Addressing African acute care needs through consensus-building

Addressing African acute care needs through consensusbuildingGathering stakeholder perspectives and establishing consensus are essential first steps in the development of a collaborative acute care framework for Africa.In this issue, we present the summary from the first in a series of African Federation for Emergency Medicine consensus conferences on acute and emergency care, building on the recent publication of the emergency nursing consensus paper. 1 These meetings aim to gather a range of providers, academics, researchers and policy makers to formulate goals and action plans to address the regional burden of acute disease.Specifically, they serve to guide the scientific agenda of AFEM.In the year since the meeting, AFEM has begun to develop and implement several proposals that emerged from the discussion, including curricula, communication networks, and operational and essential component documents.There remain four foundational challenges to integrate acute and emergency care into health systems in sub-Saharan Africa:1.The burden of acute disease in sub-Saharan Africa is severely under-documented.Some data exist on the distribution of inpatient diagnoses in the region, but the actual range of acute presentations to health facilities is almost completely unknown.Studies that compare police, hospital, and insurance records with other sources in low-income countries, for example, suggest that as few as one in 10 injuries may be documented in official counts. 2-52. Healthcare facilities often lack an integrated approach to triage, resuscitation, and stabilization of acutely ill patients.Even at a single small district hospital, acutely ill patients may be cared for by several different departments, depending on age, pregnancy status, and specific disease states.This vertical approach means that there is rarely a dedicated acute intake area staffed with non rotating personnel trained in resuscitation and stabilization.