The World Health Organization predicts a striking rise in the burden of traumatic brain injury (TBI) burden in the next decades. A disproportionately large increase is predicted in low and middle income countries, which have brain injury rates three times higher than high income countries. The aim of this study was to identify current TBI practices and treatment capacity in three LMICs: Republic of Armenia, Georgia and Republic of Moldova.
After a national inventory of hospitals treating TBI, a situational analysis was conducted in the highest volume adult and pediatric hospital in each country. The situational analysis included key informant interviews with content analysis and a quantitative checklist of treatment resources.
All three countries follow international, national and hospital protocols for TBI treatment, and the in -hospital management of patients with TBI is similar to international standards in all three countries. Although healthcare specialists were well trained, however, lack of proper equipment, a scant number of hospitals outside the capital region, lack of specialized personnel in regional areas and lack of rehabilitation services were mentioned in interviews from all three countries.
Particular gaps were found in pre-hospital and rehabilitative care, as well as national leadership and data collection. Surveillance and standardized data collection are important measures to fill treatment gaps and reduce the burden of TBI.

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