Background Emergency Medical Services (EMS) are a community’s gateway to acute and emergency medical care for members of the public facing time-sensitive, critical illness and injury.1 A functional EMS is an effective, frontline intervention to reduce the disproportionately high morbidity and mortality in Low- and-Middle Income Countries (LMICs).1–3 The World Health Organisation and the African Federation for Emergency Medicine have promoted the formation of locally appropriate EMS systems in LMICs.1–4
Description of the problem Under article 43 of the Constitution of Kenya “a person shall not be denied emergency medical treatment.” However, recent events including floods and the Westgate terrorism attack have revealed a low-functioning system for care of the injured in Kenya. There is extensive variability in the level of care provided at the pre-hospital setting due to the absence of national standards in training of personnel, available equipment and infrastructure. Furthermore, emergency rooms in the public health facilities are often poorly resourced to deliver definitive emergency care.
Results In 2012 and 2013, Johns Hopkins International Injury Research Unit, CDC-Kenya and the Ministry of Health brought together local EMS stakeholders to form a consortium. Members were tasked with creating a locally appropriate EMS Policy. In 2015, a comprehensive policy that recognises pre-hospital care as a component of the healthcare system was developed. It establishes a regulatory body for EMS, defines minimum training and equipment standards and mandates data reporting for quality improvement.
Conclusions The development of a locally appropriate EMS policy requires consensus and extensive stakeholder engagement. The implementation of this policy will provide the opportunity for definitive emergency care as stipulated in the national constitution and serve as a model for EMS development in LMICs.
Kobusingye OC et al. Emergency medical systems in Low-and middle-income countries: recommendations for action. Bulletin of the World Health Organization 2005;83:626–31
Razzak JA and Kellermann AL. Emergency medical care in developing countries: is it worthwhile? Bulletin of the World Health Organization 2002;80:900–905
Henry JA and Reingold AL. Prehospital trauma systems reduce mortality in developing countries: a systematic review and meta-analysis. Journal of trauma and Acute Care Surgery 2012;73:261–268
Calvello E et al. Emergency care in sub-Saharan Africa: Results of a consensus conference. African Journal of Emergency Medicine 2013;3:42–8
- Emergency Medical Services
- Low-and Middle-Income Countries