Improving emergency medical services in Kenya and Uganda

Uganda and Kenya continue to suffer from a so-called enormous disease burden – an important indicator that the healthcare system is in urgent need of improvement. The majority of the population has no access to timely medical (emergency) care, which is partly reflected through the high mortality rates.

The emergency medical services are poorly developed. Emergencies, such as traffic accidents, birth complications or internal medicine emergencies which require rapid medical attention, remain common causes of death. It is estimated that up to 80 percent of emergency patients in need of help die before reaching a hospital. Thus, compared to countries in the global North, a person in these countries is twice as likely to die before reaching the hospital.

Consequently, there is a great need for a reliable and functioning emergency medical services system: a solid emergency medical system is an effective safety net for people, providing life-saving measures regardless of the cause, and can thus stabilize patients at an early stage and save their lives.

Our goal is a nationwide establishment of a functioning and high-quality emergency medical services system in Uganda and Kenya that is accessible to all ensuring adequate care for emergency patients. To achieve this, we strive for the following subgoals:

• Improved regulation of emergency medical services in Kenya and Uganda through adoption and implementation of appropriate legislation and policies.
   
• Improved capacity and deployment of qualified personnel in the emergency medical services system through nationally standardized training courses, consistent certification by qualified training institutions, and mentoring by professional associations.
   
• Improved and functioning emergency medical care.

In our first phase of the program, in close coordination with state actors, the legal framework was created, and generally binding standards were promoted. At the same time, the needs of the training, hospital and rescue services were identified and in part already met.

In our second phase, we are closing further gaps in the legal framework in close coordination with stakeholders in the emergency medical services system and expanding the already standardized guidelines to additional districts and regions. Building on this, we are extending training opportunities and courses in local academic institutions. In both Uganda and Kenya, operational call and  dispatch centers are being established, standards for their operation are being defined, and the staff are being trained accordingly.

An exchange between the actors in Kenya, Uganda and Germany helps to transfer knowledge, to deepen and to strengthen the established relationships between professionals in the emergency medical services of the German “Malteser Hilfsdienst” and the Kenyan and Ugandan institutions.

Building on the measures of these phases, the training and equipment of the emergency medical services in Uganda and Kenya will be improved step by step, thus enabling high-quality care for accident patients and severely injured persons. Through close coordination and cooperation with the ministries of health, professional associations and training institutions, initial successes have already been achieved and structures consolidated that will strengthen the emergency system in the long term. This has already been demonstrated, for example, in the fight against the COVID-19 pandemic and following a flood in Uganda in 2020. After the floods in the rural district of Kasese, emergency personnel were on site and were able to support the local forces together with Malteser International.
 

Our measures at a glance:
 

Establish and implement legal framework

• Disseminate the emergency medical services strategy at national and regional level
• Development of standards and standard operating procedures for prehospital, in-hospital and emergency medical services systems
   

Training of emergency medical services professionals with the support of Malteser Hilfsdienst

• Training of first responders, emergency medical technicians, paramedics and dispatchers  by qualified training institutions according to a standardized national curriculum
• Exchange and learning visits of Kenyan and Ugandan actors of the emergency medical services system and Malteser Hilfsdienst e.V.
   

 Improved and functioning coordination of prehospital care

• Establishment of call and dispatch centers to coordinate rescue resources in the selected districts with computer-based communication and coordination systems that comply with WHO and national guidelines
   

Provision of initial equipment and material support to the ambulance system

• Establishment of centers of competency under the supervision of the ambulance associations
• Equipment for two partner hospitals
• Equipment/improvement of selected ambulances, which are also used for training purposes
• Procurement of sample equipment