• Hadley K H Wesson, Abdulgafoor M Bachani, John Masasabi Wekesa, Joseph Mburu, Adnan A Hyder, and Kent A Stevens.
• Johns Hopkins International Injury Research Unit, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, USA; Department of Surgery, Virginia Commonwealth University Medical Center, 1200 E. Broad Street, Richmond, VA 23219, USA.
• Injury. 2013 Dec 1;44 Suppl 4:S75-80.

AbstractTrauma is a major cause of death and disability worldwide, of which more than 90% occur in low- and middle-income countries. Given the magnitude of this inequality, there is a need to devise and use tools to assess the capacity of facility-based trauma care. This study used two tools, hospital flowcharts and the World Health Organization's Trauma Care Checklist, to describe trauma care capacity at two hospitals in Kenya and ways in which this capacity can be strengthened. We found these hospitals had a large volume of trauma, but due to the lack of intensive care units, specialized trauma units, and axillary services, such as orthopedics and neurosurgery, the hospitals had a limited ability to provide definitive care for injured patients in critical condition. Additionally, organizational capabilities, such as trauma registries, trauma-specific training, and quality improvement programmes were lacking. The state of trauma care at district and provincial levels in Kenya demonstrates a strong case for national and global investment in clinical and systemic interventions.Copyright © 2013 Elsevier Ltd. All rights reserved.

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