title: World Health Assembly Resolution 60.22. [corrected].
abstract: The World Health Assembly 2007 Resolution 60.22 tasked the global health community to address the lack of emergency care in low- and middle-income countries. Little progress has yet been made in integrating emergency care into most low- and middle-income-country health systems. At a rural Ugandan district hospital, however, a collaborative between a nongovernmental organization and local and national stakeholders has implemented an innovative emergency care training program. To our knowledge, this is the first description of using task shifting in general hospital-based emergency care through creation of a new nonphysician clinician cadre, the emergency care practitioner. The program provides an example of how emergency care can be practically implemented in low-resource settings in which physician numbers are limited. The Ministry of Health is directing its integration into the national health care system as a component of a larger ongoing effort to develop a tiered emergency care system (out-of-hospital, clinic- and hospital-based provider and physician trainings) in Uganda. This tiered emergency care system is an example of a horizontal health system advancement that offers a potentially attractive solution to meet the mandate of World Health Assembly 60.22 by providing inexpensive educational interventions that can make emergency care truly accessible to the rural and urban communities of low- and middle-income countries.
authors.affiliation: Idaho Emergency Physicians, Boise, ID, and the University of Washington WWAMI; Global Emergency Care Collaborative, Boston, MA. Electronic address: hhammerstedt@gmail.com.
authors.forename: Heather
authors.initials: H
authors.lastname: Hammerstedt
authors.affiliation: Mbarara University of Science and Technology, Mbarara, Uganda.
authors.forename: Samuel
authors.initials: S
authors.lastname: Maling
authors.affiliation: Karoli Lwanga "Nyakibale" Hospital, Rukungiri, Uganda.
authors.forename: Ronald
authors.initials: R
authors.lastname: Kasyaba
authors.affiliation: Global Emergency Care Collaborative, Boston, MA; University of Arizona, Department of Emergency Medicine, Tucson, AZ.
authors.forename: Bradley
authors.initials: B
authors.lastname: Dreifuss
authors.affiliation: Global Emergency Care Collaborative, Boston, MA; University of Illinois at Chicago, Department of Emergency Medicine, Center for Global Health, Chicago, IL.
authors.forename: Stacey
authors.initials: S
authors.lastname: Chamberlain
authors.affiliation: Global Emergency Care Collaborative, Boston, MA; Maine Medical Center, Department of Emergency Medicine, Portland, ME, and Tufts University School of Medicine, Boston, MA.
authors.forename: Sara
authors.initials: S
authors.lastname: Nelson
authors.affiliation: Global Emergency Care Collaborative, Boston, MA; University of Massachusetts, Department of Emergency Medicine, Worcester, MA.
authors.forename: Mark
authors.initials: M
authors.lastname: Bisanzo
authors.affiliation: Ministry of Health, Kampala, Uganda.
authors.forename: Isaac
authors.initials: I
authors.lastname: Ezati
mesh_terms: D003906:Developing Countries; D004632:Emergency Medical Services / Q000458:organization & administration / Q000600:supply & distribution*; D004635:Emergency Medicine / Q000193:education; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D010865:Pilot Projects; D014454:Uganda