CHALLENGES OF DELIVERING CRITICAL CARE IN LOW-RESOURCE SETTINGS

Abstract

Critical illness presents a significant global burden and highlights pronounced disparities in health care delivery. Critical care is generally defined as the specialized care of patients with life-threatening injuries and illnesses; it encompasses the identification, monitoring, and treatment of patients with critical conditions (A. Spencer et al., 2023). Patients who require intensive care management often necessitate enhanced monitoring and multidisciplinary treatment by specialists and subspecialists—services that are typically provided only in tertiary care centres in high-income countries (HICs). Critical care is typically delivered in a dedicated physical location, an intensive care unit (ICU), which is linked to emergency departments, operating theatres, and specialist consulting services for other subspecialties.

Intensive care units in low- and middle-income countries (LMICs) are often limited to central referral or major private hospitals in urban areas, despite a much greater burden of critical illness in these regions. Developing stable healthcare infrastructure to support critical care thus represents a major challenge in LMICs. Low-resource settings are characterized by inadequate access to essential medicines and equipment, laboratory support, clean water, reliable power, and consequently trained healthcare staff capable of delivering comprehensive intensive care services. These challenges extend to all aspects of critical care delivery, including workforce training, healthcare infrastructure, medication availability, patient comorbidities, emergency and prehospital services, and ethical considerations surrounding futility and informed consent; innovative solutions to some of these problems are also available.