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Addressing World Health Assembly Resolution 60.22: A Pilot Project to Create Access to Acute Care Services in Uganda - 21/10/14

Doi : 10.1016/j.annemergmed.2014.01.035 
Heather Hammerstedt, MD, MPH a, b, , Samuel Maling, MBChB c, Ronald Kasyaba, MBChB d, Bradley Dreifuss, MD b, e, Stacey Chamberlain, MD, MPH b, f, Sara Nelson, MD b, g, Mark Bisanzo, MD, DTM&H b, h, Isaac Ezati, MBChB i
a Idaho Emergency Physicians, Boise, ID, and the University of Washington WWAMI 
b Global Emergency Care Collaborative, Boston, MA 
c Mbarara University of Science and Technology, Mbarara, Uganda 
d Karoli Lwanga “Nyakibale” Hospital, Rukungiri, Uganda 
e University of Arizona, Department of Emergency Medicine, Tucson, AZ 
f University of Illinois at Chicago, Department of Emergency Medicine, Center for Global Health, Chicago, IL 
g Maine Medical Center, Department of Emergency Medicine, Portland, ME, and Tufts University School of Medicine, Boston, MA 
h University of Massachusetts, Department of Emergency Medicine, Worcester, MA 
i Ministry of Health, Kampala, Uganda 

Corresponding Author.

Abstract

The World Health Assembly 2007 Resolution 60.22 tasked the global health community to address the lack of emergency care in low- and middle-income countries. Little progress has yet been made in integrating emergency care into most low- and middle-income-country health systems. At a rural Ugandan district hospital, however, a collaborative between a nongovernmental organization and local and national stakeholders has implemented an innovative emergency care training program. To our knowledge, this is the first description of using task shifting in general hospital-based emergency care through creation of a new nonphysician clinician cadre, the emergency care practitioner. The program provides an example of how emergency care can be practically implemented in low-resource settings in which physician numbers are limited. The Ministry of Health is directing its integration into the national health care system as a component of a larger ongoing effort to develop a tiered emergency care system (out-of-hospital, clinic- and hospital-based provider and physician trainings) in Uganda. This tiered emergency care system is an example of a horizontal health system advancement that offers a potentially attractive solution to meet the mandate of World Health Assembly 60.22 by providing inexpensive educational interventions that can make emergency care truly accessible to the rural and urban communities of low- and middle-income countries.

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 Supervising editor: Theodore R. Delbridge, MD, MPH
 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org/). The authors have stated that no such relationships exist and provided the following details: Global Emergency Care Collaborative is a US-based 501c3 nongovernmental nonprofit organization, whose private donors and funding from small family-based foundations, such as AllPeopleBeHappy Foundation (allpeoplebehappy.org), support the emergency care practitioner educational programming. No funding support was received for the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the article; or decision to submit the article for publication.
 A podcast for this article is available at www.annemergmed.com.


© 2014  American College of Emergency Physicians. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 64 - N° 5

P. 461-468 - novembre 2014 Retour au numéro
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