Malawi: Impact Evaluation of Emergency Response and Post-Crash Care in Malawi and Tanzania DDI_MWI_2018-2021_ERPCCIE_v01_M_WB Development Economics Data Group 2023-04-05 Metadata Editor Version 01 (April 2023) MWI_2018-2021_ERPCCIE_v01_M Impact Evaluation of Emergency Response and Post-Crash Care 2018-2021 ERPCCIE 2018-2021 Sveta Milusheva Kevin Croke Saahil Karpe Linda Chokotho Wakisa Mulwafu Jonna Bertfelt Meyhar Mohammed 2022-04-15 Development Impact Evaluation Global Road Safety Facility AO Alliance Research Support Budget in the Development Economics Vice-Presidency of the World Bank UK Aid Metadata Editor Sveta Milusheva Jonna Bertfelt Meyhar Mohammed Other Household Health Survey [hh/hea] v01: Edited, anonymous dataset for public distribution Transportation, Roads, Infrastructure 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. Malawi 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 event Trauma cases that presented themselves to the facilities. Event/transaction data [evn] 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. Health facility staff, working in the facilities Computer Assisted Personal Interview [capi] The questionnaire is provided in English and is available for download. 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. Cleaning of time variables, cleaning of categories based on information entered in "Other." World Bank Microdata Library Development Impact Evaluation (DIME) Sveta Milusheva Licensed access 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. mw_trauma_nopii.dta 115421 89 .dta Trauma Level Dataset v01 Unique project ID 115421 Which hospital is this? 115421 Balaka District Hospital 14822 Dedza District Hospital 7317 Dowa District Hospital 8641 Kasungu District Hospital 11598 Lisungwi Community Hospital 2966 Mzimba District Hospital 18473 Mzuzu Central Hospital 9201 Ntcheu District Hospital 11978 Queen Elizabeth Central Hospital 15489 Rumphi District Hospital 14936 Was the patient transferred here from other facility? 115421 0 1 0 No 98647 1 Yes 16774 What is the patients gender? 115403 18 1 2 1 Male 75741 2 Female 39662 Sysmiss 18 What is the highest level of education for this patient? 98184 17237 1 99 1 None 4028 2 Primary 58966 3 Secondary 30369 4 College / University 2955 77 Unknown 1828 99 Other 38 Sysmiss 17237 In what region does the patient reside? 115421 18 77 638 CR 41829 NR 42551 SR 30385 In what district does the patient reside? 115421 656 Balaka 11223 Blantyre 15031 Chikwawa 70 Chiradzulu 282 Chitipa 72 Dedza 6592 Dowa 8492 Karonga 141 Kasungu 11360 Likoma 12 Lilongwe 362 Lilongwe City 190 Machinga 66 Mangochi 341 Mchinji 41 Mulanje 86 Mwanza 41 Mzimba 30309 Neno 2780 Nkhata Bay 647 Nkhotakota 25 Nsanje 42 Ntcheu 14617 Ntchisi 87 Phalombe 15 Rumphi 11370 Salima 63 Thyolo 221 Zomba 187 What was the cause of injury? 115403 18 1 99 1 Road Traffic Accident (RTA) 17827 2 Fall 61365 3 Blunt trauma 14561 4 Stab / Cut (penetrating wound) 10216 5 Gunshot 0 6 Blast 0 7 Burn 0 8 Drowning 0 9 Bite 7419 10 Lightning 0 11 Foreign body 0 77 Unknown 0 99 Other 4015 Sysmiss 18 What was the intent of the trauma? 