The GVK EMRI maternal and neonatal transport system in India: a mega plan for a mammoth problem

Kumutha, J.; Rao, G.V. Ramana; Sridhar, Bendalam; Vidyasagar, Dharmapuri

doi:10.1016/j.siny.2015.07.003

Cited by 19 publications

(17 citation statements)

References 4 publications

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“…India has a 108 free ambulance service in most parts of the country which is the mainstay for transfer from home and between institutions for pregnant women [ 55 ]. However a study in Gujarat on referral systems and transportation revealed that the focus of the system was more on the number of ambulances and drivers, and less on the number of referrals transported [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Referrals between Public Sector Health Institutions for Women with Obstetric High Risk, Complications, or Emergencies in India – A Systematic Review

et al. 2016

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Emergency obstetric care (EmOC) within primary health care systems requires a linked referral system to be effective in reducing maternal death. This systematic review aimed to summarize evidence on the proportion of referrals between institutions during pregnancy and delivery, and the factors affecting referrals, in India. We searched 6 electronic databases, reviewed four regional databases and repositories, and relevant program reports from India published between 1994 and 2013. All types of study or reports (except editorials, comments and letters) which reported on institution-referrals (out-referral or in-referral) for obstetric care were included. Results were synthesized on the proportion and the reasons for referral, and factors affecting referrals. Of the 11,346 articles identified by the search, we included 232 articles in the full text review and extracted data from 16 studies that met our inclusion criteria Of the 16, one was RCT, seven intervention cohort (without controls), six cross-sectional, and three qualitative studies. Bias and quality of studies were reported. Between 25% and 52% of all pregnancies were referred from Sub-centres for antenatal high-risk, 14% to 36% from nurse run delivery or basic EmOC centres for complications or emergencies, and 2 to 7% were referred from doctor run basic EmOC centres for specialist care at comprehensive EmOC centres. Problems identified with referrals from peripheral health centres included low skills and confidence of staff, reluctance to induce labour, confusion over the clinical criteria for referral, non-uniform standards of care at referral institutions, a tendency to by-pass middle level institutions, a lack of referral communication and supervision, and poor compliance. The high proportion of referrals from peripheral health centers reflects the lack of appropriate clinical guidelines, processes, and skills for obstetric care and referral in India. This, combined with inadequate referral communication and low compliance, is likely to contribute to gaps and delays in the provision of emergency obstetric care.

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Section: Discussionmentioning

confidence: 99%

Referrals between Public Sector Health Institutions for Women with Obstetric High Risk, Complications, or Emergencies in India – A Systematic Review

et al. 2016

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“…With the EMS system from GVK EMRI developing across India, new opportunities for health surveillance are appearing [43,48]. Although the service is still under development and the number of emergency ambulances will have to grow to a sufficient size, the service has established an important role for the first access to the health care system in the operating states.…”

Section: Discussionmentioning

confidence: 99%

“…Technical results on fever cluster detection using EMS data and ARIMA models for forecasting needs in emergency-data-based syndromic surveillance, were published as part of the SEED [18,41,42]. The GVK EMRI EMS system is able to deliver routinely-collected health information (for purposes other than surveillance) in a comprehensive and cross-institutional manner [43]. Figure 1 shows the process by which the routine EMS data from GVK EMRI used for the syndromic surveillance approach is generated automatically through incoming calls via the "108" universal emergency telephone number and captured at the dispatch centre in Hyderabad.…”

Section: System For Early Warning Based On Emergency Data (Seed)mentioning

confidence: 99%

Section: System For Early Warning Based On Emergency Data (Seed)mentioning

confidence: 99%

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Towards Sustainable Public Health Surveillance in India: Using Routinely Collected Electronic Emergency Medical Service Data for Early Warning of Infectious Diseases

et al. 2017

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Infectious disease surveillance, timely detection and early warning of outbreaks present a complex challenge to health authorities in India. Approaches based on the use of unexplored data sources, like emergency medical services (EMS) data, can contribute to the further advancement of public health surveillance capacities in India and support and strengthen the Integrated Disease Surveillance Programme (IDSP) strategy. This research followed a mixed method approach including a series of semi-structured interviews and fever data analysis of the EMS operating dispatch system in Andra Pradesh, India. In this paper, we explore whether routinely collected EMS health data can improve sustainable infectious disease surveillance and early warning capacity. The result highlights the need for improved surveillance systems for early warning of infectious diseases in India. The data availability at the EMS dispatch centre includes patient data and spatial information and can be used for near real-time analysis. Routine data relevant for health surveillance can be extracted to provide timely health information that supplements and enhances more traditional surveillance mechanisms and thus provides a cost-efficient, near real-time early warning system for the operating states. The designed intervention is sustainable and can improve infectious disease surveillance to potentially help the government officials to appropriately prioritize timely interventions to prevent infectious disease spread.

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“…Globally, no robust clinical trials have evaluated the benefit of cellular communication in the prehospital environment, but several small studies have shown promising results in improving patient care in other clinical arenas [ 8 - 10 ]. For example, LMIC community health workers (CHWs) and midwives have been given cellular devices to enable real-time medical direction from physicians for the management of emergent conditions, particularly maternal and neonatal emergencies [ 4 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Barriers to Real-Time Medical Direction via Cellular Communication for Prehospital Emergency Care Providers in Gujarat, India

Lindquist¹,

Strehlow²,

Rao³

et al. 2016

Cureus

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Background: Many low- and middle-income countries depend on emergency medical technicians (EMTs), nurses, midwives, and layperson community health workers with limited training to provide a majority of emergency medical, trauma, and obstetric care in the prehospital setting. To improve timely patient care and expand provider scope of practice, nations leverage cellular phones and call centers for real-time online medical direction. However, there exist several barriers to adequate communication that impact the provision of emergency care. We sought to identify obstacles in the cellular communication process among GVK Emergency Management and Research Institute (GVK EMRI) EMTs in Gujarat, India.Methods: A convenience sample of practicing EMTs in Gujarat, India were surveyed regarding the barriers to call initiation and completion.Results: 108 EMTs completed the survey. Overall, ninety-seven (89.8%) EMTs responded that the most common reason they did not initiate a call with the call center physician was insufficient time. Forty-six (42%) EMTs reported that they were unable to call the physician one or more times during a typical workweek (approximately 5-6 twelve-hour shifts/week) due to their hands being occupied performing direct patient care. Fifty-eight (54%) EMTs reported that they were unable to reach the call center physician, despite attempts, at least once a week.Conclusion: This study identified multiple barriers to communication, including insufficient time to call for advice and inability to reach call center physicians. Identification of simple interventions and best practices may improve communication and ensure timely and appropriate prehospital care.

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The GVK EMRI maternal and neonatal transport system in India: a mega plan for a mammoth problem

Cited by 19 publications

References 4 publications

Referrals between Public Sector Health Institutions for Women with Obstetric High Risk, Complications, or Emergencies in India – A Systematic Review

Referrals between Public Sector Health Institutions for Women with Obstetric High Risk, Complications, or Emergencies in India – A Systematic Review

Towards Sustainable Public Health Surveillance in India: Using Routinely Collected Electronic Emergency Medical Service Data for Early Warning of Infectious Diseases

Barriers to Real-Time Medical Direction via Cellular Communication for Prehospital Emergency Care Providers in Gujarat, India

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