Patient safety

Two African countries participate in a study to measure the incidence of harmful incidents in hospitals.

The challenges of conducting research and assessing harm in developing and transitional countries are many, which is why most of the studies conducted to estimate the incidence of harmful incidents originate in high-income countries. Little has been known until now about the reality of unsafe care in other less developed regions. For this reason, WHO Patient Safety conducted, from 2006 to 2008, a large-scale study involving 26 hospitals in six countries from the Eastern Mediterranean and two African countries, South Africa and Kenya. In total, the hospital experiences of more than 18 000 patients were examined in the two regions.

The countries participating in the study showed responsibility and commitment to improve the safety of their patients even if unveiling the magnitude of the problem and identifying the characteristics of unsafe care also meant exposing possible imperfections in the delivery of health care within their health systems. Yet it is the first necessary step in the path towards patient safety improvement.

The objective of the study was not to compare countries or regions. Instead, it was to obtain broad-based data on the magnitude of patient harm, the most frequent harmful incidents and their severity, when they had occurred, what their causes were, and their preventability, as well as contributing factors.

The results of the studies may not be generalizable beyond the participating hospitals, given that these hospitals were not a representative sample of all hospitals in the regions. However, for the first time, we have data which cannot be ignored about the reality of these countries' health systems which represent an urgent appeal to improve patient safety in developing and transitional countries more generally. Furthermore, the studies have demonstrated that some of the classical tools for measuring harm in hospital settings, which rely on good record-keeping, can be adapted and used to measure adverse events in developing countries, as long as a minimum amount of information is available in the medical records. The lack of adequate tools had been a major limitation up to now for conducting this type of study in data-poor settings.

In addition to providing pioneering results and contributing to fuller answers to the most pressing questions, the study contributed to local awareness-raising and capacity-building and helped the participating countries evaluate their situations and set a baseline for improvement. The results of this study will soon be published.