115268 153 1 99 1 Unintentional / Accidental 99760 2 Self inflicted (patient hurt themselves deliberately) 1711 3 Assault 13534 77 Unknown 128 99 Other 135 Sysmiss 153 What was the gender of the perpetrator? 10537 104884 1 2 1 Male 8892 2 Female 1645 Sysmiss 104884 In what setting did the accident happen? 115268 153 1 99 1 On the Road 23658 2 At Work 6200 3 At Home 67472 4 In school 4124 5 During Leisure / sport 6982 6 Public space (in- or outside) 6396 77 Unknown 103 99 Other 333 Sysmiss 153 What type of fall was this? 57017 58404 1 4 1 Walking/running 45603 2 Height 10951 3 Unknown 29 4 Other 434 Sysmiss 58404 In what region did the trauma happen? 115421 156 77 624 CR 42036 NR 42423 SR 30182 In what district did the trauma happen? 115421 780 Balaka 11436 Blantyre 14943 Chikwawa 56 Chiradzulu 207 Chitipa 40 Dedza 6621 Dowa 8548 Karonga 100 Kasungu 11474 Likoma 5 Lilongwe 135 Lilongwe City 21 Machinga 42 Mangochi 302 Mchinji 9 Mulanje 54 Mwanza 33 Mzimba 30225 Neno 2822 Nkhata Bay 634 Nkhotakota 22 Nsanje 32 Ntcheu 15119 Ntchisi 70 Phalombe 13 Rumphi 11419 Salima 17 Thyolo 170 Zomba 72 Was the patient under influence of alcohol or other drugs? 115268 153 0 77 0 No 109585 1 Yes (Confirmed) 4151 2 Suspected 1411 77 Unknown 121 Sysmiss 153 What was the patient's mode of transport from crash site to first health care fa 2774 112647 0 99 0 Minibus (Public Transport) 267 1 Bus 18 2 Motorcycle 581 3 Bicycle 519 4 Private Vehicle 605 5 Ambulance 142 6 Walked 131 7 Commercial Vehicle (incl. Taxi) 323 8 Police 44 9 Lorry 100 10 Oxcart 33 77 Unknown 8 99 Other 3 Sysmiss 112647 How can the area where the accident happened best be described? 17685 97736 1 88 1 Rural 10684 2 Urban 5092 3 Semi Urban 1857 77 Unknown 36 88 Don't know 16 Sysmiss 97736 What type of vehicle was the patient in at the time of the accident? 4186 111235 1 99 1 Private vehicle (motorized) 1780 2 Public transit vehicle (minibus/ Taxi) 1549 3 Truck or other Commercial vehicle 688 4 Long distance bus 121 77 Unknown 17 99 Other 31 Sysmiss 111235 What did the patient collide with, at the time of the accident? 4186 111235 1 99 1 Private vehicle (motorized) 893 2 Public transit vehicle 614 3 Truck or other Commercial vehicle 426 4 Bicycle 50 5 Motorbike 86 7 A non-moving object (e.g. a tree) 111 11 Nothing, this was a single vehicle crash due to vehicle failure 1321 12 Nothing, this a single vehicle crash due to external factors such as bad road, b 605 77 Unknown 29 99 Other 51 Sysmiss 111235 What was the pedestrian hit by? 3830 111591 1 99 1 Private vehicle (motorized) 1344 2 Public transit vehicle 818 3 Truck or other Commercial vehicle 263 4 Bicycle 565 5 Motorbike 745 8 Ox cart 26 77 Unknown 23 99 Other 40 6 Missing (roleonroad – pedestrian) 6 Sysmiss 111591 What was the cyclist hit by/ hit? 3529 111892 1 99 1 Private vehicle (motorized) 279 2 Public transit vehicle 190 3 Truck or other Commercial vehicle 128 4 Bicycle 650 5 Motorbike 333 7 A non-moving object (e.g. a tree) 69 8 An animal 