Background Injuries are the leading cause of death among children aged 1 to 19 years. To improve paediatric injury care in the hospital setting and set priorities, assessing emergency services capacity is an essential step.

Methods An on-site investigation took place at Maputo Central Hospital (MCH), the largest hospital of the country. It was performed by a team led by a senior clinician, applying WHO Emergency Unit Assessment Tool, that encompasses aspects pertaining to e.g. facility metrics, infrastructure, essential equipment, human resources and clinical services. Five staff members from the paediatric emergency unit were interviewed. Interviews and observation of premises took in total 6 hours.

Results The assessment revealed a number of limitations in all covered areas, including among others the absence of a triage area, resuscitation trauma room, isolation room (e.g. for burns patients), and CT scan. Considering the caseload (35276 cases/children per year), there were too few clinicians (nurses and surgeons) with sufficient training. As well unavailability of guidelines, protocols for trauma care, infection preventions and control, a systematic process for collecting patient data and inexistent security protocol to protect staff, patients and infrastructure from violence. By contrast, the availability of drug and equipment was generally good.

Conclusion At MCH, paediatric emergency care faces worrying challenges that jeopardize good outcomes. As it is very likely that similar challenges arise in most other hospitals from the country, an action plan to redress the situation is much needed