Critical care in sub-Saharan Africa, where are we? A review

Critical care services in sub-Saharan Africa have not gained much grounds despite becoming part of modern clinical practice in the 1950s. Managing patients with potentially recoverable illnesses and injuries is still not at par with evidence-based practices in developed climes, and most die from many preventable causes. Many hospitals in Africa do not have an intensive care unit, leaving critically ill patients being treated mostly in the general wards. A survey from Zambia indicated that only 7% of hospitals in the country have an intensive care unit, whereas a cross-sectional survey in Nigeria revealed that there were 30 public and private intensive care units serving a population of over 200 million, spread around all the geo-political zones, with most in the teaching hospitals. The situation is not generally better in most parts of the continent. This review focuses on why critical care is at the level it is in sub-Saharan Africa and provides suggestions on what should be done to change the narrative.