Healthcare workers’ knowledge about essential emergency and critical care in primary health care in Tanzania

Background Tanzania has recently introduced a national strategy for the provision of essential emergency and critical care (EECC) to all critically ill patients in the country. EECC is a simple and cost-effective approach for reducing mortality from critical illness, however, gaps in its provision remain, particularly in primary healthcare (PHC) facilities. Healthcare workers (HCWs) need to have adequate knowledge to be able to deliver EECC, but the baseline knowledge levels are unknown. Methods We conducted a cross-sectional analysis of EECC knowledge scores among acute HCWs from PHC facilities—comprising district hospitals, health centers and dispensaries in five regions of Tanzania and Zanzibar. Knowledge was assessed using a tool covering the foundational identification and treatment of critical illness that comprises EECC. Descriptive statistics were computed and results were described across subgroups stratified by cadre, facility level and years of professional experience. Results The mean EECC knowledge score among HCWs was 31% (95% CI: 30–32). Knowledge score for the identification of critical illness was 19% and treatment was 32%. Medical doctors had mean knowledge scores of 44%, clinical officers 32% and nurses 29%. HCWs working in dispensaries, health centers and district hospitals scored 26%, 32%, and 31% respectively. No correlation was found between knowledge scores and years of professional experience in clinical care, nor in the critical care fields. Conclusion HCWs in PHC facilities have a low level of knowledge about essential emergency and critical care. This is likely a significant barrier for the provision of effective EECC. The findings support prioritizing strategies to improve EECC knowledge as one component of improving care to critically ill patients.