Abstract
Armenia, an ex-Soviet Republic in transition since independence in 1991, has made remarkable strides in development. The crisis of prioritization that has plagued many post-Soviet republics in transition has meant differential growth in varied sectors in Armenia. Emergency systems is one of the sectors which is neglected in the current drive to modernize. The legacy of the Soviet Semashko system has left a void in specialized care including emergency care. This manuscript is a descriptive overview of the current state of emergency care in Armenia using in-depth key informant interviews and review of published and unpublished internal United States Agency for International Development (USAID) and Ministry of Health (MOH) documents as well as data from the Yerevan Municipal Ambulance Service and international agencies. The Republic of Artsakh is briefly discussed.The development of emergency care systems is an extremely efficient way to provide care across many different conditions in many age groups. Conditions such as traumatic injuries, heart attacks, cardiac arrest, stroke, and respiratory failure are very time-dependent. Armenia has a decent emergency infrastructure in place and has the benefit of an educated and skilled physician workforce. The missing piece of the puzzle appears to be investment in graduate and post-graduate education in emergency care and development of hospital-based emergency care for stabilization of stroke, myocardial infarction, trauma, and sepsis as well as other acute conditions.
Highlights
The rising importance of emergency systems and emergency medical care on the global stage With the shift of global disease burden to trauma and non-communicable diseases from infectious diseases such as tuberculosis, human immunodeficiency virus, and malaria, it has become clear that strictly funding vertical programs focused on a single disease discourages the development of strong healthcare delivery systems
More than 75% of that burden falls on low- and middle-income countries (LMICs) with the highest burden in East Asia followed by the Europe/Central Asia (EE/CA) region [30, 31]
Emergency care has remained fairly undeveloped, yet it has the potential to catalyze the entirety of healthcare
Summary
The rising importance of emergency systems and emergency medical care on the global stage With the shift of global disease burden to trauma and non-communicable diseases from infectious diseases such as tuberculosis, human immunodeficiency virus, and malaria, it has become clear that strictly funding vertical programs focused on a single disease discourages the development of strong healthcare delivery systems. The absence of hospital-based emergency services leaves patients to fend for themselves when deciding to seek care for acute conditions such as trauma, stroke, and cardiac issues. The National Institute of Health is currently working to establish new post-graduate programs in emergency medicine This effort will start by working with the municipal ambulance system to voluntarily retrain already practicing doctors employed by the ambulance services in order to standardize their education and bolster their depth of knowledge. EMS in cardiac and stroke chains of survival, improving current emergency services through education and training of existing staff, developing graduate and post-graduate training, and expanding regional and hospital-based emergency care are tantamount to EMS development and quality improvement in the Republic of Armenia
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