org\/c-arm-for-better-operative-fracture-care-in-hawassa-ethiopia\/. (accessed 29 March 2026)."},{"key":"15141_CR36","doi-asserted-by":"publisher","first-page":"2083","DOI":"10.2106\/JBJS.22.00333","volume":"104","author":"S Hailu","year":"2022","unstructured":"Hailu S, Leulseged A, Lemma S. Patient-Reported Outcome Measures for Acetabular Fractures Treated Operatively without a C-Arm in Ethiopia. J Bone Joint Surg Am. 2022;104:2083\u201394. https:\/\/doi.org\/10.2106\/JBJS.22.00333.","journal-title":"J Bone Joint Surg Am"},{"key":"15141_CR37","unstructured":"Teferi B, Lambisso B, Tessema G, et al. Assessment of negative pressure wound therapy follow-up and report initiative in Tikur Anbessa Specialized Hospital. Ethiop Med J. 2020;58."},{"key":"15141_CR38","doi-asserted-by":"publisher","unstructured":"Amlani L, Ndasi H, Aminake G, et al. The utility of low-cost negative pressure wound therapy in Cameroon. Pan Afr Med J. 2024;48. https:\/\/doi.org\/10.11604\/pamj.2024.48.151.39732.","DOI":"10.11604\/pamj.2024.48.151.39732"},{"issue":"Suppl 10","key":"15141_CR39","doi-asserted-by":"publisher","first-page":"S37","DOI":"10.1097\/bot.0000000000000411","volume":"29","author":"BT Haonga","year":"2015","unstructured":"Haonga BT, Zirkle LG. The SIGN Nail: Factors in a Successful Device for Low-Resource Settings. J Orthop Trauma. 2015;29(Suppl 10):S37\u20139. https:\/\/doi.org\/10.1097\/bot.0000000000000411.","journal-title":"J Orthop Trauma"}],"container-title":["BMC Health Services Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12913-026-15141-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-026-15141-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-026-15141-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:07:43Z","timestamp":1791418063000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12913-026-15141-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,14]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["15141"],"URL":"https:\/\/doi.org\/10.1186\/s12913-026-15141-6","relation":{},"ISSN":["1472-6963"],"issn-type":[{"value":"1472-6963","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,14]]},"assertion":[{"value":"27 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was approved by the Institutional Review Board (IRB) of Addis Ababa University (Protocol #: 053\/23\/Ortho) on August 16th, 2023, and was deemed exempt from full review. Since the study involved a voluntary survey of orthopaedic surgeons and did not utilize patient data, the need for formal written informed consent was waived by the IRB. Completion and submission of the survey were considered as providing informed consent to participate. Research was conducted in accordance with the principles of the Declaration of Helsinki and local statutory requirements.","order":1,"name":"Ethics","label":"Ethical approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"N\/A.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"1367"}}