Harnessing inter-disciplinary collaboration to improve emergency care in low- and middle-income countries (LMICs): results of research prioritisation setting exercise
Fiona Lecky, Teri Reynolds, Olubukola Otesile, Sara Hollis, Janette Turner, Gordon Fuller, Ian Sammy, J Williams-Johnson, Heike Geduld, Andrea G. Tenner, Simone French, Ishtar Govia, Julie Balen, Steve Goodacre, Sujan Babu Marahatta, Shaheem DeVries, Hendry R. Sawe, Mohamed El‐Shinawi, Juma A. Mfinanga, Andrés M. Rubiano, Henda Chebbi, Sang Do Shin, Jose Maria E. Ferrer, Mashyaneh Haddadi, Tsion Firew, Kathryn A. Taubert, Andrew Lee, Pauline Convocar, Sabariah Faizah Jamaluddin, Shahzmah Kotecha, Emad Abu Yaqeen, Katie Wells, Lee Wallis
Abstract
BACKGROUND: More than half of deaths in low- and middle-income countries (LMICs) result from conditions that could be treated with emergency care - an integral component of universal health coverage (UHC) - through timely access to lifesaving interventions. METHODS: The World Health Organization (WHO) aims to extend UHC to a further 1 billion people by 2023, yet evidence supporting improved emergency care coverage is lacking. In this article, we explore four phases of a research prioritisation setting (RPS) exercise conducted by researchers and stakeholders from South Africa, Egypt, Nepal, Jamaica, Tanzania, Trinidad and Tobago, Tunisia, Colombia, Ethiopia, Iran, Jordan, Malaysia, South Korea and Phillipines, USA and UK as a key step in gathering evidence required by policy makers and practitioners for the strengthening of emergency care systems in limited-resource settings. RESULTS: The RPS proposed seven priority research questions addressing: identification of context-relevant emergency care indicators, barriers to effective emergency care; accuracy and impact of triage tools; potential quality improvement via registries; characteristics of people seeking emergency care; best practices for staff training and retention; and cost effectiveness of critical care - all within LMICs. CONCLUSIONS: Convened by WHO and facilitated by the University of Sheffield, the Global Emergency Care Research Network project (GEM-CARN) brought together a coalition of 16 countries to identify research priorities for strengthening emergency care in LMICs. Our article further assesses the quality of the RPS exercise and reviews the current evidence supporting the identified priorities.