Ethiopia’s quest to champion emergency care systems

Hagos, Amir Aman; Firew, Tsion; Gebreyesus, Alegnta; Sambo, Boureima Hama; Reynolds, Teri

doi:10.2471/blt.19.240440

Cited by 9 publications

(9 citation statements)

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“…The World Health Organization (WHO) and International Committee of the Red Cross’s Basic Emergency Care Course (BEC) is an open-access five-day course for front-line emergency care providers in resource-limited settings [ 8 ] that has been implemented in multiple countries including Ethiopia [ 9 ], Zambia [ 10 ], Uganda [ 11 ], Tanzania [ 11 ], and Nigeria [ 12 ]. The BEC employs lectures and hands-on skill-based exercises to train providers in the assessment and management of emergency conditions [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Applying the WHO-ICRC BEC course to train emergency and inpatient healthcare workers in Sierra Leone early in the COVID-19 outbreak

Sonenthal

Kachimanga

Komba

et al. 2022

BMC Health Serv Res

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Background Treating critical illness in resource-limited settings during disease outbreaks is feasible and can save lives. Lack of trained healthcare workers is a major barrier to COVID-19 response. There is an urgent need to train healthcare workers to manage COVID-19. The World Health Organization and International Committee of the Red Cross’s Basic Emergency Care course could provide a framework to cross-train personnel for COVID-19 care while strengthening essential health services. Methods We conducted a prospective cohort study evaluating the Basic Emergency Care course for healthcare workers from emergency and inpatient units at two hospitals in Sierra Leone, a low-income country in West Africa. Baseline, post-course, and six month assessments of knowledge and confidence were completed. Questions on COVID-19 were added at six months. We compared change from baseline in knowledge scores and proportions of participants “very comfortable” with course skills using paired Student’s t-tests and McNemar’s exact tests, respectively. Results We enrolled 32 participants of whom 31 completed pre- and post-course assessments. Six month knowledge and confidence assessments were completed by 15 and 20 participants, respectively. Mean knowledge score post-course was 85% (95% CI: 82% to 88%), which was increased from baseline (53%, 48% to 57%, p-value < 0.001). There was sustained improvement from baseline at six months (73%, 67% to 80%, p-value 0.001). The percentage of participants who were “very comfortable” performing skills increased from baseline for 27 of 34 skills post-training and 13 skills at six months. Half of respondents strongly agreed the course improved ability to manage COVID-19. Conclusions This study demonstrates the feasibility of the Basic Emergency Care course to train emergency and inpatient healthcare workers with lasting impact. The timing of the study, at the beginning of the COVID-19 pandemic, provided an opportunity to illustrate the strategic overlap between building human resource capacity for long-term health systems strengthening and COVID-19. Future efforts should focus on integration with national training curricula and training of the trainers for broader dissemination and implementation at scale.

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Section: Introductionmentioning

confidence: 99%

Applying the WHO-ICRC BEC course to train emergency and inpatient healthcare workers in Sierra Leone early in the COVID-19 outbreak

Sonenthal

Kachimanga

Komba

et al. 2022

BMC Health Serv Res

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“…The topics and skills covered are listed in table 1. The course has been successfully implemented in several sub-Saharan African countries 15–20. It has not yet been implemented in a humanitarian context but given its focus on providing care in a resource-limited setting, it may be capable of improving access to care and patient outcomes in a setting such as eastern Ukraine.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of change in emergency care knowledge and skills among front-line healthcare providers in Ukraine with the Basic Emergency Care course: a pretest/post-test study