49 9 Oxcart 16 11 Nothing, this was a single bicycle crash due to bicycle failure 1430 12 Nothing, this a single bicycle crash due to external factors such as bad road, b 353 77 Unknown 7 99 Other 25 Sysmiss 111892 What was the motocyclist hit by /hit? 3123 112298 1 99 1 Private vehicle (motorized) 339 2 Public transit vehicle 208 3 Truck or other Commercial vehicle 124 4 Bicycle 210 5 Motorbike 774 7 A non-moving object (e.g. a tree) 162 11 Nothing, this was a single vehicle crash due to vehicle failure 697 12 Nothing, this a single vehicle crash due to external factors such as bad road, b 422 77 Unknown 41 99 Other 146 Sysmiss 112298 What was the oxcart driver or passanger hit by/ hit? 302 115119 1 99 1 Private vehicle (motorized) 16 2 Public transit vehicle 31 3 Truck or other Commercial vehicle 12 4 Bicycle 1 5 Motorbike 4 7 A non-moving object (e.g. a tree) 25 11 Nothing, this was a single vehicle crash due to vehicle failure 71 12 Nothing, this a single vehicle crash due to external factors such as bad road, b 99 77 Unknown 15 99 Other 28 Sysmiss 115119 Was the patient wearing a helmet at the time of the accident? 7235 108186 0 2 0 No 5757 1 Yes 1347 2 Don't know / Unknown 131 Sysmiss 108186 Was the patient wearing a seatbelt at the time of the accident? 5225 110196 0 2 0 No 4136 1 Yes 873 2 Don't know / Unknown 216 Sysmiss 110196 Heart rate day 1 102319 13102 2 198 Temperture day 1 108190 7231 0.769999980926514 135 Blood pressure day 1 91125 24296 4 232 Respiratory rate day 1 109441 5980 1 136 AVPU score day 1 115223 198 1 4 1 Unresponsive 141 2 Responds to pain 2839 3 Responds to voice 1642 4 Alert 110601 Sysmiss 198 GCS day 1 - eye 100124 15297 -77 4 -77 86 1 184 2 4027 3 862 4 94965 Sysmiss 15297 GCS day 1 - voice 100124 15297 -77 5 -77 85 1 174 2 1611 3 2357 4 1638 5 94259 Sysmiss 15297 GCS day 1 - motor 100124 15297 -77 6 -77 85 1 285 2 1729 3 736 4 1737 5 2605 6 92947 Sysmiss 15297 GCS day 1 100124 15297 -231 15 -231 84 -151 1 -68 1 -66 1 3 64 4 29 5 180 6 854 7 1091 8 322 9 1379 10 216 11 209 12 398 13 1137 14 2761 15 91397 Sysmiss 15297 Best verbal response 13550 101871 -77 2 -77 100 0 644 1 828 2 11978 Sysmiss 101871 Best motor response 13550 101871 -77 2 -77 105 0 429 1 1403 2 11613 Sysmiss 101871 Best eye response 13550 101871 -77 1 -77 109 0 559 1 12882 Sysmiss 101871 Is this an open or closed fracture? 36677 78744 1 2 1 Open fracture 891 2 Closed fracture 35786 Sysmiss 78744 Where is the injury located? 115241 180 1 99 1 Head and neck injury (incl. cervical spine) 6975 2 Face injury (incl. facial skeleton, nose, mouth, eyes and ears) 8161 3 Thorax injury (incl. chest injuries to rib cage, thoracic spine and diaphragm) 2707 4 Abdomen injury (incl. abdominal organs and lumbar spine) 1420 5 Extremities injury (incl. Limbs and pelvic skeleton - sprains, fractures, disloc 87932 6 External injury (incl. injuries such as lacerations, contusions, burns, hypother 7138 77 Unknown 84 99 Other 824 Sysmiss 180 Is this a serious injury? 