AFEM Consensus Conference, 2013. AFEM Out-of-Hospital Emergency Care Workgroup Consensus Paper: Advancing Out-of-Hospital Emergency Care in Africa-Advocacy and Development (original) (raw)
Related papers
Access to out-of-hospital emergency care in Africa: Consensus conference recommendations
African Journal of Emergency Medicine, 2016
Out-of-hospital emergency care (OHEC) should be accessible to all who require it. However, available data suggests that there are a number of barriers to such access in Africa, mainly centred around challenges in public knowledge, perception and appropriate utilisation of OHEC. Having reached consensus in 2013 on a two-tier system of African OHEC, the African Federation for Emergency Medicine (AFEM) OHEC Group sought to gain further consensus on the narrower subject of access to OHEC in Africa. The objective of this paper is to report the outputs and statements arising from the AFEM OHEC access consensus meeting held in Cape Town, South Africa in April 2015. The discussion was structured around six dimensions of access to care (i.e. awareness, availability, accessibility, accommodation, affordability and acceptability) and tackled both Tier-1 (community first responder) and Tier-2 (formal prehospital services and Emergency Medical Services) OHEC systems. In Tier-1 systems, the role of community involvement and support was emphasised, along with the importance of a first responder system acceptable to the community in which it is embedded in order to optimise access. In Tier-2 systems, the consensus group highlighted the primacy of a single toll-free emergency number, matching of Emergency Medical Services resource demand and availability through appropriate planning and the cost-free nature of Tier-2 emergency care, amongst other factors that impact accessibility. Much work is still needed in prioritising the steps and clarifying the tools and metrics that would enable the ideal of optimal access to OHEC in Africa. Les soins d'urgence hors de l'hoˆpital (OHEC) devraient eˆtre accessibles a`tous ceux qui en ont besoin. Cependant, les donne´es disponibles sugge`rent qu'il existe un certain nombre d'obstacles a`cet acce`s en Afrique, qui sont principalement lie´s aux difficulte´s en termes de connaissances du public des OHEC, de leur opinion sur ces derniers ainsi que de l'utilisation des OHEC approprie´e par le public. Un consensus ayant e´te´atteint en 2013 sur un syste`me des OHEC d'Afrique a`deux niveaux, le Groupe des OHEC de la Fe´de´ration africaine pour la me´decine d'urgence (AFEM) a cherche´a`obtenir un consensus plus large sur le sujet plus pre´cis de l'acce`s aux OHEC en Afrique. L'objectif de cet article est de rapporter les re´sultats et les de´clarations issus de la re´union de concertation sur l'acce`s aux OHEC de l'AFEM tenue aC ape Town en Afrique du Sud en avril 2015. La discussion e´tait organise´e selon six dimensions d'acce`s aux soins (a`savoir la sensibilisation, la disponibilite´, l'acces-sibilite´, le logement, l'abordabilite´et l'acceptabilite´) et a aborde´les deux syste`mes d'OHEC de Niveau 1 (premier intervenant au sein de la communaute´) et de Niveau 2 (services pre´hospitaliers formels et services me´dicaux d'urgence). Dans les syte`mes de Niveau 1, le roˆle de la participation et du soutien communautaire a e´te´souligne´, ainsi que l'importance d'un syste`me de premier intervenant acceptable pour la communaute´dans laquelle il est inte´gre´afin d'optimiser l'acce`s. Dans les syste`mes de Niveau 2, le groupe de concertation a souligne´la primaute´d'un seul nume´ro d'urgence gratuit, le fait de faire correspondre la demande en ressources des Services me´dicaux d'urgence a`la disponibilite´graˆce a`une planification approprie´e, et la gratuite´des soins d'urgence de Niveau 2, entre autres facteurs ayant une incidence sur l'accessibilite´. Un travail pousse´est encore ne´cessaire en matie`re de classement des e´tapes par priorite´et de clarification des outils et crite`res qui permettraient un acce`s ide´al et optimal aux OHEC en Afrique.
Developing a framework for emergency nursing practice in Africa
African Journal of Emergency Medicine, 2012
Whilst collaborating with members of the emergency team, the emergency nurse plays a crucial role in the identification and care of patients with medical, surgical and injury related emergencies. In Africa, as well as all over the world, the practice of emergency nursing is extremely challenging. In November 2011, an international emergency nursing workgroup (both academic and clinical) was convened in Cape Town, South Africa, to explore the development of a framework for emergency nursing practice in Africa. The resultant framework has implications for nursing education and training, continuing education, and staffing at both the institutional and regional levels throughout the African continent and possibly further afield. ª 2012 African Federation for Emergency Medicine. Production and hosting by Elsevier B.V. All rights reserved. Abstract Tout en collaborant avec les membres de l'e´quipe d'urgence, l'infirmier urgentiste joue un roˆle crucial dans l'identification et la prise en charge des patients traite´s pour des urgences me´dicales, chirurgicales et lie´es a`des blessures. En Afrique, mais aussi partout dans le monde, la pratique des soins infirmiers d'urgence est extreˆmement difficile. En novembre 2011, un groupe de travail international sur les soins infirmiers d'urgence (a`la fois univertaire et clinique) s'est re´uni au Cap, en Afrique du Sud, pour e´tudier le developpement d'un cadre relatif a`la pratique des soins infirmiers d'urgence en Afrique. Le cadre qui en est ressorti a des re´percussions sur l'enseignement et la formation en soins infirmiers, la fomation continue, et la dotation en personnel a`des niveaux institutionnel et re´gional sur l'ensemble du continent africain, voire au-dela`. ª 2012 African Federation for Emergency Medicine. Production and hosting by Elsevier B.V. All rights reserved.
