Harnessing inter-disciplinary collaboration to improve emergency care in low- and middle-income countries (LMICs): results of research prioritisation setting exercise.


Journal

BMC emergency medicine
ISSN: 1471-227X
Titre abrégé: BMC Emerg Med
Pays: England
ID NLM: 100968543

Informations de publication

Date de publication:
31 08 2020
Historique:
received: 30 07 2020
accepted: 19 08 2020
entrez: 2 9 2020
pubmed: 2 9 2020
medline: 16 6 2021
Statut: epublish

Résumé

More than half of deaths in low- and middle-income countries (LMICs) result from conditions that could be treated with emergency care - an integral component of universal health coverage (UHC) - through timely access to lifesaving interventions. The World Health Organization (WHO) aims to extend UHC to a further 1 billion people by 2023, yet evidence supporting improved emergency care coverage is lacking. In this article, we explore four phases of a research prioritisation setting (RPS) exercise conducted by researchers and stakeholders from South Africa, Egypt, Nepal, Jamaica, Tanzania, Trinidad and Tobago, Tunisia, Colombia, Ethiopia, Iran, Jordan, Malaysia, South Korea and Phillipines, USA and UK as a key step in gathering evidence required by policy makers and practitioners for the strengthening of emergency care systems in limited-resource settings. The RPS proposed seven priority research questions addressing: identification of context-relevant emergency care indicators, barriers to effective emergency care; accuracy and impact of triage tools; potential quality improvement via registries; characteristics of people seeking emergency care; best practices for staff training and retention; and cost effectiveness of critical care - all within LMICs. Convened by WHO and facilitated by the University of Sheffield, the Global Emergency Care Research Network project (GEM-CARN) brought together a coalition of 16 countries to identify research priorities for strengthening emergency care in LMICs. Our article further assesses the quality of the RPS exercise and reviews the current evidence supporting the identified priorities.

Sections du résumé

BACKGROUND
More than half of deaths in low- and middle-income countries (LMICs) result from conditions that could be treated with emergency care - an integral component of universal health coverage (UHC) - through timely access to lifesaving interventions.
METHODS
The World Health Organization (WHO) aims to extend UHC to a further 1 billion people by 2023, yet evidence supporting improved emergency care coverage is lacking. In this article, we explore four phases of a research prioritisation setting (RPS) exercise conducted by researchers and stakeholders from South Africa, Egypt, Nepal, Jamaica, Tanzania, Trinidad and Tobago, Tunisia, Colombia, Ethiopia, Iran, Jordan, Malaysia, South Korea and Phillipines, USA and UK as a key step in gathering evidence required by policy makers and practitioners for the strengthening of emergency care systems in limited-resource settings.
RESULTS
The RPS proposed seven priority research questions addressing: identification of context-relevant emergency care indicators, barriers to effective emergency care; accuracy and impact of triage tools; potential quality improvement via registries; characteristics of people seeking emergency care; best practices for staff training and retention; and cost effectiveness of critical care - all within LMICs.
CONCLUSIONS
Convened by WHO and facilitated by the University of Sheffield, the Global Emergency Care Research Network project (GEM-CARN) brought together a coalition of 16 countries to identify research priorities for strengthening emergency care in LMICs. Our article further assesses the quality of the RPS exercise and reviews the current evidence supporting the identified priorities.

Identifiants

pubmed: 32867675
doi: 10.1186/s12873-020-00362-7
pii: 10.1186/s12873-020-00362-7
pmc: PMC7457362
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

68

Subventions

Organisme : World Health Organization
ID : 001
Pays : International
Organisme : UK Global Challege Research Fund
ID : X/159905
Pays : International

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Auteurs

Fiona E Lecky (FE)

School of Health and Related Research, University of Sheffield, Sheffield, and Emergency Deparment, Salford Royal Hospital, Salford, UK.

Teri Reynolds (T)

World Health Organisation, Geneva, Switzerland.

Olubukola Otesile (O)

School of Health and Related Research, University of Sheffield, Sheffield, and Emergency Deparment, Salford Royal Hospital, Salford, UK.

Sara Hollis (S)

World Health Organisation, Geneva, Switzerland.

Janette Turner (J)

School of Health and Related Research, University of Sheffield, Sheffield, and Emergency Deparment, Salford Royal Hospital, Salford, UK.

Gordon Fuller (G)

School of Health and Related Research, University of Sheffield, Sheffield, and Emergency Deparment, Salford Royal Hospital, Salford, UK.

Ian Sammy (I)

Scarborough General Hospital, Tobago, Canada.

Jean Williams-Johnson (J)

The University of West Indies, Kingston, Jamaica.

Heike Geduld (H)

Divsion of Emergency Medicine, Stellenbosch University, Cape Town, South Africa.

Andrea G Tenner (AG)

University of California San Francisco, San Francisco, USA.

Simone French (S)

The University of West Indies, Kingston, Jamaica.

Ishtar Govia (I)

The University of West Indies, Kingston, Jamaica.

Julie Balen (J)

School of Health and Related Research, University of Sheffield, Sheffield, and Emergency Deparment, Salford Royal Hospital, Salford, UK.

Steve Goodacre (S)

School of Health and Related Research, University of Sheffield, Sheffield, and Emergency Deparment, Salford Royal Hospital, Salford, UK.

Sujan B Marahatta (SB)

Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal.

Shaheem DeVries (S)

Emergency Medical Services for the Western Cape Government, Cape Town, South Africa.

Hendry R Sawe (HR)

Emergency Medical Association of Tanzania (EMAT), Dar es Salaam, Tanzania.
Muhimbili University of Health and Allied Science, Dar es Salaam, Tanzania.

Mohamed El-Shinawi (M)

Ain Shams University, Cairo, Egypt.

Juma Mfinanga (J)

Muhimbili National Hospital, Dar es Salaam, Tanzania.

Andrés M Rubiano (AM)

Neurosciences Institute, El Bosque University, Bogotá, Colombia.
Colombian Trauma Association, Bogotá, Colombia.

Henda Chebbi (H)

Ministry of Health, Bab Saadoun, Tunisia.

Sang Do Shin (S)

Seoul National University Hospital, Seoul, South Korea.

Jose Maria E Ferrer (JME)

American Heart Association (AHA), Dallas, USA.

Mashyaneh Haddadi (M)

Ministry of Health, Tehran, Iran.

Tsion Firew (T)

Columbia University, Emergency Medicine, New York, NY, USA.
Ministry of Health, Addis Ababa, Ethiopia.

Kathryn Taubert (K)

American Heart Association (AHA), Geneva, Switzerland.

Andrew Lee (A)

School of Health and Related Research, University of Sheffield, Sheffield, and Emergency Deparment, Salford Royal Hospital, Salford, UK.

Pauline Convocar (P)

Philippine College of Emergency Medicine, Parañaque, Philippines.

Sabariah Jamaluddin (S)

Sungai Buloh Hospital, Sungai Buloh, Malaysia.

Shahzmah Kotecha (S)

Bugando Medical Centre, Mwanza, Tanzania.

Emad Abu Yaqeen (EA)

Ministry of Health, Amman, Jordan.

Katie Wells (K)

Divsion of Emergency Medicine, University of Vermont, Burlington, Vermont, USA.

Lee Wallis (L)

Division of Emergency Medicine, University of Cape Town, F51 Old Main Building, Groote Schuur Hospital Observatory, Cape Town, South Africa. lee.wallis@uct.ac.za.

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