115421 0 1 0 No 107132 1 Yes 8289 Pain level day 1 114948 473 1 5 1 None 313 2 Mild 51224 3 Moderate 57077 4 Severe 6066 5 Extreme 268 Sysmiss 473 What was the patients outcome at casualty department? On the day of arrival. 115376 45 1 99 1 Treated and sent home 107297 2 Admitted to hospital ward 7335 3 Taken to operating theatre 110 4 Taken to intensive care /High Dependency Unit 42 5 Died (in casualty department) 95 6 Referred to another hospital 432 7 Dead on arrival 0 8 Quarantined 1 99 Other 64 Sysmiss 45 Is the patient still in the hospital? 6388 109033 0 2 0 No 2587 1 Yes 3755 2 Don't know / Unknown 46 Sysmiss 109033 Heart rate day 2 3755 111666 -77 166 Temperture day 2 3755 111666 -77 136.199996948242 Blood pressure day 2 3755 111666 -77 243 Respiratory rate day 2 3755 111666 -77 120 -77 172 12 28 13 6 14 48 15 31 16 390 17 149 18 758 19 241 20 1072 21 82 22 269 23 42 24 193 25 29 26 47 27 17 28 88 29 10 30 25 31 2 32 14 34 4 35 7 36 3 37 2 38 1 39 1 40 4 41 1 46 3 48 1 49 1 52 1 61 1 64 2 69 1 77 1 79 1 80 1 86 1 88 2 89 1 90 1 120 1 Sysmiss 111666 AVPU score day 2 3696 111725 1 4 1 Unresponsive 4 2 Responds to pain 144 3 Responds to voice 55 4 Alert 3493 Sysmiss 111725 GCS day 2 - eye 3286 112135 -77 4 -77 1 1 4 2 31 3 50 4 3200 Sysmiss 112135 GCS day 2 - voice 3286 112135 1 5 1 6 2 16 3 19 4 62 5 3183 Sysmiss 112135 GCS day 2 - motor 3286 112135 1 6 1 13 2 4 3 7 4 17 5 62 6 3183 Sysmiss 112135 GCS day 2 1 115420 -77 -77 -77 1 Sysmiss 115420 Best verbal response 424 114997 -77 2 -77 1 0 2 1 10 2 411 Sysmiss 114997 Best motor response 424 114997 -77 2 -77 1 0 1 1 14 2 408 Sysmiss 114997 Best eye response 424 114997 -77 1 -77 1 0 2 1 421 Sysmiss 114997 Pain level day 2 3745 111676 1 5 1 None 15 2 Mild 1308 3 Moderate 1933 4 Severe 485 5 Extreme 4 Sysmiss 111676 Which body part was treated? 115421 111969 1 358 1 2 13 1 2 3 1 1 2 3 4 5 1 1 2 5 5 1 2 6 1 1 3 4 1 3 5 3 1 3 6 1 1 4 4 1 5 24 1 6 15 2 169 2 3 1 2 3 5 1 2 3 99 1 2 4 2 2 4 5 1 2 5 20 2 5 6 2 2 6 4 3 132 3 4 3 3 4 5 1 3 5 4 3 5 6 2 3 6 2 4 115 4 5 6 4 6 2 5 2294 5 6 28 5 7 1 5 99 1 6 159 6 99 1 7 56 77 1 99 13 Head and neck injury (incl. cervical spine) 3755 111666 0 1 0 3325 1 430 Sysmiss 111666 Face injury (incl. facial skeleton, nose, mouth, eyes and ears) 3755 111666 0 1 0 3533 1 222 Sysmiss 111666 Thorax injury (incl. chest injuries to rib cage, thoracic spine and diaphragm) 3755 111666 0 1 0 3598 1 157 Sysmiss 111666 Abdomen injury (incl. abdominal organs and lumbar spine) 3755 111666 0 1 0 3620 1 135 Sysmiss 111666 Extremities injury (incl. Limbs and pelvic skeleton - sprains, fractures, dislo 3755 111666 0 1 0 1361 1 2394 Sysmiss 111666 External injury (incl. injuries such as lacerations, contusions, burns, hypother 3755 111666 0 1 0 3538 1 217 Sysmiss 111666 None 3755 111666 0 1 0 3698 1 57 Sysmiss 111666 Unknown 3755 111666 0 1 0 3754 1 1 Sysmiss 111666 Other 3755 111666 0 1 0 3739 1 16 Sysmiss 111666 EMS Pilot facility (==1) 115421 Control 62849 EMS Pilot Facility 52572 Central/District facility 115421 Central 24690 District 90731 Mode of transport 115293 128 1 4 1 Public Transport 47704 2 