PROJECT 47: EMERGENCY DEPARTMENTS IN 47 COUNTIES

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BACKGROUND

 

For many people in Kenya and across the world, the emergency department (ED) is the primary point of access to the health system. An increasing number of patients with acute disease currently present to EDs across Kenya. This is due to the rising incidence of non-communicable diseases (NCDs) (such as cancer, diabetes and hypertension), mental illness and trauma (largely secondary to road traffic injuries) in the background of an already existing large burden of communicable diseases. Recently, the need for strengthening Kenya’s emergency medical care system has gained more recognition by the government and other stakeholders involved in the healthcare system in Kenya. The gap in lack of an emergency medical care system is a good opportunity for the County Governments to step in and provide the necessary critical services for its people. An absence of an emergency medical care system is furthermore a barrier to achieving Universal Health Coverage (UHC), a top priority for President Kenyatta’s big four agenda in his last term. The goal of Project 47 is to assess the current state and locations of emergency departments in all 47 counties in Kenya, identify gaps, and set priority actions for use by County Governments, planners and partners as a roadmap toward universal emergency care coverage. This proposal has been developed by the Emergency Medicine Kenya Foundation (EMKF), a non-profit organization dedicated to the development of evidence-based universal emergency care in Kenya through education and research and the project partners below.

 

OBJECTIVES OF THIS PROJECT

 

The primary objective is to gather information about the current location and state of emergency departments in Kenya including spatial access to these departments. An emergency department here is defined as any dedicated intake area for acutely ill and injured patients that is open and staffed 24 h in a facility that has a functioning operating theatre. The specific objectives are:
  1. Identify the location of emergency departments in all 47 counties
  2. Characterize the current state of emergency departments in the counties
  3. Determine the proportion of the population within the counties that can access emergency medical care within the ‘golden hour’
  4. Determine the proportion of the population within the counties that can access emergency surgery (caesarean delivery, laparotomy, and treatment of open fracture (the Bellwether Procedures)) within 2 h
  5. Plan priority actions for counties in response to the identified gaps and goals
  6. Draft an implementation roadmap for County Governments to complete the priority actions
  7. To design ways to monitor the implementation progress towards carrying out the priority actions
  8. Strengthen the emergency departments in the counties to improve efficiency in emergency triage and treatment
  9. Provide support to the County Governments in strengthening the critical hospital infrastructure to handle medical emergencies
   

CONCEPTUAL MODEL

 

PROJECT TASKS

 

The project tasks are:

  1. Assessment of emergency departments: This will assess the capacity “hardware” (e.g. facilities, human resources) and “software” (e.g. guidelines) of the emergency departments (as defined above) to handle medical emergencies. The WHO Generic Essential Emergency Equipment List and the WHO Integrated Management for Emergency and Essential Surgical Care tools will be used for this assessment.
  2. GPS & GIS mapping of emergency departments: We will map out all emergency departments (as defined above) in the County. Geographic Information System (GIS) network analysis will be used to quantify the population-level spatial accessibility to the emergency departments.

 

Additional tasks that will be performed by this project include:

 

3. Donation of emergency medical care equipment: EMKF will donate an ECG machine and a Vital Signs monitor to the County Referral Hospital emergency department and train the staff on Triage and ECG interpretation. We will also donate our evidence-based Emergency Care Algorithms to the emergency department staff to support emergency care treatment in the Counties.

 

REPORTING, VALIDATION AND PRESENTATION OF FINDINGS

 

Detailed key findings will be developed in a Draft Report. The Draft Report will be presented to each County Government to validate the results. We will work with the County Government to plan priority actions for the county in response to the identified gaps and goals and draft an implementation roadmap for each of the County Governments to complete these priority actions. We will also design ways for the County Government to monitor the implementation progress. A final discussion and feedback on the findings and roadmap will be done and amendments agreed upon reflected in the Final Report given to each County Government.

 

PROJECT PARTNERS

 

 

 

 

 

 

In case of any queries, kindly contact Dr Benjamin Wachira on +254 728 593 360 and benjamin.wachira@aku.edu or Emily Nyagaki on +254 733 878 809 or emily@emergencymedicinekenya.org