_ABSTRACT

Background and Purpose: The epidemiology of traumatic spinal cord injury (TSCI) and processes of care in Namibia is unknown. To improve survival of persons with TSCI one will need to determine the health care pathways and rehabilitation processes involved and factors associated with success and adverse outcomes. The purpose of the study is to determine health care and rehabilitation processes followed in the Namibian healthcare context in the management of individuals with TSCI. Relevance: TSCI is a catastrophic event that strikes out of the blue and can be devastating and costly in humans and social terms. There is limited research data with regard to the incidences and prevalence of TSCI, the processes of care followed by the management of these patients in Namibia. Participants: Namibians or permanent residents of Khomas region that have sustained a TSCI, admitted at KSH and WCH Spinalis unit. Participants diagnosed by a qualified medical doctor with clear radiographic and clinical diagnostic tests such as MRI, X- rays and CT scans are to be included in the study. Injuries must result in persisting impairment (not just a concussion) after emergence from neurogenic shock, which generally occurs within the first 24–72h after injury.18 years or older and surviving for at least 7 days since injury onset and gave consents to participate in the study.

Methods: The research study will be conducted at the two government national, referral hospitals in Khomas region in Windhoek, Namibia. These are Katutura State Hospital (KSH) and Windhoek Central Hospital (WCH) Spinalis. A population-based cohort design and a quantitative prospective clinical study with 150 participants. Data will be collected for one year period, pre and post discharge from the hospital. The international basic core data set tool in will be used capturing the variables. The data extraction sheet will primarily be used to gather data from participant’s medical records. The ASIA; EQ5D: SCIM III: Processes of care and outcomes data gathering sheet based on (ICF) and SCI complication scale will be used to collect data.

Analysis/Results: For epidemiologic features, descriptive statistics will be used. Inferential statistics, such as measures of association, will be used to explore relationships between exposures and outcomes. For annual incidence and mortality rates, the WHO World Standard Population will be used. The evaluation of outcomes, ANOVA will be computed across the four time points to assess for differences.  The relationship between different care pathways (factor variable) and outcomes (dependent variable), either a factorial, two-way ANOVA or multi-level modeling will be used to assess for systematic differences.

Implications: This study is necessary to disclose the incidence, etiology, characteristics, processes of care and outcomes for traumatic spinal cord injuries in Namibia.

Key words: Traumatic spinal cord injury, process of care, outcomes.

Funding: No source of funding for this study.