{"id":"https://openalex.org/W7212376756","doi":"https://doi.org/10.64898/2026.09.08.26362483","title":"Building Critical Care Capacity in a Low-Resource Setting: Lessons Learned from Establishing an ICU in Uganda","display_name":"Building Critical Care Capacity in a Low-Resource Setting: Lessons Learned from Establishing an ICU in Uganda","publication_year":2026,"publication_date":"2026-09-11","ids":{"openalex":"https://openalex.org/W7212376756","doi":"https://doi.org/10.64898/2026.09.08.26362483"},"language":"en","primary_location":{"id":"doi:10.64898/2026.09.08.26362483","doi":"https://doi.org/10.64898/2026.09.08.26362483","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.09.08.26362483","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/09/11/2026.09.08.26362483.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"volume":null,"type":"preprint","indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://www.medrxiv.org/content/medrxiv/early/2026/09/11/2026.09.08.26362483.full.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5073774375","display_name":"Niels Jig Jansen","orcid":"https://orcid.org/0000-0002-2078-7977","observed_orcids":["https://orcid.org/0000-0002-2078-7977"]},"institutions":[{"id":"https://openalex.org/I2800431315","display_name":"Mutolere Hospital","ror":"https://ror.org/03850me26","country_code":"UG","type":"healthcare","lineage":["https://openalex.org/I2800431315"]}],"countries":["UG"],"is_corresponding":true,"raw_author_name":"Niels J. Jansen","raw_affiliation_strings":["Department of Intensive Care, Saint Francis Hospital, Mutolere, Uganda","Department of Surgery, Saint Francis Hospital, Mutolere, Uganda"],"raw_orcid":"https://orcid.org/0000-0002-2078-7977","affiliations":[{"raw_affiliation_string":"Department of Intensive Care, Saint Francis Hospital, Mutolere, Uganda","institution_ids":["https://openalex.org/I2800431315"]},{"raw_affiliation_string":"Department of Surgery, Saint Francis Hospital, Mutolere, Uganda","institution_ids":["https://openalex.org/I2800431315"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5031160396","display_name":"John Manzi","orcid":"https://orcid.org/0000-0003-2574-4260","observed_orcids":["https://orcid.org/0000-0003-2574-4260","https://orcid.org/0009-0003-4147-072X"]},"institutions":[{"id":"https://openalex.org/I2800431315","display_name":"Mutolere Hospital","ror":"https://ror.org/03850me26","country_code":"UG","type":"healthcare","lineage":["https://openalex.org/I2800431315"]}],"countries":["UG"],"is_corresponding":false,"raw_author_name":"John Manzi","raw_affiliation_strings":["Department of Intensive Care, Saint Francis Hospital, Mutolere, Uganda","Department of Surgery, Saint Francis Hospital, Mutolere, Uganda"],"raw_orcid":"https://orcid.org/0009-0003-4147-072X","affiliations":[{"raw_affiliation_string":"Department of Intensive Care, Saint Francis Hospital, Mutolere, Uganda","institution_ids":["https://openalex.org/I2800431315"]},{"raw_affiliation_string":"Department of Surgery, Saint Francis Hospital, Mutolere, Uganda","institution_ids":["https://openalex.org/I2800431315"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5151521834","display_name":"Sil van den Bersselaar","orcid":"https://orcid.org/0009-0001-3994-1452","observed_orcids":["https://orcid.org/0009-0001-3994-1452"]},"institutions":[{"id":"https://openalex.org/I2800431315","display_name":"Mutolere Hospital","ror":"https://ror.org/03850me26","country_code":"UG","type":"healthcare","lineage":["https://openalex.org/I2800431315"]}],"countries":["UG"],"is_corresponding":false,"raw_author_name":"Sil van den Bersselaar","raw_affiliation_strings":["Department of Intensive Care, Saint Francis Hospital, Mutolere, Uganda"],"raw_orcid":"https://orcid.org/0009-0001-3994-1452","affiliations":[{"raw_affiliation_string":"Department of Intensive Care, Saint Francis Hospital, Mutolere, Uganda","institution_ids":["https://openalex.org/I2800431315"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5066988723","display_name":"Lars Ingmar