BackgroundThe Kampala Metropolitan Area (KMA) is the fastest developing region in Uganda. Over recent years, this has placed exponential demand on the road sector, which consequently has contributed to rapid growth in motorized vehicles which, predisposes the region to a high risk of road traffic incidents (RTIs). A number of concerted road safety and post-crash management measures to respond to RTIs in the KMA in particular and Uganda as a whole have been undertaken. However, there is a need to greatly improve the measures by better identifying the factors influencing the exposure, vulnerability and emergency medical service (EMS) capacity for RTI victims. The present study seeks to investigate and reveal these factors.MethodsA Delphi technique employing a questionnaire and involving a multidisciplinary panel of experts was used in three rounds.ResultsThe ten (10) most important factors affecting the exposure, vulnerability and EMS capacity for victims of RTIs in the KMA were identified. Socio-cultural, infrastructure and road safety aspects were the factors most identified as affecting the exposure and vulnerability. The absence of a national EMS policy and post-crash care system, as well as the fact that many victims lack health insurance, were noted to be the factors adversely affecting the EMS capacity.ConclusionsThere exists is a real need to substantially reduce the burden of RTIs in KMA, with ultimate goal of saving lives that are being lost needlessly and reducing the impact of injuries and trauma and the economic losses associated with it. This study offers insights into the causes of RTIs and the most appropriate ways of responding to them especially with the establishment and empowerment of predefined and structured EMS systems.

The huge burden and vulnerability imposed by non-communicable diseases (NCDs) during the COVID-19 pandemic highlighted how healthy lifestyle behaviors and the well-being of people living with NCDs need to be prioritized. The aim of our study is to better understand the impact of the COVID-19 pandemic on healthy lifestyle behaviors and perceived mental and physical health among adults living with NCDs, as compared to people without NCDs. We conducted a cross-sectional study using a global online survey through Qualtrics. Over four months, 3550 participants from 65 countries worldwide responded to the survey. The study included 3079 surveys with no missing data (complete survey responses) that were used for analysis. People with NCDs were more likely to report statistically significant worsening physical health (p = 0.001) and statistically insignificant worsening mental health (p = 0.354) when compared to pre-pandemic levels. They reported lower rates of smoking during the pandemic than those without NCDs, and a statistically significant (p < 0.001) relationship was found between weight gain and NCDs. Therefore, the perceived physical and mental health, including changes in body weight and tobacco consumption, of people with NCDs were significantly impacted during the pandemic. In conclusion, this study indicates that the pandemic had a significant impact on perceived physical and mental health, changes in body weight, and tobacco consumption among people with NCDs.

BackgroundPre-hospital emergency care is a vital and integral component of health systems particularly in the resource constrained countries like Uganda. It can help to minimize deaths, injuries, morbidities, disabilities and trauma caused by the road traffic incidents (RTIs). This study identifies the weaknesses and capacities affecting the pre-hospital emergency care for the victims of RTIs in the Greater Kampala Metropolitan Area (GKMA).MethodsA cross-sectional study was conducted in the GKMA using a three-part structured questionnaire. Data related to the demographics, nature of RTIs and victims’ pre-hospital experience and existing Emergency Medical Services (EMS) were collected from victims and EMS specialists in 3 hospitals and 5 EMS institutions respectively. Data was descriptively analyzed, and after the principal component analysis was employed to identify the most influential weaknesses and capacities affecting the pre-hospital emergency care for the victims of RTI in the GKMA.ResultsFrom 459 RTI victims (74.7% males and 25.3% females) and 23 EMS specialists (91.3% males and 8.7% females) who participated in the study between May and June 2016, 4 and 5 key weaknesses and capacities respectively were identified to affect the pre-hospital emergency care for RTI victims in the GKMA. Although some strengths exist like ambulance facilitation, EMS structuring, coordination and others), the key weaknesses affecting the pre-hospital care for victims were noted to relate to absence of predefined EMS systems particularly in the GKMA and Uganda as a whole. They were identified to involve poor quality first aid treatment; insufficient skills/training of the first responders; inadequate EMS resources; and avoidable delays to respond and transport RTI victims to medical facilities.ConclusionsThough some strengths exist, the weaknesses affecting prehospital care for RTI victims primarily emanate from the absence of predefined and well-organized EMS systems in the GKMA and Uganda as a whole.Electronic supplementary materialThe online version of this article (10.1186/s12873-017-0137-2) contains supplementary material, which is available to authorized users.

Introduction:Prehospital emergency care is a vital and integral component of health systems, particularly in resource-constrained countries like Uganda. It can help to minimize deaths, injuries, morbidities, disabilities, and trauma caused by road traffic incidents (RTIs). This study identifies the weaknesses and capacities affecting the prehospital emergency care for the victims of RTIs in the Greater Kampala Metropolitan Area (GKMA).Methods:A cross-sectional study was conducted in the GKMA using a three-part structured questionnaire. Data related to the demographics, nature of RTIs and victims’ pre-hospital experience and existing Emergency Medical Services (EMS) were collected from victims and EMS specialists in 3 hospitals and 5 EMS institutions, respectively. Data were descriptively analyzed, and a principal component analysis was employed to identify the most influential weaknesses and capacities affecting the prehospital emergency care for the victims of RTI in the GKMA.Results:From 459 RTI victims (74.7% males and 25.3% females) and 23 EMS specialists (91.3% males and 8.7% females) who participated in the study between May and June 20164. key weaknesses and 5 key capacities were identified to affect the prehospital emergency care for RTI victims in the GKMA. Although some strengths exist, (e.g., ambulance facilitation, EMS structuring, and coordination), the key weaknesses affecting the pre-hospital care for victims were noted to relate to the absence of predefined EMS systems, particularly in the GKMA and Uganda as a whole. They were identified to involve poor quality first aid treatment, insufficient skills/training of the first responders, inadequate EMS resources, and avoidable delays to respond and transport RTI victims to medical facilities.Discussion:Though some strengths exist, the weaknesses affecting prehospital care for RTI victims primarily emanate from the absence of predefined and well-organized EMS systems in the GKMA and Uganda as a whole.

In the wake of globalization, proliferation of digital technologies (DTs) is rapidly changing many activities across sectors, including health to “go digital”. Harnessing opportunities of DTs can be a pathway for delivery of health services such as community-based rehabilitation to the vulnerable groups of populations, particularly those in the low resourced countries where the health systems are still weak and experiencing a deficit of trained health workers to effectively deliver a full spectrum of health services. This perspective explored how some DTs can be leveraged in delivery of CBR services in the rural and remote areas of low resourced countries. This is described based on information access and exchange, social satisfaction, shortages of rehabilitation workforce, professional development and capacity building. However, a caution is made since seizing such advantages of DTs can inevitably be associated with spillovers and limitations among others including needs prioritization, skills and language limitations, internet addiction and censorship, professionalism and ethical dilemma and sustainability if proper remedies are not taken. Moreover, as DTs are revolutionizing various activities across sectors, including health; this is not meant to substitute the traditional health care activities including those delivered through CBR but rather to augment their delivery in low resourced settings and elsewhere.