Development and Pilot Testing of Rapid Assessment Tool for Pre-Hospital System in Kampala, Uganda

 

A collaborative Project of Johns Hopkins International Injury Unit and Makerere School of Public Health

INTRODUCTION
High mortality and morbidity from injuries is a global public health problem. In Uganda, injury related mortality for unintentional injuries including Road Traffic Injuries makes up for 25% of all recorded deaths. Providing early and prompt care to the injured has proven to reduce negative health outcomes, and research has demonstrated that efficient pre-hospital care systems can significantly reduce morbidity and mortality from RTIs. However, in many developing countries including Uganda, these systems are often over-looked and under-developed, with focus being heavily placed on primary and secondary prevention. A number of players, including the Police, private-for-profit, and private-not-for-profit, as well as local humanitarian agencies, provide care in mostly fragmented fashion. The Ministry of Health has finalized plans to form a standalone public institution by an Act of Parliament, called Uganda National Ambulance Service (UNAS) with a mandate to coordinate all emergency-related health services in the country. We envision Kampala city becoming a forerunner of premier pre-hospital emergency system in Uganda. A major challenge is the assessment of available resources and prioritization of the areas of improvement in pre-hospital care. Development of an assessment tool using a holistic framework, with focus on finding gaps will ensure formulation of specific strategies of capacity development in human, systems and material resources.

OBJECTIVES
a) To develop a rapid assessment tool for EMS systems in Kampala City
b) To pilot test the tool in order to describe the current capacity of pre-hospital care in Kampala City
c) To describe the gaps and propose specific strategies for improving EMS in Kampala.

METHODOLOGY
We conducted a cross sectional study in the city of Kampala in order to understand how acutely ill and injured patients reach the hospitals and what services are provided to them in the pre-hospital phase.
In order to gain maximum knowledge and to understand all aspects of pre-hospital care system, we carried out document reviews, in-depth interviews with key players, focus group discussions with lay people and care providers, and onsite inspection of ambulances and ambulance stations about the services they provide and the processes that are followed. All the major organizations and stakeholders were identified under the guidance of Ministry of Health, Makerere University School of Public Health, as well as Kampala Capital City Authority (KCCA).

RESULTS
The final phase of data analysis is under way, and we plan to engage all the stakeholders again to inform them about the preliminary findings and observations on the pre-hospital system in the city of Kampala on 29th January 2016

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