Impact Evaluation of Emergency Response and Post-Crash Care 2018-2021
Malawi, 2018 - 2021
Get MicrodataIdentification
MWI_2018-2021_ERPCCIE_v01_M
Impact Evaluation of Emergency Response and Post-Crash Care 2018-2021
ERPCCIE 2018-2021
| Name | Country code |
|---|---|
| Malawi | MWI |
Other Household Health Survey [hh/hea]
The Malawi Emergency Medical Services (EMS) pilot was developed by the Government of Malawi to decrease the burden of road traffic crashes and develop an emergency response along the stretch of Malawi’s largest and busiest road, the M1 highway that runs between Lilongwe and Blantyre. The pilot is funded by the World Bank’s Southern Africa Trade and Transportation Facilitation Program (SATTFP2) and is being implemented by the Ministry of Health. To evaluate the effectiveness of an EMS system, an impact evaluation was developed that used data collected from the trauma registries that were set up as a part of the EMS system. The microdata dataset contains trauma level data from 10 facilities with demographic information of patient, details of trauma, and patient health information for the duration of August 2018 - June 2021.
Please find additional information on the data in the article ‘Implementation of a multi‐center digital trauma registry: Experience in district and central hospitals in Malawi’ in The International Journal of Health Planning and Management.
Event/transaction data [evn]
Trauma event
Version
v01: Edited, anonymous dataset for public distribution
2022-04-15
Scope
The aim of the trauma registry was to collect detailed data on every trauma patient arriving to the health facility in order to understand the circumstances and outcomes of their trauma. This included demographics, information on the trauma, health data collected from the patient, and outcome data from the trauma.
Coverage
115,421 trauma events spread across all 28 districts in Malawi. For more information on geographic coverage, see Figure 7. Geographic Information on Trauma in Malawi in Section IV of the 'Trauma Incidence and Emergency Medical Services in Malawi' report.
District
Trauma cases that presented themselves to the facilities.
Producers and sponsors
| Name | Affiliation |
|---|---|
| Sveta Milusheva | The World Bank Group |
| Kevin Croke | Harvard T.H. Chan School of Public Health |
| Saahil Karpe | Lyft |
| Linda Chokotho | Department of Surgery, College of Medicine, University of Malawi |
| Wakisa Mulwafu | Department of Surgery, College of Medicine, University of Malawi |
| Name | Affiliation | Role |
|---|---|---|
| Jonna Bertfelt | The World Bank Group | Field Coordinator |
| Meyhar Mohammed | The World Bank Group | Consultant |
| Name | Abbreviation |
|---|---|
| Development Impact Evaluation | DIME |
| Global Road Safety Facility | GRSF |
| AO Alliance | |
| Research Support Budget in the Development Economics Vice-Presidency of the World Bank | RSB |
| UK Aid |
Sampling
The EMS pilot was implemented in two central and four district hospitals and includes provision of ambulances, central dispatch system reached by a new emergency number (118) and capacity building of medical personnel in trauma care units. It also includes the building of a trauma registry (TR) to facilitate collection of data on trauma cases, health care provision, and health outcomes.
All the elements of the EMS pilot are being rolled out in six facilities on the southern segment of the M1, linking Lilongwe and Blantyre. Out of the six facilities, one facility already had a well-functioning TR system, so the team set up a TR in five facilities. An additional five facilities were selected for the data collection in the TR as “control” or “comparison” facilities where the intervention was not rolled out, but the trauma data was collected. The five additional facilities were statistically similar to the facilities where the roll-out is going on. The variable “treatment_facility” can identify the facilities which were included for the pilot intervention and control. This dataset contains details of trauma cases from 10 hospitals. The sample of trauma cases are based on the trauma cases that presented themselves to the facilities.
For more information on the sampling procedure, see Section III of the 'Trauma Incidence and Emergency Medical Services in Malawi' report.
Survey instrument
The questionnaire is provided in English and is available for download.
