Developing sustainable emergency care systems in sub-saharan africa: milestones and lessons from 15 years of clinical and educational initiatives in Tanzania

The impact of emergency care systems on a country's health infrastructure is well-recognized in most high-income countries. On the contrary, most Sub-Saharan African countries lack a well-organized basic emergency care system that is capable of delivering essential emergency care functions. In 2010, Tanzania launched the first-ever public emergency medicine department at the Muhimbili National Hospital and a residency training program in emergency medicine at the Muhimbili University of Health and Allied Sciences as an initial step in developing the country’s emergency care system. We conducted a comprehensive review of the growth of emergency care to document the ongoing challenges and discuss lessons learned 15 years after the establishment of the Emergency Department and residency training. These insights are intended to inform other Sub-Saharan countries as they develop their emergency care systems.