Advanced life support courses in Africa: Certification, availability and perceptions

Abstract

Background Advanced life support (ALS) short training courses are in demand across Africa, though overwhelmingly designed and priced for non-African contexts. The continental expansion of emergency care is driving wider penetration of these courses, but their relevance and accessibility is not known. We surveyed clinicians within emergency settings to describe ALS courses' prevalence and perceived value in Africa. Methods We conducted a cross-sectional quantitative analysis of 235 clinicians' responses to the African Federation for Emergency Medicine's online needs assessment for an open-access ALS course in Africa. Participants responded to multiple-choice and open answer questions assessing demographics, ALS course certification and availability, perceptions of ALS courses, and barriers and facilitators to undertaking such courses. Results 235 clinicians working in 23 African nations responded. Most clinicians reported ALS course completion within the past three years (73%) and in-country access to ALS courses (76%). Most believed the content adequately met their region's needs (60%). Price and course availability were the most common barriers to taking an ALS course. The most common courses were cardiac and paediatric-focused, and the most common reasons to take a course included general career development, personal interest, and departmental requirements. Conclusion One-quarter of emergency care clinicians lack access to ALS courses in twenty-three African nations. Most clinicians believe that ALS courses have value in their clinical settings and meet the needs of their region. Our findings illustrate the need for an affordable, widely available ALS course tailored to lower-resource African settings that could reach rural and peri-urban clinicians.

The initiative for medical equity and global health (IMEGH) resuscitation training program: A model for resuscitation training courses in Africa

“…This is often not the case in low-resourced settings [ 1 , 6 ]. In addition, these courses developed in high-resourced settings are not always relevant in the low-resource settings (LRS) [7] . Some existing courses designed for LRS such the World Health Organization (WHO) and International Committee of the Red Cross's Basic Emergency Care Course (BEC) do not focus on in-hospital resuscitation [ 8 ].…”

“…Yet opportunities for these types of training are few. Qualified trainers, training centers with appropriate simulation equipment, and funding are insufficient to meet the need [7] . To our knowledge, in 2018 there were no accredited (AHA or other certifying body) resuscitation training centers in Rwanda.…”

“…), resuscitation medications, equipment and local protocols are inconsistent or lacking. [ 7 , [11] , [12] , [13] ] Furthermore, unlike many high-income health care systems, there is no national resuscitation registry to track outcomes following IHCA, which would allow the evaluation of the impact of resuscitation interventions [14] .…”

Evaluation of junior doctors’ retention of knowledge and skills after simulation training in shockable rhythm cardiac arrest in a low-resource setting in Nepal

“…Training in ALS in the UK is usually undertaken via Advanced Life Support Training (ALS), Resuscitation Council UK, 2021 1 which is based on models of care from high income countries 2 with a refresher course in the UK every four years. 3 In Nepal and in other low resource settings, 2 there are no registered ALS training centres, with the cost of a course outside of the country exceeding several months’ salary and acting as a significant barrier in Nepal and in other low resource settings. 2 When doctors are trained in Advanced Life Support (ALS) and it is applied correctly, it can have an impact on restoring circulation in 40–60% of patients 4 providing oxygenation and restoring spontaneous circulation and brain function.…”

“…3 In Nepal and in other low resource settings, 2 there are no registered ALS training centres, with the cost of a course outside of the country exceeding several months’ salary and acting as a significant barrier in Nepal and in other low resource settings. 2 When doctors are trained in Advanced Life Support (ALS) and it is applied correctly, it can have an impact on restoring circulation in 40–60% of patients 4 providing oxygenation and restoring spontaneous circulation and brain function. Advanced Life Support training is an evidence-based proven standard for the management of cardiac arrest restoring life, leading to a return of spontaneous circulation and has a huge impact in increasing the rate of survival to hospital discharge.…”