The WHO Emergency Care System

Framework and Assessment Tool:

The Ethiopian Federal MoH Experience

Helena Hailu & Teri Reynolds

Emergency, Trauma and Acute Care
Department for Management of NCDs, Disability, Violence and Injury Prevention
Calls on member states and WHO to assess, establish and monitor
integrated prehospital and facility-based emergency care
systems…

Urges Member States “to identify and prioritize a core set of emergency
and essential surgery and anaesthesia services at the primary health
care and first-referral hospital level…”

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
Emergency, Trauma and Acute Care
Department for Management of NCDs, Disability, Violence and Injury Prevention
Emergency Care for the SDGs
3.1 Reduce by three quarters, between 2015 and 2030, the maternal mortality ratio
Treatment for obstetric emergencies

3.2 Reduce by three quarters, between 2015 and 2030, the under-five mortality rate
Treatment for acute paediatric conditions including diarrhea and pneumonia

3.3 Reverse the incidence of malaria and other major diseases and reduce deaths caused by half by 2030
Treatment of acute infections and sepsis

3.4 By 2030, reduce by one-third premature mortality from NCDs

Treatment of acute exacerbations of NCDs

3.5 Strengthen the treatment of substance abuse

Emergency care and harm reduction interventions

3.6 Halve the number of global road traffic crash fatalities and serious injuries by 2020
Post-crash emergency care

3.8 Achieve universal health coverage including financial risk protection and access to quality essential healthcare
Emergency care is an essential component of universal health care

3.9 By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals
Treatment for acute exposure to hazardous materials

11.5 By 2030, significant reduce the number of deaths caused and people affected by disasters
Disaster preparedness and response for resilient health systems

16.1Significantly reduce all forms of violence and related death rates everywhere
Treatment for victims of violence

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
 DCP3
• The Disease Control Priorities project estimates that…

• more than half (24 million out of 45 million) of the

deaths that occur in LMICs each year are from
conditions…

• that could be addressed by organized prehospital

and facility-based emergency care.

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
 What is emergency care?

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
 Safely from the world  care
Emergency, Trauma and Acute Care
Department for Management of NCDs, Disability, Violence and Injury Prevention
Emergency, Trauma and Acute Care
Department for Management of NCDs, Disability, Violence and Injury Prevention
 Who needs emergency care?

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
 Scene

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
 Transport

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
 Facility arrival

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
 Facility-based care

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
Emergency, Trauma and Acute Care
Department for Management of NCDs, Disability, Violence and Injury Prevention
 Emergency Care System Assessment

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
 Areas covered by the WHO ECSA
• System organization and governance
• Financing
• Emergency care data
• Quality improvement
• Scene care
• Transport and transfer
• Facility-based care
• Rehabilitation for emergency conditions
• Emergency and disaster preparedness

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
 ECSA Data Visualization

MEAN

Lowest answer Highest answer

2 5

3.9

Blank space = “I don’t know” Color = Agreement

or did not respond (green = high, red = low)

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
 Among the ECSA elements,
Ethiopian system strengths include…
• Dedicated Directorate of Emergency and
Critical Care
• Legislation ensuring access emergency care
• Comprehensive set of standard operating
procedures for emergency care with well-
developed regulatory mechanisms
• Good availability of ambulances and
dissemination of emergency care facilities
across the country

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
 Based on WHO ECSA results,
the Ethiopian Federal MoH…

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
 Based on WHO ECSA results,
the Ethiopian Federal MoH…
• Development of 5-year strategic plan
• Mapping coordination across agencies
• Improving systematic collection and use of
emergency care data for system planning
• Emergency care training from lay providers to
EMTs to nurses and specialists

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
 Wednesday 21.9.16 @ 12:15 Sonaatti 2

WHO Emergency Care System Development Toolkit:

collaborations for implementation

Emergency, Trauma and Acute Care

Department for Management of NCDs, Disability, Violence and Injury Prevention
www.who.int/emergencycare