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

Lecky FE 1 , Reynolds T 2 , Otesile O 1 , Hollis S 2 , Turner J 1 , Fuller G 1 Show all authors , Sammy I 3 , Williams-Johnson J 4 , Geduld H 5 , Tenner AG 6 , French S 4 , Govia I 4 , Balen J 1 , Goodacre S 1 , Marahatta SB 7 , DeVries S 8 , Sawe HR 9 , El-Shinawi M 10 , Mfinanga J 11 , Rubiano AM 12 , Chebbi H 13 , Do Shin S 14 , Ferrer JME 15 , Haddadi M 16 , Firew T 17 , Taubert K 18 , Lee A 1 , Convocar P 19 , Jamaluddin S 20 , Kotecha S 21 , Yaqeen EA 22 , Wells K 23 , Wallis L 24

Affiliations 

  • 1 School of Health and Related Research, University of Sheffield, Sheffield, and Emergency Deparment, Salford Royal Hospital, Salford, UK
  • 2 World Health Organisation, Geneva, Switzerland
  • 3 Scarborough General Hospital, Tobago, Canada
  • 4 The University of West Indies, Kingston, Jamaica
  • 5 Divsion of Emergency Medicine, Stellenbosch University, Cape Town, South Africa
  • 6 University of California San Francisco, San Francisco, USA
  • 7 Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal
  • 8 Emergency Medical Services for the Western Cape Government, Cape Town, South Africa
  • 9 Emergency Medical Association of Tanzania (EMAT), Dar es Salaam, Tanzania
  • 10 Ain Shams University, Cairo, Egypt
  • 11 Muhimbili National Hospital, Dar es Salaam, Tanzania
  • 12 Neurosciences Institute, El Bosque University, Bogotá, Colombia
  • 13 Ministry of Health, Bab Saadoun, Tunisia
  • 14 Seoul National University Hospital, Seoul, South Korea
  • 15 American Heart Association (AHA), Dallas, USA
  • 16 Ministry of Health, Tehran, Iran
  • 17 Columbia University, Emergency Medicine, New York, NY, USA
  • 18 American Heart Association (AHA), Geneva, Switzerland
  • 19 Philippine College of Emergency Medicine, Parañaque, Philippines
  • 20 Sungai Buloh Hospital, Sungai Buloh, Malaysia
  • 21 Bugando Medical Centre, Mwanza, Tanzania
  • 22 Ministry of Health, Amman, Jordan
  • 23 Divsion of Emergency Medicine, University of Vermont, Burlington, Vermont, USA
  • 24 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
BMC Emerg Med, 2020 08 31;20(1):68.
PMID: 32867675 DOI: 10.1186/s12873-020-00362-7

Abstract

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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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