Quality of Medical Records in Sudanese Public Hospitals During Armed Conflict: A Multi-Centre Cross-Sectional Study

Background: Accurate and complete medical records are essential for effective health service delivery, patient safety, and quality improvement. However, deficiencies in documentation remain a challenge in many low-resource settings. This study aimed to assess the completeness and readability of medical records in public hospitals across Sudan, providing evidence to inform health system strengthening. Methods: A cross-sectional study was conducted in October 2023, reviewing 604 medical records from surgical departments in six public hospitals across Sudan. Records were evaluated for completeness using a standardised checklist covering five domains: socio-demographic data, patient history, investigations and management, operation sheet notes, and handwriting clarity. Descriptive statistics were used to summarise findings, and one-way ANOVA was applied to compare completeness rates between hospitals and departments. Results: The overall completeness rate of medical records was 55.68% (SD ± 20). Socio-demographic data were 66.7% complete, patient history 39.23%, investigations and management 55.30%, and operation sheet notes 63.59%. Handwriting was readable in 60.3% of records. Significant differences in completeness were observed between hospitals and departments (p < 0.05). Conclusions: Substantial deficiencies in documentation and legibility were identified in Sudanese public hospitals, with notable variation across institutions and departments. Targeted interventions, such as standardised templates and electronic health records, are needed to improve documentation quality and support better health service delivery.