Veldhuis","orcid":"https://orcid.org/0000-0002-9568-0138","observed_orcids":["https://orcid.org/0000-0002-9568-0138"]},"institutions":[{"id":"https://openalex.org/I2800431315","display_name":"Mutolere Hospital","ror":"https://ror.org/03850me26","country_code":"UG","type":"healthcare","lineage":["https://openalex.org/I2800431315"]}],"countries":["UG"],"is_corresponding":false,"raw_author_name":"Lars I. Veldhuis","raw_affiliation_strings":["Department of Intensive Care, Saint Francis Hospital, Mutolere, Uganda"],"raw_orcid":"https://orcid.org/0000-0002-9568-0138","affiliations":[{"raw_affiliation_string":"Department of Intensive Care, Saint Francis Hospital, Mutolere, Uganda","institution_ids":["https://openalex.org/I2800431315"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5073774375"],"corresponding_institution_ids":["https://openalex.org/I2800431315"],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11731","display_name":"Global Health and Surgery","score":0.9204000234603882,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11731","display_name":"Global Health and Surgery","score":0.9204000234603882,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T14093","display_name":"Global Health and Epidemiology","score":0.03849999979138374,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10218","display_name":"Sepsis Diagnosis and Treatment","score":0.007400000002235174,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/resource-limited-settings","display_name":"resource-limited settings","score":0.9919999837875366},{"id":"https://openalex.org/keywords/rural-hospitals","display_name":"rural hospitals","score":0.8550000190734863},{"id":"https://openalex.org/keywords/uganda","display_name":"Uganda","score":0.7739999890327454},{"id":"https://openalex.org/keywords/power-supply-instability","display_name":"power supply instability","score":0.7919999957084656},{"id":"https://openalex.org/keywords/nurse-patient-ratio","display_name":"nurse-to-patient ratio","score":0.7950000166893005},{"id":"https://openalex.org/keywords/continuous-patient-monitoring","display_name":"continuous patient monitoring","score":0.8259999752044678},{"id":"https://openalex.org/keywords/standardized-clinical-protocols","display_name":"standardized care protocols","score":0.7369999885559082},{"id":"https://openalex.org/keywords/employee-training","display_name":"employee training","score":0.6060000061988831},{"id":"https://openalex.org/keywords/communication-barriers","display_name":"communication barriers","score":0.6330000162124634},{"id":"https://openalex.org/keywords/patient-safety","display_name":"patient safety","score":0.6570000052452087},{"id":"https://openalex.org/keywords/mechanical-ventilation","display_name":"mechanical ventilation","score":0.6819999814033508},{"id":"https://openalex.org/keywords/inotropic-support","display_name":"inotropic support","score":0.6970000267028809}],"concepts":[{"id":"https://openalex.org/C2776376669","wikidata":"https://www.wikidata.org/wiki/Q5094647","display_name":"Intensive care unit","level":2,"score":0.5857999920845032},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.5582000017166138},{"id":"https://openalex.org/C27415008","wikidata":"https://www.wikidata.org/wiki/Q7256382","display_name":"Psychological intervention","level":2,"score":0.5277000069618225},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.5103999972343445},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.44440001249313354},{"id":"https://openalex.org/C201650216","wikidata":"https://www.wikidata.org/wiki/Q829492","display_name":"Procurement","level":2,"score":0.4083000123500824},{"id":"https://openalex.org/C195094911","wikidata":"https://www.wikidata.org/wiki/Q14167904","display_name":"Process management","level":1,"score":0.3817000091075897},{"id":"https://openalex.org/C2987404301","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care","level":2,"score":0.35920000076293945},{"id":"https://openalex.org/C190248442","wikidata":"https://www.wikidata.org/wiki/Q839486","display_name":"Qualitative