Data collection
| Start | End |
|---|---|
| 2018/08/01 | 2021/06/30 |
- Computer Assisted Personal Interview [capi]
| Name |
|---|
| Health facility staff, working in the facilities |
Weekly monitoring of the incoming trauma data was done. With the help of several different strategies, the quality of the data in the trauma registry improved over time. Improvements in data quality included an increase in monthly capture rates, completeness of important variables and improvements in correctness of data, in terms of outliers and inconsistencies. Data quality was ensured through frequent in-person and digital communication with trauma data collection teams, weekly updates and sharing of an online data dashboard showing results from ongoing data analysis, and through the activities of the team, which conducted ongoing visits and refresher trainings. Even as data quality constantly improved, ongoing supervision was key in both improving and maintaining data quality over time. Three additional activities were extremely important for quality assurance: 1) the digital nature of the data collection, 2) high frequency checks, and 3) data validation.
Over the course of 35 months (August 2018–June 2021) the trauma registry collected detailed data on trauma, trauma care and outcomes from 118,013 patients. For more information on the data collection process, as well as the timeline, see Table 1. Trauma Registry Implementation and Activity Timeline in Section III of the 'Trauma Incidence and Emergency Medical Services in Malawi' report.
During the onset of the COVID-19 pandemic, data collection continued in the facilities but the number of monthly entries declined. For two facilities, Queen Elizabeth Central Hospital (QECH) and Mzuzu Central Hospital – external staff was helping with the trauma registry. In order to prevent risk of COVID spread, two clerks from these facilities stopped working after April 2020 which led to a significant drop in the number of cases collected from these facilities. Data collection stopped in two other facilities – Dedza District Hospital and QECH A&E (pediatric ward of QECH) from July 1, 2020 due to data quality issues which also led to a drop in the total number of cases. The impacts of COVID on the data collection efforts are explained in more detail in Section V of the 'Trauma Incidence and Emergency Medical Services in Malawi' report.
Data processing
Cleaning of time variables, cleaning of categories based on information entered in "Other."
Access policy
World Bank Microdata Library
Depositor information
| Name | Affiliation |
|---|---|
| Meyhar Mohammed | The World Bank Group |
2022-05-03
Data Access
| Name | Affiliation | URL | |
|---|---|---|---|
| Development Impact Evaluation (DIME) | The World Bank Group | https://www.worldbank.org/en/research/dime | dime@worldbank.org |
| Sveta Milusheva | The World Bank Group | smilusheva@worldbank.org |
Licensed access
Use of the dataset must be acknowledged using a citation which would include:
- the identification of the Primary Investigator
- the title of the survey (including country, acronym and year of implementation)
- the survey reference number
- the source and date of download
Example:
Sveta Milusheva (The World Bank Group), Kevin Croke (Harvard T.H. Chan School of Public Health), Saahil Karpe (Lyft), Linda Chokotho (University of Malawi) and Wakisa Mulwafu (University of Malawi). Malawi - Impact Evaluation of Emergency Response and Post-Crash Care 2018-2021. Ref: MWI_2018-2021_ERPCCIE_v01_M. Dataset downloaded from [URL] on [date].
Disclaimer and copyrights
The user of the data acknowledges that the original collector of the data, the authorized distributor of the data, and the relevant funding agency bear no responsibility for use of the data or for interpretations or inferences based upon such uses.
Contacts
| Name | Affiliation | |
|---|---|---|
| Sveta Milusheva | The World Bank Group | smilusheva@worldbank.org |
| Jonna Bertfelt | The World Bank Group | jbertfelt@worldbank.org |
Metadata production
DDI_MWI_2018-2021_ERPCCIE_v01_M_WB
| Name | Abbreviation | Affiliation | Role |
|---|---|---|---|
| Development Economics Data Group | DECDG | The World Bank Group | Documentation of the study |
2023-04-05
Metadata version
Version 01 (April 2023)