Community-based perceptions of emergency care in communities lacking formalised emergency medicine systems

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dc.contributor.advisorWallis, Leeen_ZA
dc.contributor.authorBroccoli, Morgan Carolen_ZA
dc.date.accessioned2015-11-30T13:09:45Z
dc.date.available2015-11-30T13:09:45Z
dc.date.issued2015en_ZA
dc.description.abstractKenya and Zambia face an increasing burden of emergent disease, with a high incidence of communicable diseases, increasing prevalence of non-communicable diseases and traumatic injuries. However, neither country has an integrated emergency care system that provides community access to high-quality emergency services. There has been recent interest in strengthening the emergency care systems in these countries, but before any interventions are implemented, an assessment of the current need for emergency care must be conducted, as the burden of acute disease and barriers to accessing emergency care in Zambia and Kenya remain largely undocumented. Aims and Objectives: The aim of this project was to ascertain community-based perceptions of the critical interventions necessary to improve access to emergency care in Zambia and Kenya, with the following objectives: 1. Determine the current pattern of out-of-hospital emergency care delivery at the community level. 2. Identify the communities’ experiences with emergency conditions and the barriers they face when trying to access care. 3. Discover community-generated solutions to the paucity of emergency care in urban and rural settings. Methods: Semi-structured focus groups were piloted in Zambia with 200 participants. Results were analysed with subsequent tool refinement for Kenya. Data were collected via focus groups with 600 urban and rural community members in cities and rural villages in the 8 Kenyan provinces. Thematic analysis of community member focus groups identified frequency of emergencies, perceptions of emergency care, perceived barriers to emergency care, and ideas for potential interventions. Results: Analysis of the focus group data identified several common themes. Community members in Zambia and Kenya experience a wide range of medical emergencies, and they rely on family members, neighbours, and Good Samaritans for assistance. These community members frequently provide assistance with transportation to medical facilities, and also attempt some basic first aid. These communities are already assisting one another during emergencies, and are willing to help in the future. Participants in this study also identified several barriers to emergency care : a lack of community education, absent or non-functional communication systems, insufficient transportation, no triage system, a lack of healthcare providers trained in emergency care, and inadequate equipment and supplies. Conclusions: Community members in Zambia and Kenya experience a wide range of medical emergencies. There is substantial reliance on family members and neighbours for assistance, commonly with transportation. Creating community education initiatives, identifying novel transportation solutions, implementing triage in healthcare facilities, and improving receiving facility care were community-identified solutions to barriers to emergency care.en_ZA
dc.identifier.apacitationBroccoli, M. C. (2015). <i>Community-based perceptions of emergency care in communities lacking formalised emergency medicine systems</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Division of Emergency Medicine. Retrieved from http://hdl.handle.net/11427/15459en_ZA
dc.identifier.chicagocitationBroccoli, Morgan Carol. <i>"Community-based perceptions of emergency care in communities lacking formalised emergency medicine systems."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Division of Emergency Medicine, 2015. http://hdl.handle.net/11427/15459en_ZA
dc.identifier.citationBroccoli, M. 2015. Community-based perceptions of emergency care in communities lacking formalised emergency medicine systems. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Broccoli, Morgan Carol AB - Kenya and Zambia face an increasing burden of emergent disease, with a high incidence of communicable diseases, increasing prevalence of non-communicable diseases and traumatic injuries. However, neither country has an integrated emergency care system that provides community access to high-quality emergency services. There has been recent interest in strengthening the emergency care systems in these countries, but before any interventions are implemented, an assessment of the current need for emergency care must be conducted, as the burden of acute disease and barriers to accessing emergency care in Zambia and Kenya remain largely undocumented. Aims and Objectives: The aim of this project was to ascertain community-based perceptions of the critical interventions necessary to improve access to emergency care in Zambia and Kenya, with the following objectives: 1. Determine the current pattern of out-of-hospital emergency care delivery at the community level. 2. Identify the communities’ experiences with emergency conditions and the barriers they face when trying to access care. 3. Discover community-generated solutions to the paucity of emergency care in urban and rural settings. Methods: Semi-structured focus groups were piloted in Zambia with 200 participants. Results were analysed with subsequent tool refinement for Kenya. Data were collected via focus groups with 600 urban and rural community members in cities and rural villages in the 8 Kenyan provinces. Thematic analysis of community member focus groups identified frequency of emergencies, perceptions of emergency care, perceived barriers to emergency care, and ideas for potential interventions. Results: Analysis of the focus group data identified several common themes. Community members in Zambia and Kenya experience a wide range of medical emergencies, and they rely on family members, neighbours, and Good Samaritans for assistance. These community members frequently provide assistance with transportation to medical facilities, and also attempt some basic first aid. These communities are already assisting one another during emergencies, and are willing to help in the future. Participants in this study also identified several barriers to emergency care : a lack of community education, absent or non-functional communication systems, insufficient transportation, no triage system, a lack of healthcare providers trained in emergency care, and inadequate equipment and supplies. Conclusions: Community members in Zambia and Kenya experience a wide range of medical emergencies. There is substantial reliance on family members and neighbours for assistance, commonly with transportation. Creating community education initiatives, identifying novel transportation solutions, implementing triage in healthcare facilities, and improving receiving facility care were community-identified solutions to barriers to emergency care. DA - 2015 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2015 T1 - Community-based perceptions of emergency care in communities lacking formalised emergency medicine systems TI - Community-based perceptions of emergency care in communities lacking formalised emergency medicine systems UR - http://hdl.handle.net/11427/15459 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15459
dc.identifier.vancouvercitationBroccoli MC. Community-based perceptions of emergency care in communities lacking formalised emergency medicine systems. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Division of Emergency Medicine, 2015 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/15459en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDivision of Emergency Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherEmergency Medicineen_ZA
dc.titleCommunity-based perceptions of emergency care in communities lacking formalised emergency medicine systemsen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMSc (Med)en_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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