research","level":2,"score":0.3479999899864197},{"id":"https://openalex.org/C122637931","wikidata":"https://www.wikidata.org/wiki/Q118084","display_name":"Unit (ring theory)","level":2,"score":0.3370000123977661},{"id":"https://openalex.org/C87156501","wikidata":"https://www.wikidata.org/wiki/Q7268708","display_name":"Qualitative property","level":2,"score":0.335999995470047},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.335099995136261},{"id":"https://openalex.org/C203915360","wikidata":"https://www.wikidata.org/wiki/Q352454","display_name":"Critical care nursing","level":3,"score":0.33469998836517334},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.33399999141693115},{"id":"https://openalex.org/C2993568657","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Critical illness","level":3,"score":0.32749998569488525},{"id":"https://openalex.org/C2780815959","wikidata":"https://www.wikidata.org/wiki/Q18390984","display_name":"Monitoring and evaluation","level":2,"score":0.3192000091075897},{"id":"https://openalex.org/C12725497","wikidata":"https://www.wikidata.org/wiki/Q810247","display_name":"Baseline (sea)","level":2,"score":0.3176000118255615},{"id":"https://openalex.org/C26517878","wikidata":"https://www.wikidata.org/wiki/Q228039","display_name":"Key (lock)","level":2,"score":0.29739999771118164},{"id":"https://openalex.org/C2779343474","wikidata":"https://www.wikidata.org/wiki/Q3109175","display_name":"Context (archaeology)","level":2,"score":0.2973000109195709},{"id":"https://openalex.org/C151799412","wikidata":"https://www.wikidata.org/wiki/Q920550","display_name":"Assertiveness","level":2,"score":0.2919999957084656},{"id":"https://openalex.org/C21547014","wikidata":"https://www.wikidata.org/wiki/Q1423657","display_name":"Operations management","level":1,"score":0.2782000005245209},{"id":"https://openalex.org/C83864248","wikidata":"https://www.wikidata.org/wiki/Q177323","display_name":"Developing country","level":2,"score":0.2773999869823456},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.27630001306533813},{"id":"https://openalex.org/C2776902269","wikidata":"https://www.wikidata.org/wiki/Q5165493","display_name":"Continuous monitoring","level":2,"score":0.26669999957084656},{"id":"https://openalex.org/C3018642899","wikidata":"https://www.wikidata.org/wiki/Q813243","display_name":"Mechanical ventilator","level":3,"score":0.26409998536109924},{"id":"https://openalex.org/C107645774","wikidata":"https://www.wikidata.org/wiki/Q5467169","display_name":"Human resources","level":2,"score":0.2578999996185303}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.64898/2026.09.08.26362483","doi":"https://doi.org/10.64898/2026.09.08.26362483","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.09.08.26362483","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/09/11/2026.09.08.26362483.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.64898/2026.09.08.26362483","doi":"https://doi.org/10.64898/2026.09.08.26362483","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.09.08.26362483","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/09/11/2026.09.08.26362483.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"sustainable_development_goals":[{"display_name":"Good health and well-being","score":0.9537000060081482,"id":"https://metadata.un.org/sdg/3"},{"display_name":"Reduced inequalities","score":0.4000000059604645,"id":"https://metadata.un.org/sdg/10"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7212376756.pdf","grobid_xml":"https://content.openalex.org/works/W7212376756.grobid-xml"},"referenced_works_count":10,"referenced_works":["https://openalex.org/W1967642370","https://openalex.org/W2071172254","https://openalex.org/W2118087450","https://openalex.org/W2158525457","https://openalex.org/W2913811884","https://openalex.org/W2922960103","https://openalex.org/W2982810542","https://openalex.org/W3024462871","https://openalex.org/W4383710187","https://openalex.org/W4396553620"],"related_works":["https://openalex.org/W2144897453","https://openalex.org/W2593503662","https://openalex.org/W7167810972","https://openalex.org/W7220556532","https://openalex.org/W4416168790