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"Availability of skilled staff is a huge factor to consider in terms of location," says Ian Smyth, lecturer at Ulster Business School.
Indeed, the Guidelines for Essential Trauma Care published by the World Health Organization (WHO) consider ultrasound availability desirable as long as there is availability of skilled staff [2].
Although implementation of the plan was generally successful, the greatest challenges were limited availability of skilled staff and test reagents.
Decisions about who would provide care depended on the site layout and the availability of skilled staff at different times of day: " Where are people going to be monitored?
It is also expected the primary health service development program (often referred as Mpango wa Maendeleo ya Afya ya Msingi (MMAM)) will improve service accessibility and availability by increasing the number of skilled staff, drugs and other medical supplies to the facilities.
The main problem is not lack of money but a crippling shortage of skilled staff.
Within urban areas, Harare and Bulawayo absorb a large proportion of skilled staff [ 38].
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