Results from the implementation of the World Health Organization Basic Emergency Care Course in Lagos, Nigeria

Abstract

Background The emergency care of time-sensitive injuries and illnesses is increasingly recognized as an essential component of effective health care systems. However, many low- and middle-income countries (LMICs) lack healthcare providers formally trained in the care of emergency conditions. The Disease Control Priorities 3 project estimates that effective emergency care systems could avert up to half of all premature deaths in LMICs. Nigeria, a lower-middle income country of nearly 200 million people in Sub-Saharan Africa, could save approximately 100,000 lives per year with an effective emergency care system. The World Health Organization developed the Basic Emergency Care (BEC) course to train frontline healthcare workers in the management of emergency conditions in low resource settings. In this study we describe our work implementing the BEC course Nigeria. Methods This study was designed as a mixed methods research analysis comparing pre- and post- course examination results and surveys to evaluate participant knowledge acquisition and levels of confidence with management of various emergency conditions. Thirty-two participants were involved in the course which took place over four days at the Lagos University Teaching hospital. Quantitative data was analyzed using Stata 14.2 (College Station, TX). Paired data sets were analyzed using McNemar's chi-squared. Unpaired data sets were analyzed using a Wilcoxon signed-rank test. Results Post-course test scores showed significant improvement (p-value <0.001) as compared to pre-course. The average pre-course test score was 73% and average post-course score was 86.5%. Pre- and post-course questionnaires demonstrated significantly increased confidence in managing emergency conditions and agreement with course objectives. Conclusions The WHO Basic Emergency Care (BEC) course successfully increased the knowledge and confidence of frontline emergency care providers in Nigeria. The course was well received by participants. Future study should focus on BEC course scalability and long-term knowledge retention.

Confidence and knowledge in emergency management among medical students across Colombia: A role for the WHO basic emergency care course

“…Low response rates in surveys of healthcare professionals has been well documented in the literature [15]. In addition, even lower response rates amongst physicians have also been noted in LMICs consistent with the response rate in the study [16][17][18]. However, research has suggested that nonresponse bias is less of a concern amongst the physician population [15,[19][20][21].…”

“…For example, a recently published 2017 quasi-experimental study based in Tanzania and Uganda identified that participants of a 5-day BEC training shows a significant increase in emergency care knowledge and confidence at all four study sites [20]. Similarly in Nigeria, post-BEC test scores showed a significant improvement as compared to pre-course (73% vs. 86.5%, p < 0.001) [17].…”

“…As of the date of submission, this is the first attempt to identify medical students as a learner group for the WHO, besides one study that included 2 medical students in Nigeria [17]. Moreover, of all the studies examining emergency care in LMICs, this is the first to break down results by provider gender, age, and number of previous training courses.…”

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

“…For each skill, we reported the number and proportion of participants responding “very comfortable”. This outcome was selected for consistency with prior studies [ 10 , 12 , 20 ]. For the COVID-19 assessment, a group of content experts developed and refined ten questions on experience and comfort treating COVID-19.…”

“…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 ].…”