","https://openalex.org/W1972101863","https://openalex.org/W4385198490","https://openalex.org/W4317035100","https://openalex.org/W2911171663","https://openalex.org/W4399567395"],"abstract_inverted_index":{"Abstract":[0],"Background":[1],"Access":[2],"to":[3,100,140,335],"intensive":[4,239],"care":[5,27,136,220,240,281,312],"unit":[6,241],"(ICU)":[7],"services":[8],"remains":[9],"severely":[10],"limited":[11,133,279],"in":[12,40,57,166,221,242,263,314],"many":[13],"low-":[14],"and":[15,22,78,86,104,143,150,178,182,192,213,229,235,285,296,330],"middle-income":[16],"countries":[17],"(LMICs).":[18],"Although":[19],"conceptual":[20],"frameworks":[21,212],"policy-level":[23],"recommendations":[24],"for":[25,67,130],"critical":[26,135,155,219,280,311],"development":[28],"exist,":[29],"real-world":[30],"experiences":[31],"describing":[32],"the":[33,116,254],"practical":[34,206,227],"challenges":[35,103,121,228],"of":[36,110,157,253,258,305,332],"starting":[37],"an":[38,124],"ICU":[39,62,159,165,262,307,333],"a":[41,54,163,167,197,237,243,259,315],"low-resource":[42,168,245,317],"setting":[43,169,318],"are":[44,231],"scarce.":[45],"Methods":[46],"This":[47,203],"mixed-methods":[48,250],"descriptive":[49,251],"study":[50,204,252],"was":[51,63],"conducted":[52],"at":[53],"rural":[55,264,316],"hospital":[56],"Uganda.":[58],"A":[59,108],"six-":[60],"bed":[61],"established":[64,261],"with":[65],"capabilities":[66],"mechanical":[68],"ventilation,":[69],"inotropic":[70],"support,":[71],"continuous":[72,151,176,187,297,327],"monitoring,":[73,188],"point-of-care":[74],"blood":[75],"gas":[76],"analysis,":[77],"piped":[79],"oxygen.":[80],"Quantitative":[81],"data":[82,93],"including":[83],"demographics,":[84],"diagnoses,":[85],"interventions":[87],"were":[88,94,113,154,268,300],"collected.":[89],"In":[90,248],"addition,":[91],"qualitative":[92],"collected":[95],"through":[96],"structured":[97,323],"group":[98],"discussions":[99,272],"identify":[101],"key":[102,289],"lessons":[105,230],"learned.":[106],"Results":[107],"total":[109],"45":[111,266],"patients":[112,267],"admitted":[114],"during":[115],"first":[117,255],"three":[118],"months.":[119],"Key":[120,223],"identified":[122,273,301],"included":[123],"unstable":[125,274],"power":[126,275],"supply,":[127,195,276],"procurement":[128,277],"delays":[129],"essential":[131],"medications,":[132],"baseline":[134],"knowledge,":[137,282],"cultural":[138],"barriers":[139],"assertive":[141],"communication,":[142],"financial":[144,286],"constraints.":[145],"Continuous":[146,292],"training,":[147,177,293,329],"standardized":[148,294],"protocols,":[149,295],"patient":[152,201,298],"monitoring":[153,299],"components":[156,304],"successful":[158,306],"operation.":[160,308],"Conclusions":[161],"Establishing":[162,310],"functional":[164],"is":[170,319],"possible,":[171],"but":[172,321],"requires":[173,322],"extensive":[174],"planning,":[175,324],"robust":[179],"infrastructure.":[180],"Simple":[181],"affordable":[183],"interventions,":[184],"such":[185],"as":[186,288,302],"improved":[189],"nurse-to-patient":[190],"ratios,":[191],"reliable":[193,325],"oxygen":[194],"had":[196],"substantial":[198],"impact":[199],"on":[200],"safety.":[202],"provides":[205],"insights":[207],"that":[208,217],"complement":[209],"existing":[210],"policy":[211],"inform":[214],"similar":[215],"initiatives":[216],"strengthen":[218],"LMICs.":[222],"Points":[224],"Question":[225],"What":[226],"encountered":[232],"when":[233],"establishing":[234],"initiating":[236],"six-bed":[238],"rural,":[244],"setting?":[246],"Findings":[247],"this":[249],"3":[256],"months":[257],"newly":[260],"Uganda,":[265],"admitted,":[269],"while":[270],"stakeholder":[271],"delays,":[278],"communication":[283],"barriers,":[284],"constraints":[287],"implementation":[290],"challenges.":[291],"important":[303],"Meaning":[309],"capacity":[313],"feasible":[320],"infrastructure,":[326],"workforce":[328],"adaptation":[331],"systems":[334],"local":[336],"circumstances.":[337]},"counts_by_year":[],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2026-09-13T00:00:00"}