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Emergency care surveillance and emergency care registries in low-income and middle-income countries: conceptual challenges and future directions for research
  1. Hani Mowafi1,
  2. Christine Ngaruiya1,
  3. Gerard O'Reilly2,
  4. Olive Kobusingye3,
  5. Vikas Kapil4,
  6. Andres M Rubiano5,
  7. Marcus Ong6,
  8. Juan Carlos Puyana7,
  9. AKM Fazlur Rahman8,
  10. Rashid Jooma9,
  11. Blythe Beecroft10,
  12. Junaid Razzak11
  1. 1Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
  2. 2Department of Epidemiology & Preventative Medicine, Monash University, Clayton, Victoria, Australia
  3. 3Department of Disease Control & Environmental Health, Makerere University School of Public Health, Kampala, Uganda
  4. 4Center for Global Health Leadership, Centers for Disease Control and Prevention Center for Global Health, Atlanta, Georgia, USA
  5. 5Department of Neurosurgery, Universidad El Bosque, Bogota, Colombia
  6. 6Department of Emergency Medicine, Duke-NUS Medical School, Singapore, Singapore
  7. 7Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
  8. 8Center for Injury Prevention Research, Dhaka, Bangladesh
  9. 9Department of Neurosurgery, Aga Khan University Medical College Pakistan, Karachi, Sindh, Pakistan
  10. 10CGHS, John E Fogarty International Center, Bethesda, Maryland, USA
  11. 11Emergency Medicine, Johns Hopkins University, Baltimore, Maryland, USA
  1. Correspondence to Dr Hani Mowafi; hani.mowafi{at}yale.edu

Abstract

Despite the fact that the 15 leading causes of global deaths and disability-adjusted life years are from conditions amenable to emergency care, and that this burden is highest in low-income and middle-income countries (LMICs), there is a paucity of research on LMIC emergency care to guide policy making, resource allocation and service provision. A literature review of the 550 articles on LMIC emergency care published in the 10-year period from 2007 to 2016 yielded 106 articles for LMIC emergency care surveillance and registry research. Few articles were from established longitudinal surveillance or registries and primarily composed of short-term data collection. Using these articles, a working group was convened by the US National Institutes of Health Fogarty International Center to discuss challenges and potential solutions for established systems to better understand global emergency care in LMICs. The working group focused on potential uses for emergency care surveillance and registry data to improve the quality of services provided to patients. Challenges included a lack of dedicated resources for such research in LMIC settings as well as over-reliance on facility-based data collection without known correlation to the overall burden of emergency conditions in the broader community. The group outlined potential solutions including incorporating data from sources beyond traditional health records, use of standard clinical forms that embed data needed for research and policy making and structured population-based research to establish clear linkages between what is seen in emergency units and the wider community. The group then identified current gaps in LMIC emergency care surveillance and registry research to form a research agenda for the future.

  • emergency care
  • lmics
  • surveillance
  • registries
  • research

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

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Footnotes

  • Handling editor Seye Abimbola

  • Funding This work was partly supported by the intramural programme of the Fogarty International Center, National Institutes of Health, USA.

  • Disclaimer The findings and conclusions in this report are those of the author(s) and do not

    necessarily represent the official position or policy of the US National Institutes of Health,

    the Centers for Disease Control and Prevention/the Agency for Toxic Substances and

    Disease Registry, the US Department of Health and Human Services or any other

    institutions with which authors are affiliated.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No additional data are available.