et al. 2022

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ObjectiveEvaluate the change in participant emergency care knowledge and skill confidence after implementation of the WHO-International Committee of the Red Cross (ICRC) Basic Emergency Care (BEC) course.DesignPretest/post-test quasi-experimental study.SettingMechnikov Hospital in Dnipro, Ukraine.ParticipantsSeventy-nine participants engaged in the course, of whom 50 (63.3%) completed all assessment tools. The course was open to healthcare providers of any level who assess and treat emergency conditions as part of their practice. The most common participant profession was resident physician (24%), followed by health educator (18%) and prehospital provider (14%).InterventionsThe 5-day WHO-ICRC BEC course.Primary and secondary outcome measuresChange in pre-course and post-course knowledge and skill confidence assessments. Open-ended written feedback was collected upon course completion and analysed for common themes.ResultsParticipant knowledge assessment scores improved from 19 (IQR 15–20) to 22 (IQR 19–23) on a 25-point scale (p<0.001). Participant skill confidence self-assessment scores improved from 2.5 (IQR 2.1–2.8) to 2.9 (IQR 2.5–3.3) on a 4-point scale (p<0.001). The most common positive feedback themes were high-quality teaching and useful skill sessions. The most common constructive feedback themes were translation challenges and request for additional skill session time.ConclusionsThis first implementation of the WHO-ICRC BEC course for front-line healthcare providers in Ukraine was successful and well received by participants. This is also the first report of a BEC implementation outside of Africa and suggests that the course is also effective in the European context, particularly in humanitarian crisis and conflict settings. Future research should evaluate long-term knowledge retention and the impact on patient outcomes. Further iterations should emphasise local language translation and consider expanding clinical skills sessions.

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“…In the same vein, Ethiopia has recently made several efforts to implement world health organization of basic emergency care by improving and developing a pre-hospital care system as a mechanism to deal with the stress of emergencies arising from high RTC, communicable and non-communicable health deficiencies, disproportionately affecting the productive age groups, resulting in early death and disability [ 15 , 24 , 25 ]. The country, is currently pursuing the “two-tiered” pre-hospital emergency care systems, that primarily aim at rapidly bringing patients to hospital to offer basic emergency medical services by trained personnel [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

The practice and determinants of ambulance service utilization in pre-hospital settings, Jimma City, Ethiopia

Adem,

Tezera,

Agegnehu

2024

BMC Emerg Med

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Background In pre-hospital setting, ambulance provides emergency care and means of transport to arrive at appropriate health centers are as vital as in-hospital care, especially, in developing countries. Accordingly, Ethiopia has made several efforts to improve accessibility of ambulances services in prehospital care system that improves the quality of basic emergency care. Yet, being a recent phenomenon in Ethiopia, empirical studies are inadequate with regard to the practice and determinants of ambulance service utilization in pre-hospital settings. Hence, this study aimed to assess the ambulance service utilization and its determinants among patients admitted to the Emergency Departments (EDs) within the context of pre-hospital care system in public hospitals of Jimma City. Method A cross-sectional study design was used to capture quantitative data in the study area from June to July 2022. A systematic sampling technique was used to select 451 participants. Interviewer-administered questionnaire was used to collect data. Data analysis was done using SPSS version 26.0; descriptive and logistic regressions were done, where statistical significance was determined at p < 0.05. Results Ambulance service was rendered to bring about 39.5% (of total sample, 451) patients to hospitals. The distribution of service by severity of illnesses was 48.7% among high, and 39.4% among moderately acute cases. The major determinants of ambulance service utilization were: service time (with AOR, 0.35, 95%CI, 0.2-0.6 for those admitted to ED in the morning, and AOR, 2.36, 95%CI, 1.3-4.4 for those at night); referral source (with AOR, 0.2, 95%CI, 0.1-0.4 among the self-referrals); mental status (with AOR, 1.9, 95%CI, 1-3.5 where change in the level of consciousness is observed); first responder (AOR, 6.3 95%CI, 1.5-26 where first responders were the police, and AOR, 3.4, 95%C1, 1.7-6.6 in case of bystanders); distance to hospital (with AOR,0.37, 95%CI, 0.2-0.7 among the patients within ≤15km radius); and prior experience in ambulance use (with AOR, 4.1,95%CI, 2.4-7). Conclusion Although the utilization of ambulance in pre-hospital settings was, generally, good in Jimma City; lower levels of service use among patients in more acute health conditions is problematic. Community-based emergency care should be enhanced to improve the knowledge and use of ambulance services.

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Ethiopia’s quest to champion emergency care systems

Cited by 9 publications

References 1 publication

Applying the WHO-ICRC BEC course to train emergency and inpatient healthcare workers in Sierra Leone early in the COVID-19 outbreak

Applying the WHO-ICRC BEC course to train emergency and inpatient healthcare workers in Sierra Leone early in the COVID-19 outbreak

Evaluation of change in emergency care knowledge and skills among front-line healthcare providers in Ukraine with the Basic Emergency Care course: a pretest/post-test study

The practice and determinants of ambulance service utilization in pre-hospital settings, Jimma City, Ethiopia

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