Private Transport 43496 3 Walking 20456 4 Ambulance 3637 Sysmiss 128 Age cateogry 115421 Child (8-15 years) 18421 Early Working Age (15-24 years) 26286 Elderly (55 + years) 7430 Infant (0-7 years) 20355 Prime Working Age (25-54 years) 42929 Year of trauma 115421 2014 2021 2014 1 2017 1 2018 12714 2019 49409 2020 39119 2021 14177 Month of trauma 115404 17 1 35 1 August'18 1515 2 Sept'18 2517 3 Oct'18 2579 4 Nov'18 2898 5 Dec'18 3205 6 Jan'19 3271 7 Feb'19 3205 8 Mar'19 3813 9 Apr'19 3720 10 May'19 4076 11 Jun'19 4138 12 Jul'19 4334 13 Aug'19 4382 14 Sep'19 4056 15 Oct'19 4824 16 Nov'19 4816 17 Dec'19 4774 18 Jan'20 4494 19 Feb'20 3798 20 Mar'20 4161 21 Apr'20 2646 22 May'20 3092 23 June'20 3076 24 July'20 2768 25 Aug'20 2747 26 Sep'20 2890 27 Oct'20 3020 28 Nov'20 3276 29 Dec'20 3151 30 Jan'21 2383 31 Feb'21 2123 32 Mar'21 2544 33 Apr'21 2567 34 May'21 2419 35 Jun'21 2126 Sysmiss 17 Day of arrival 115421 1 7 1 Monday 22927 2 Tuesday 19217 3 Wednesday 18078 4 Thursday 18650 5 Friday 18909 6 Saturday 10248 7 Sunday 7392 VS missing variable 115421 0 1 0 At least 1 VS missing 25122 1 VS entred 90299 GCS categorical 100037 15384 1 3 1 GCS between 0 and 5 273 2 GCS between 6 and 10 3862 3 GCS between 11 and 15 95902 Sysmiss 15384 AVPU score 115223 198 1 4 1 141 2 2839 3 1642 4 110601 Sysmiss 198 Kampala Trauma Score 115223 198 6 16 6 3 7 19 8 47 9 135 10 264 11 845 12 5590 13 7345 14 3911 15 23174 16 73890 Sysmiss 198 Occupation categorized 74138 41283 0 5 0 Unemployed 12679 1 Agriculture/manual labor 33856 2 Business/Professional/techical worker 14133 3 Skilled manual labor 0 4 Student 11238 5 Unknown/ other 2232 Sysmiss 41283 Total number of injuries 115421 0 3 0 583 1 99044 2 8048 3 7746 Injury type 114506 915 0 6 0 Contusion 3617 1 Laceration 11334 2 Bite/stab/abrasion/burn 10767 3 Fracture 36677 5 Soft-tissue injury 46868 6 Other 5243 Sysmiss 915 Minutes time difference trauma-arrival to hospital 115402 19 -2103365 3244050 Minutes time difference arrival-attend by doctor 115234 187 -2103757 2103855 Hour of arrival 115403 18 1 6 1 00:00-03:00 hrs 1651 2 04:00-07:00 hrs 15859 3 08:00-11:00 hrs 53464 4 12:00-15:00 hrs 23962 5 16:00-19:00 hrs 14191 6 20:00-23:00 hrs 6276 Sysmiss 18 Hour of trauma 115402 19 1 6 1 00:00-03:00 hrs 2660 2 04:00-07:00 hrs 16209 3 08:00-11:00 hrs 29128 4 12:00-15:00 hrs 28027 5 16:00-19:00 hrs 32440 6 20:00-23:00 hrs 6938 Sysmiss 19 Casualty outcome 115376 45 1 5 1 Treated and sent home 107297 2 Hospitalized 7487 3 Died 95 4 Referred 432 5 Other 65 Sysmiss 45 Hit by consolidated for all role on road 14703 100718 1 7 1 Private vehicle/ truck 3824 2 Public vehicle 1861 3 Bicycle 1476 4 Motorcycle 1942 5 Non-moving object 367 6 Nothing 4828 7 Other 405 Sysmiss 100718 Role on road categorized 17799 97622 1 5 1 Driver/passenger 5225 2 Pedestrian 3831 3 Cyclist 5019 4 Motorcyclist 3231 5 Other 493 Sysmiss 97622 Room 8 entrypoint Queen elizabeth central (==1) 115421 0 1 0 Other 105554 1 Room 8 Queen Elizabeth Central Hospital 9867 Tauma cause: road traffic crash (== 1) 115421 0 1 0 97594 1 17827