Annals of Emergency Medicine, 2012
The recent adoption of World Health Assembly Resolution 60.22, titled "Health Systems: Emergency Care Systems," has established an important health care policy tool for improving emergency care access and availability globally. The resolution highlights the role that strengthened emergency care systems can play in reducing the increasing burden of disease from acute illness and injury in populations across the socioeconomic spectrum and calls on governments and the World Health Organization to take specific and concrete actions to make this happen. This resolution constitutes recognition by the World Health Assembly of the growing public health role of emergency care systems and is the highest level of international attention ever devoted to emergency care systems worldwide. Emergency care systems for secondary prevention of acute illnesses and injury remain inadequately developed in many low-and middle-income countries, despite evidence that basic strategies for improving emergency care systems can reduce preventable mortality and morbidity and can in many cases also be cost-effective. Emergency care providers and their professional organizations have used their comprehensive expertise to strengthen emergency care systems worldwide through the development of tools for emergency medicine education, systems assessment, quality improvement, and evidence-based clinical practice. World Health Assembly 60.22 represents a unique opportunity for emergency care providers and other advocates for improved emergency care to engage with national and local health care officials and policymakers, as well as with the World Health Organization, and leverage the expertise within the international emergency medicine community to make substantial improvements in emergency care delivery in places where it is most needed.
2012
Whilst collaborating with members of the emergency team, the emergency nurse plays a crucial role in the identification and care of patients with medical, surgical and injury related emergencies. In Africa, as well as all over the world, the practice of emergency nursing is extremely challenging. In November 2011, an international emergency nursing workgroup (both academic and clinical) was convened in Cape Town, South Africa, to explore the development of a framework for emergency nursing practice in Africa. The resultant framework has implications for nursing education and training, continuing education, and staffing at both the institutional and regional levels throughout the African continent and possibly further afield.
African Journal of Emergency Medicine, 2014
La première conférence internationale sur la médecine d’urgence (MU) s’est tenue les 15 et 16 mai 2014 à l’International Convention Centre de Gaborone, au Botswana. Le soutien affiché par les principales parties prenantes a permis de positionner la conférence, dès sa conception, sur la délivrance de directives proposées par des experts sur la pertinence de la médecine d’urgence, son enseignement et la mise en œuvre de systèmes s’y rapportant. Le thème de la conférence était, fort à propos, « Établir le programme d’action en médecine d’urgence dans la région Afrique australe ». Plus de 300 délégués, locaux, régionaux et internationaux, se sont réunis pour prendre part à cet événement marquant. Les pays représentés incluaient notamment le Botswana, l’Afrique du Sud, la Zambie, la Namibie, le Zimbabwe, le Swaziland, le Lesotho, le Nigeria et les États-Unis. Les hypothèses de la conférence ont permis de croiser les soins d’urgence, le fardeau des blessures et de la maladie en Afrique et...
Placing Emergency Care on the Global Agenda
Annals of Emergency Medicine, 2010
Emergency care serves a key function within health care systems by providing an entry point to health care and by decreasing morbidity and mortality. Although primarily focused on evaluation and treatment for acute conditions, emergency care also serves as an important locus of provision for preventive care with regard to injuries and disease progression. Despite its important and increasing role, however, emergency care has been frequently overlooked in the discussion of health systems and delivery platforms, particularly in developing countries. Little research has been done in lower-and middle-income countries on the burden of disease reduction attributable to emergency care, whether through injury treatment and prevention, urgent and emergency treatment of acute conditions, or emergency treatment of complications from chronic conditions. There is a critical need for research documenting the role of emergency care services in reducing the global burden of disease. In addition to applying existing methodologies toward this aim, new methodologies should be developed to determine the costeffectiveness of these interventions and how to effectively cover the costs of and demands for emergency care needs. These analyses could be used to emphasize the public health and clinical importance of emergency care within health systems as policymakers determine health and budgeting priorities in resource-limited settings.
Emergency Care and Health Systems: Consensus-based Recommendations and Future Research Priorities
Academic Emergency Medicine, 2013
The theme of the 14th annual Academic Emergency Medicine consensus conference was "Global Health and Emergency Care: A Research Agenda." The goal of the conference was to create a robust and measurable research agenda for evaluating emergency health care delivery systems. The concept of health systems includes the organizations, institutions, and resources whose primary purpose is to promote, restore, and/or maintain health. This article further conceptualizes the vertical and horizontal delivery of acute and emergency care in low-resource settings by defining specific terminology for emergency care platforms and discussing how they fit into broader health systems models. This was accomplished through discussion surrounding four principal questions touching upon the interplay between health systems and acute and emergency care. This research agenda is intended to assist countries that are in the early stages of integrating emergency services into their health systems and are looking for guidance to maximize their development and health systems planning efforts. A chieving the highest attainable standard of health requires universal access to essential services that are rationally distributed and utilized. Timely action in response to emergent disease presentations is one such essential health service. At present, many national health systems are oriented to specific diseases rather than cross-cutting "systems" interventions that might have a larger long-term effect by strengthening systemwide capacity. The natural history and epidemiology of emergencies emphasize that highly functional health systems, including intact and codified referral networks, are necessary to improve survival of patients with acute diseases. Failure to prioritize integration across disease-oriented programs and service delivery units, and failure to deliver emergency health services promptly, results in care that is poorly