ECCCOing the call for emergency and critical care training in low middle-income countries

Brotherton, B. Jason; Halestrap, Pete; Mbugua, Evelyn; Gitura, Hannah; Aliba, David; Matson, Jonathan E.; Lee, Burton W.

doi:10.1186/s13054-019-2532-4

Cited by 9 publications

(11 citation statements)

References 2 publications

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“…Nonetheless, PCC human resources were not sufficiently available at the training institutions, perhaps partly due to the limited training opportunities in PCC in the setting as well as suboptimal healthcare financing. Brotherton et al [ 23 ] in Kenya reported the creation of an Emergency and Critical Care Clinical Officer (ECCCO) higher diploma program since 2015 but there are currently no accredited degree or fellowship programs in PCC in Nigeria. Also, critical care-related courses like PALS are often expensive; only 11.9% of our participants had current certification in PALS.…”

Section: Discussionmentioning

confidence: 99%

“…Also, critical care-related courses like PALS are often expensive; only 11.9% of our participants had current certification in PALS. is highlights the need for collaboration with other postgraduate colleges for PCC training [23][24][25]. Several international training programs such as the Paediatric Emergency and Critical Care (PECC) Kenya fellowship training program, the African Paediatric Fellowships Program (APFP) in South Africa, and the Commonwealth Medical Fellowships program in the United Kingdom are available to build critical care capacity in resource-limited settings [26][27][28].…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Paediatric Critical Care Needs and Practice in Nigeria: Paediatric Residents’ Perspective

Abiodun

Eki-Udoko

2021

Critical Care Research and Practice

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Background. There is a dire need for paediatric critical care (PCC) services, but their availability in tertiary hospitals in Nigeria is not well defined. Objective. We evaluated self-reported PCC practice, resources, and perceived challenges in various zones of the country, using paediatric residents’ perspective. Methods. This is a descriptive cross-sectional survey, carried out at an Intensive Course in Paediatrics at the University of Benin Teaching Hospital, Nigeria. Participants’ PCC practice and perceived adequacy of PCC resources and services were assessed using a 100 mm uncalibrated visual analogue scale (VAS). A comparison between northern and southern zones was done. A 2-sided p value < 0.05 was considered significant. Results. A total of 143 residents participated in the study, 37.1% of them were male, and 62.9% were female. Their mean age was 34.6 ± 3.2 years. They were mainly (86.7%) from federal institutions across the country. Less than a half (46.7%) of the trainees attended to critically ill children daily, but only 4 out of every 10 respondents stated that such severely ill children survived till hospital discharge; 12.1% of the trainees had PICUs in their institutions. Financial constraints hindered PICU admissions. PCC staff were relatively fewer in northern zones than southern zones ( p < 0.05 ). Their perceived adequacy of PCC equipment and services were low (VAS scores 32.7 ± 2.6 and 30.9 ± 2.8, respectively) with a strong positive correlation between the two measurements (r = 0.839; p < 0.001 ). Conclusion. There is an unmet need for PCC practice in Nigerian tertiary hospitals with a resultant low survival rate of critically ill children. PCC training curricula and improved critical care resources are desirable in the setting.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Evaluation of Paediatric Critical Care Needs and Practice in Nigeria: Paediatric Residents’ Perspective

Abiodun

Eki-Udoko

2021

Critical Care Research and Practice

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“…ECCCO is an 18-month training program, started at Kijabe in January 2015, to help bridge this gap. 36 Numerous faculty volunteers from Vanderbilt, Mayo Clinic, University of Minnesota, Georgetown and others, as well as countless North American residents and fellows, have served in clinical and teaching capacities to enrich this training mission. The American Thoracic Society also contributed via the (now closed) Global Scholars Program.…”

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confidence: 99%

Academic careers in global pulmonary and critical care medicine: perspectives from experts in the field

Papali¹,

Dı́az

Carter

et al. 2020

Journal of Global Health Reports

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Academic global pulmonary/critical care medicine (PCCM) remains a relatively novel concept not fully embraced by all training programs, so PCCM early-career professionals may have little guidance in building successful careers in this field. To highlight various approaches used by current PCCM faculty to incorporate global health into their academic careers, speakers from a global health careers mini symposia held at the 2017 and 2018 American Thoracic Society International Conferences were invited to submit perspectives reflecting on academic PCCM and global health. The collection of essays was collated into a single manuscript. Eight current global PCCM faculty from diverse geographic and professional backgrounds provide experiential guidance for early-career professionals interested in global academic PCCM. Trainees and junior faculty interested in academic global PCCM will find innumerable obstacles to developing this non-traditional career pathway, but there exist diverse pathways to success.

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“…In recognizing the need for capacity building through the training of providers, AIC Kijabe Hospital started its Emergency and Critical Care Clinical Officer (ECCCO) training program in 2015 ( 6 , 7 ) Clinical officers, analogous to advanced practice providers such as physician assistants or nurse practitioners in the United States, are the frontline providers in many sub-Saharan African nations ( 8 ). Therefore, owing to their position as the essential worker in many Kenyan settings, these individuals were chosen as the primary learners for this specialized training.…”

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confidence: 99%

COVID-19 and the Need for Global Critical Care Training. Why Ventilators Alone Are Not the Answer

Brotherton¹,

Mbugua²,

Halestrap

et al. 2021

ATS Scholar

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The current coronavirus disease (COVID-19) pandemic has unearthed many weaknesses in healthcare systems worldwide. In doing so, it has caused high-income countries to deal with the uncomfortable situation of resource allocation that has long been a daily occurrence in low-and middle-income countries. The shortage of equipment continues to be a major problem in low-and middle-income countries, but there is an even greater shortage of human resources in the form of trained individuals capable of caring for critically ill patients. With physicians being in short supply in many areas throughout Africa, the question becomes where do these human resources come from? In Kenya, clinical officers are the frontline workers and backbone of care in many healthcare settings and outnumber physicians four to one. AIC Kijabe Hospital, located in rural Kenya, recognized this need and identified this cohort of clinicians as a means of ramping up local emergency and critical care. In doing so, the Emergency and Critical Care Clinical Officer training program was created in 2015. Since its inception, the Emergency and Critical Care Clinical Officer program has been training nonphysician clinicians to care for critically ill patients with physician support. In this perspective piece, we outline our attempt at capitalizing on this pool of human resources to advance the care of critically ill patients, describe lessons learned along the way, and try to highlight the utility of their unique skill set in the setting of a pandemic.

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ECCCOing the call for emergency and critical care training in low middle-income countries

Cited by 9 publications

References 2 publications

Evaluation of Paediatric Critical Care Needs and Practice in Nigeria: Paediatric Residents’ Perspective

Evaluation of Paediatric Critical Care Needs and Practice in Nigeria: Paediatric Residents’ Perspective

Academic careers in global pulmonary and critical care medicine: perspectives from experts in the field

COVID-19 and the Need for Global Critical Care Training. Why Ventilators Alone Are Not the Answer

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