Building the emergency care workforce in a low resource setting; The Seed Global Health experience in Uganda

Abstract

Introduction: Low- and middle-income countries (LMICs) face a disproportionate burden of diseases requiring emergency care. In Uganda, road traffic trauma in the context of rapid urbanization, particularly motorcycle accidents, accounts for 48% of medical emergencies. The burden of road traffic accidents, obstetric complications, and non-communicable diseases necessitate robust emergency care, yet Uganda faces systemic challenges in this sector. Following the 60th and 72nd sessions of the World Health Assembly that called for strengthened emergency, critical and operative care to achieve universal health coverage, Uganda committed to strengthening emergency medical services through taking key steps such as developing a national Emergency Medical Services (EMS) Policy. The EMS Policy outlined twelve key focus areas including development of human resources for emergency medical services, key among are emergency physicians. To support these efforts, Seed Global Health, the Ugandan Ministry of Health, Makerere University, and Mbarara University of Science and Technology partnered to strengthen the emergency medicine training between 2019 and 2024. Methods: We conducted a desk review to evaluate the collaborative effort between Seed Global Health, Ministry of Health, Makerere University and Mbarara University of Science and Technology. We reviewed policy documents, health records, and program reports to assess initiatives by Seed Global Health that were focused on developing human resources for emergency medical services, including emergency physicians training, emergency nurses and the contributions of local and international faculty. Results: The partnership between Seed Global Health, Ministry of Health, Mbarara University of Science and Technology and Makerere University successfully trained 21 new emergency physicians, with 43 more residents currently in training. It introduced essential clinical resources, enhancing diagnostic and treatment capacities for improved patient care while improving learning environments through skills laboratory support, simulation support and classroom equipment. Additionally, it supported the coordination of emergency services within emergency departments in hospitals as well as enhanced advocacy efforts to improving emergency care in Uganda. However, despite these tremendous milestones, challenges persist including a shortage of specialists relative to the high demand for services, a need for increased investment for emergency medical services and a need for better integration of emergency services within the healthcare system. Conclusion: This article highlights the value of international collaborations, long term partnership and targeted training in addressing emergency care gaps in LMICs. We recommend expanding emergency medicine programs, increasing government investment in facilities and human resources, and strengthening interdisciplinary emergency response teams. These measures are essential for providing sustainable, quality emergency care to address Uganda's growing needs.