The Status of Facility Based Emergency Care in Public Hospitals of Ethiopia Using WHO Assessment Tool

BACKGROUND: The availability of emergency care contributes to half of the total mortality burden in a low and middle income countries. The significant proportion of emergency departments in LMICs are understaffed and poorly equipped. The purpose of this study is to examine the status of emergency units and to describe the facilitators and barriers to the provision of facility-based emergency care at selected Ethiopian public hospitals. METHODS: A mixed-methods explanatory design was used. Ten hospitals were purposively selected due to their high number of patients and referral service. A WHO facility assessment tool was used to quantitatively assess the facilities, and an in-depth interview with hospital and emergency room leadership was conducted. The quantitative results were descriptively analyzed, and the qualitative data was thematically analyzed. RESULT: This survey included a total of ten hospitals. Three of the facilities were general hospitals, and seven were tertiary level hospitals. They all were equipped with an emergency room. All of the studied hospitals serve a population of over one million people. In terms of infrastructure, only 3/10 (30%) have adequate water supply, and alf (5/10) have telephone access in their ED. The qualitative resultshowedthat the most common barriers to emergency care delivery were prolonged patient stays in the emergency room, inadequate equipment, and a shortage of trained professionals. CONCLUSION: The status of emergency care in Ethiopia is still developing, and hospital care as a whole should improve to alleviate the high burden of care in emergency rooms and reduce morbidity and mortality.

The status of emergency medicine in Ethiopia, challenges and opportunities

Back ground: Emergency medicine(EM) is one of the most rapidly developing medical specialties in Africa. After just 8 years since its introduction in Ethiopia, there were 22 qualified emergency medicine specialists and 2 pediatric emergency specialists in the country. The aim of this study was to qualitatively assess the status of emergency medicine and the challenges and opportunities of working as an emergency physician in Ethiopia.Methodology: An interview and a videotaped focus group discussion involving 17 selected participants were done in December of 2016. The data was transcribed, translated and analyzed by identifying the most common themes that emerged.Result: All the participants agreed the field of emergency medicine is rapidly expanding in Ethiopia. Six themes were identified as challenges: The undeveloped state of the emergency medical system, the disorganization prevalent in emergency rooms, an undefined scope of practice, problems with acceptance of the specialty, poor continuity of care, and an unsatisfactory remuneration. Meanwhile, the increasing attention given by the government and the demand for pre-hospital and in hospital emergency care were identified as future opportunities for growth of the specialty. Conclusion: Emergency medicine in Ethiopia faces multiple challenges as it is a new field in a resource limited setting. The challenges range from problems with acceptance to difficulties of patient disposition. In order to overcome these challenges, government level support and advocacy work among health sectors, physicians, and medical associations is imperative