An Analysis of Emergency Healthcare Delivery in Ghana: Lessons from Ambulance and Emergency Services in Bibiani Anhwiaso Bekwai District

Adamtey, Ronald; Frimpong, Josephine; Dinye, Romanus D

doi:10.4314/gjds.v12i1-2.5

Cited by 8 publications

(21 citation statements)

References 4 publications

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“…10 Therefore, a scoping review was performed of peerreviewed and non-peer-reviewed "grey" literature to understand the state of the art of similar EMS systems currently working in Africa and in other comparable settings across the world. [11][12][13][14][15][16][17][18][19][20][21][22] Results highlighted some common key issues that needed to be addressed to establish a well-structured EMS in such environments, namely the availability of skilled human resources, formal prehospital care training programs, quality monitoring systems, funding, and maintenance issues. Furthermore, consultations were conducted with local stakeholders and members of the board of the National Ambulance System of Uganda and Ghana to seek advice on the preliminary NEMS design.…”

Section: Designmentioning

confidence: 99%

Designing, Implementing, and Managing a National Emergency Medical Service in Sierra Leone

Ragazzoni

Caviglia

Rosi

et al. 2020

Prehosp. Disaster med.

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Sierra Leone is one of the least developed low-income countries (LICs), slowly recovering from the effects of a devastating civil war and an Ebola outbreak. The health care system is characterized by chronic shortage of skilled human resources, equipment, and essential medicines. The referral system is weak and vulnerable, with 75% of the country having insufficient access to essential health care. Consequently, Sierra Leone has the highest maternal and child mortality rates in the world. This manuscript describes the implementation of a National Emergency Medical Service (NEMS), a project aiming to create the first prehospital emergency medical system in the country. In 2017, a joint venture of Doctors with Africa (CUAMM), Veneto Region, and Research Center in Emergency and Disaster Medicine (CRIMEDIM) was developed to support the Ministry of Health and Sanitation (MOHS) in designing and managing the NEMS system, one of the very few structured, fully equipped, and free-of-charge prehospital service in the African continent. The NEMS design was the result of an in-depth research phase that included a preliminary assessment, literature review, and consultations with key stakeholders and managers of similar systems in other African countries. From May 27, 2019, after a timeframe of six months in which all the districts have been progressively trained and made operational, the NEMS became operative at national level. By the end of March 2020, the NEMS operation center (OC) and the 81 ambulances dispatched on the ground handled a total number of 36,814 emergency calls, 35,493 missions, and 31,036 referrals.

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Section: Designmentioning

confidence: 99%

Designing, Implementing, and Managing a National Emergency Medical Service in Sierra Leone

Ragazzoni

Caviglia

Rosi

et al. 2020

Prehosp. Disaster med.

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“…Further selection followed, and finally 14 papers were included in the narrative synthesis (Table 3). [28][29][30][31][32][33][34][35][36][37][38][39][40][41] Overview of Analyzed Studies Of the 14 studies that were included in this review, most were concerned with emergency transport, especially ambulances. Study settings varied across reports from Asia (India, Pakistan, and Cambodia), the Middle East (Iranmost common), and Africa (Ghana -West, Zambia -South, and Kenya -East).…”

Section: Processing Informationmentioning

confidence: 99%

“…This was discussed in a number of studies claiming that bystanders' lack of experience and knowledge of emergency care made their actions detrimental rather than helpful. 28,33,36,41 Although the involvement of lay people was usually necessary to alert emergency services, their lack of knowledge on what information should be provided to the service hampered the system, especially if they provided misleading, incomplete, or incorrect information. 33,36 Lay people also did not know how to behave at a crash scene.…”

Section: General Injurymentioning

confidence: 99%

“…33,36 Lay people also did not know how to behave at a crash scene. 28,33,34,36,41 They often formed a large, uncoordinated, obstructive crowd of curious onlookers that impeded the traffic flow, created opportunities for theft, and made it harder for ambulance access to the scene. At worst, the bystander's behavior may have led to new crashes and new injuries.…”

Section: General Injurymentioning

confidence: 99%

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Putting Culture into Prehospital Emergency Care: A Systematic Narrative Review of Literature from Lower Middle-Income Countries

Tran

Lee

Sleigh

et al. 2019

Prehosp. Disaster med.

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Background:Prehospital emergency care is cost-effective for improving morbidity and mortality of emergency conditions. However, such care has been discounted in the public health system of many lower middle-income countries (LMICs). Where it exists, the Emergency Medical Service (EMS) system is grossly inadequate, unpopular, and misrepresented. Many EMS reviews in developing countries have identified systemic problems with infrastructure and human resources, but they neglected impacts of sociocultural factors. This study examines the sociocultural dimensions of LMICs’ prehospital emergency systems in order to improve the quality and impact of emergency care in those countries.Methods:Qualitative studies on EMS systems in LMICs were systematically reviewed and analyzed using Kleinman’s health system theory of folk, popular, and professional health sectors. Also, the three-delay model of emergency care – seeking, reaching, and receiving – provided a guiding framework.Results:The search yielded over 3,000 papers and the inclusion criteria eventually selected 14, with duplicates and irrelevant papers as the most frequent exclusion. Both user and provider experiences with emergency conditions and the processes of prehospital care were described. Sociocultural factors such as trust and beliefs underlay the way emergency care was experienced. Attitudes of family and community shaped service-seeking behaviors. Traditional medicine was often the first point of care. Private vehicles were the main transportation for accessing care due to distrust and misunderstanding of ambulance services.Conclusion:The findings led to the discussion on how culture is woven into the patients’ pathway to care, and the recommendation for any future development to place a far greater emphasis on this aspect. Instead of relying purely on the biomedical sector, the health system should acknowledge and show respect for popular knowledge and folk belief. Such strategies will improve trust, facilitate information exchange, and enable stronger healer-patient relationships.

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“…Each component incurs corresponding sources of risk that elevate death and disability: delays in (1) seeking care, 10 (2) reaching care, 11 , 12 and (3) receiving care upon arrival at the referral facility 13 . In rural Ghana, and elsewhere in Africa, these delays are driven, respectively, by (1) lack of awareness of the importance of emergency care, 14 lack of family resources to cover referral costs, 15 , 16 and concerns about the quality of care 17 ; (2) poor road conditions, 18 a scarcity of vehicles, 19 , 20 and limited means of communication 21 ; and (3) inaccessibility of competent providers of essential acute care 20 – 22 …”

Section: Introductionmentioning

confidence: 99%

Benefits and Limitations of a Community-Engaged Emergency Referral System in a Remote, Impoverished Setting of Northern Ghana

Patel

Awoonor-Williams

Asuru

et al. 2016

Glob Health Sci Pract

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An Analysis of Emergency Healthcare Delivery in Ghana: Lessons from Ambulance and Emergency Services in Bibiani Anhwiaso Bekwai District

Abstract: Abstract

Cited by 8 publications

References 4 publications

Designing, Implementing, and Managing a National Emergency Medical Service in Sierra Leone

Designing, Implementing, and Managing a National Emergency Medical Service in Sierra Leone

Putting Culture into Prehospital Emergency Care: A Systematic Narrative Review of Literature from Lower Middle-Income Countries

Benefits and Limitations of a Community-Engaged Emergency Referral System in a Remote, Impoverished Setting of Northern Ghana

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