Governing access to emergency care in Africa

Burkholder, Taylor; Bergquist, Harveen; Wallis, Lee

doi:10.1016/j.afjem.2020.07.003

Cited by 11 publications

(15 citation statements)

References 18 publications

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“…International treaties, constitutional and statutory law, regulations, guidelines, protocols and informal practice patterns are instrumental in governing the health system and improving service delivery [ 59 ]…”

Section: Resultsmentioning

confidence: 99%

Successes and challenges of health systems governance towards universal health coverage and global health security: a narrative review and synthesis of the literature

Debie

Khatri

Assefa

2022

Health Res Policy Sys

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Background The shift in the global burden of disease from communicable to noncommunicable was a factor in mobilizing support for a broader post-Millennium Development Goals (MDGs) health agenda. To curb these and other global health problems, 193 Member States of the United Nations (UN) became signatories of the Sustainable Development Goals (SDGs) and committed to achieving universal health coverage (UHC) by 2030. In the context of the coronavirus disease 2019 (COVID-19) pandemic, the importance of health systems governance (HSG) is felt now more than ever for addressing the pandemic and continuing to provide essential health services. However, little is known about the successes and challenges of HSG with respect to UHC and health security. This study, therefore, aims to synthesize the evidence and identify successes and challenges of HSG towards UHC and health security. Methods We conducted a structured narrative review of studies published through 28 July 2021. We searched the existing literature using three databases: PubMed, Scopus and Web of Science. Search terms included three themes: HSG, UHC and health security. We synthesized the findings using the five core functions of HSG: policy formulation and strategic plans; intelligence; regulation; collaboration and coalition; and accountability. Results A total of 58 articles were included in the final review. We identified that context-specific health policy and health financing modalities helped to speed up the progress towards UHC and health security. Robust health intelligence, intersectoral collaboration and coalition were also essential to combat the pandemic and ensure the delivery of essential health services. On the contrary, execution of a one-size-fits-all HSG approach, lack of healthcare funding, corruption, inadequate health workforce, and weak regulatory and health government policies were major challenges to achieving UHC and health security. Conclusions Countries, individually and collectively, need strong HSG to speed up the progress towards UHC and health security. Decentralization of health services to grass root levels, support of stakeholders, fair contribution and distribution of resources are essential to support the implementation of programmes towards UHC and health security. It is also vital to ensure independent regulatory accreditation of organizations in the health system and to integrate quality- and equity-related health service indicators into the national social protection monitoring and evaluation system; these will speed up the progress towards UHC and health security.

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Section: Resultsmentioning

confidence: 99%

Successes and challenges of health systems governance towards universal health coverage and global health security: a narrative review and synthesis of the literature

Debie

Khatri

Assefa

2022

Health Res Policy Sys

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“…There is a need for legislation in order to provide a legal assurance of access to emergency services irrespective of the capacity to pay. The potential effect of legislative assurances of access to emergency care in Africa is demonstrated by constitutional and statutory rules and other governance frameworks [9][10][11]24]. Therefore, the success of a triage demands undertaking a holistic integral approach in order to improve the system.…”

Section: Discussionmentioning

confidence: 99%

“…In most LMICs, where demand for emergency treatment far outstrips the material and human resources available, initial triage and emergency care provision are poorly handled. It is therefore critical that EDs have, depending on the urgency of their situation, frameworks for prioritizing patients [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Sudanese emergency departments: a study to identify the barriers to a well-functioning triage

Ibrahim

2022

BMC Emerg Med

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Background Triage system is a sorting system that categorizes patients on the basis of the severity of their condition and the availability of the resources in the emergency department. There has been little attention in the public literature to triage systems in Sudan. The aim of this study was to explore the triage system and identify the barriers in its application in hospitals in Sudan. Methods A cross-sectional hospital based study was conducted at eight hospitals in Khartoum during December 2020. A multi-stage cluster sampling was applied. Data were obtained by interviewing emergency department staff using a structured questionnaire. The data were analyzed using statistical package for social sciences to find the association between various variables by chi-square test. Results Most of the respondents stated that the triage system was deficient. Most of the participants of this study agreed that the role played by the administration in taking legislative decisions is crucial in improving the triage system. Among the factors found to be significant to a well-functioning triage system were, the need for substantial capital expenditure, p-value: 0.026, prudent legislative decisions, p-value: 0.026, adequate training of staff on means of performing efficient triaging, p-value: 0.007 and raising the awareness of the staff on the correct application of triage guidelines, p-value: 0.017. Conclusion Currently there is no formal triage system in the State of Khartoum and has yet to be established. Policy making by administrators will play an important role in its implementation. It is suggested that prompt executive orders on improving the current triage system in Khartoum, should be carried out sooner than later, as the ripple effects of a well-functioning triage will decrease the average length of stay, mortality and morbidity rates and will eventually increase the patient’s satisfaction.

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“…The Kenyan framework for the care of emergent conditions is built on a robust structure that is set forth in national law [21] . The Kenyan Constitution (in 2010) codified in the Bill of Rights that all Kenyan citizens “shall not be denied emergency medical treatment.” [22] Furthermore, the Health Act of 2017 defines a medical emergency as one that poses an “immediate risk to life or health of a person or has potential for deterioration”, and emergency treatment is that which is “necessary immediate health care that must be administered to prevent death or worsening of a medical situation” [14] .…”

Section: Emergency Care and Universal Health Carementioning

confidence: 99%

The status and future of emergency care in the Republic of Kenya

Lee

Wanjiku

Nduku

et al. 2022

African Journal of Emergency Medicine

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Kenya is a rapidly developing country with a growing economy and evolving health care system. In the decade since the last publication on the state of emergency care in Kenya, significant developments have occurred in the country's approach to emergency care. Importantly, the country decentralized most health care functions to county governments in 2013. Despite the triple burden of traumatic, communicable, and non-communicable diseases, the structure of the health care system in the Republic of Kenya is evolving to adapt to the important role for the care of emergent medical conditions. This report provides a ten-year interval update on the current state of the development of emergency medical care and training in Kenya, and looks ahead towards areas for growth and development. Of particular focus is the role emergency care plays in Universal Health Coverage, and adapting to challenges from the devolution of health care.

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Governing access to emergency care in Africa

Cited by 11 publications

References 18 publications

Successes and challenges of health systems governance towards universal health coverage and global health security: a narrative review and synthesis of the literature

Successes and challenges of health systems governance towards universal health coverage and global health security: a narrative review and synthesis of the literature

Sudanese emergency departments: a study to identify the barriers to a well-functioning triage

The status and future of emergency care in the Republic of Kenya

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