Capacity Assessment of Orthopaedic Trauma Services in Public Hospitals in Adamawa State

Trauma systems capacity in northern Nigerian states remains a major health infrastructure challenge, with profound implications for morbidity and mortality outcomes following injuries. This descriptive facility-based study assesses the capacity of orthopaedic trauma services in public hospitals across Adamawa State, North East Nigeria. A stratified sample of one tertiary, three secondary, and six primary facilities will be assessed using a modified WHO Trauma Care Assessment Tool. Capacity domains evaluated will include availability of orthopaedic surgeons, anaesthesia, implants, intraoperative imaging, blood bank services, intensive care support, and rehabilitation services. Quantitative scoring will be supplemented by structured interviews with facility heads, orthopaedic officers, and theatre coordinators. A composite trauma capacity index will be derived for each facility category. The study hypothesises significant infrastructure gaps at secondary and primary levels, with a high concentration of capacity in the state's sole tertiary facility. Findings will be submitted to the Adamawa State Ministry of Health and the Federal Ministry of Health to inform infrastructure investment planning and establish minimum trauma capacity standards for each facility level. This research provides a baseline assessment essential for evidence-based trauma system strengthening in a conflict-affected North East Nigerian state, where injury burden from insurgency compounds existing infrastructure deficits. Keywords: trauma capacity, orthopaedic services, facility assessment, Adamawa, health systems.