BackgroundEmergency Departments (EDs) are critical for identifying and supporting victims of gender-based violence (GBV). However, data from Sub-Saharan Africa are limited, and even in high-income settings with developed EDs, identification remains poor. This study assessed the frequency of GBV identification in the tertiary ED of Tanzania’s largest public hospital and described incident characteristics.MethodsThis retrospective study was conducted in the ED of Muhimbili National Hospital, Tanzania, analyzing patients visits from January 2016 to December 2021. We reviewed electronic medical records of adult patients using a keyword-based search to identify complaints potentially related to GBV. A structured data sheet captured demographics, clinical data, and outcomes. Data were analyzed using Statistical Package for the Social Sciences (SPSS version 25), with descriptive characteristics reported as percentages and means with standard deviations (SD).ResultsAmong 296,010 adult ED visits, 87 (0.03%) had GBV-related complaints. The mean age was 32 years (SD 14), and 86% were female. The most common form was sexual abuse (33%), followed by combined sexual and physical abuse (28%). In 21% of cases, a partner was identified as the perpetrator; in 63%, the perpetrator was unknown, refused to disclose or undocumented. Among 61 sexual assault victims, 77% were screened for Human Immunodeficiency Virus (HIV), 49% for syphilis, and 39% for hepatitis. Additionally, 46% received HIV prophylaxis, and 61% of female victims received emergency contraception. Only 14% received psychological consultation. Overall, 63% were admitted, with 84% still hospitalized after 24 h.ConclusionGBV identification in this ED was extremely low. This likely reflects a combination of underreporting, low provider awareness, poor documentation, and the limitations of using a retrospective, keyword-based record review. A significant proportion involved sexual violence, with notable gaps in post-assault care. Strengthening GBV screening, management, and follow-up protocols in EDs is urgently needed. Future research should use prospective, robust designs.

BackgroundPregnancy-associated haemorrhage (PAH) is a leading contributor to maternal mortality in KwaZulu-Natal (KZN) and the fourth most common cause in South Africa. Delays in treating PAH increase maternal mortality; prompt prehospital response is therefore critical to improve outcomes. The aim of this study was to analyse response times and clinical management of PAH by public sector Emergency Care Providers in KZN, looking specifically at postpartum haemorrhage (PPH).MethodsA retrospective cross-sectional study was conducted in two phases. Phase 1 involved analysis of emergency call centre records (n = 4779) assessing response time patterns. Phase 2 analysed randomly selected PPH cases (n = 61) to assess clinical management practices. Descriptive statistics summarised demographics, response patterns, and clinical practice, Pearson correlation examined the relationships between time variables, and chi-square tests assessed associations between clinical variables (p < 0.05).ResultsMore than half (51.5 %) of PAH cases had ambulance response times >60 min. Median pre-response time was 30 min; overall response time was 63.5 min but both were positively skewed by extreme delays, with higher trimmed means(50.9 min and 85.7 min respectively). Most cases (81.6 %, n = 3899) were transported from primary healthcare facilities to hospitals, with Intermediate Life Support Providers managing 75.7 % of the cases. In the sampled PPH patients, compliance with vital signs monitoring was initially high (91.8 %) but declined in transit (42.6 %). Providers were largely non-compliant in documenting blood loss and patient history. Despite almost all patients showing clinical signs of shock 44.3 % of PPH cases received no intravenous fluids.ConclusionSignificant time delays in EMS response and inconsistencies in PAH clinical management by EMS providers were identified. Improved resource allocation, focused training and adherence to clinical and departmental guidelines are vital to strengthening maternal emergency care in KZN.