Review of the Article Emergency Services in Sub- Saharan Africa: Challenges and Opportunities Volume 58- Issue 5

Anthony Kwame Apedzi*

• St John Ambulance, Ghana

Received: September 03, 2024; Published: September 23, 2024

*Corresponding author: Anthony Kwame Apedzi, St John Ambulance, Ghana

DOI: 10.26717/BJSTR.2024.58.009205

Abstract PDF

Literature on Emergency Services especially Emergency Medical Services (EMS) in Africa is very scanty. Authors usually write about public health and mention the contribution of EMS in few paragraphs. It is therefore plausible for this author to conduct research on Emergency Services in Sub-Sahara Africa: Challenges and Opportunities. The research raises issues that Emergency Services Practitioners should develop interest in it. The author mentioned 5 thematic areas as: infrastructure limitation such as improvement of roads, communication system for emergency services practitioners and power supply. Again, the author looked at the human resource side of emergency services. The author deserve commendations for good work done. As a professional Emergency Medical Services Practitioner, there is a need to review their research to understand why the results turn out the way he presented it. This will help buttress his findings and inform decision for policy makers. The abstract outlined the main objectives and findings of the study on emergency services in Sub-Saharan Africa. It highlighted the challenges faced by emergency services in this region, such as inadequate infrastructure, limited resources, and logistical difficulties.

The abstract also explores opportunities for improvement, including technological advancements or policy changes. Overall, the study aimed at contributing to a better understanding of the issues surrounding emergency services in Sub-Saharan Africa and proposes potential strategies for enhancement. In reviewing the abstract, it appears to offer a clear overview of the research. It introduces the topic, identifies the main challenges faced by emergency services in Sub-Saharan Africa, and hints at potential opportunities for improvement. A good abstract should provide enough information to understand the scope and focus of the study while enticing the reader to delve deeper into the full article for more detailed insights and findings. Therefore, the abstract has fulfilled the structure and content effectively.

Introduction serves as the initial overview of the article. The clarity of a research question or hypothesis in an Introduction is also crucial for setting the direction and purpose of the study. A clear research question or hypothesis helps readers understand what the study aims to investigate or prove. The article seems to be a report of what have been observed by the author. Therefore, he did not construct a hypothesis or was guided by research question(s). For instance, a clear research question could be: “What are the primary challenges faced by emergency services in Sub-Saharan Africa, and what opportunities exist for improving their effectiveness?”. The research question should have been specific enough to guide readers towards understanding the focus of the study. A background information in an Introduction is essential as it contextualizes the study, provides justification for the research, and demonstrates the gap in existing knowledge that the study aims to fill. It is a herculean task considering the number of countries that come under the Sub-Sahara Africa region. The author did well in that regard. They made references to secondary literature with focus on the average response time, that is the time an ambulance or firefighting truck will respond to emergency when called. He also read about the infrastructure challenges and resource limitation in general. The research has elements that set the stage for the reader to understand the motivation behind the study and the direction it took in addressing the identified issues in emergency services in Sub-Saharan Africa.

To review the Methods section of the article “Emergency Services in Sub-Saharan Africa: Challenges and Opportunities”, the study design, the data collection procedure and analysis is what comes to attention. The author outlined the study design they used to achieve their aim. The author used mixed methods because which is categorical data (qualitative) with thematic analysis as well as numerical data (quantitative) with sampling methods, were sampled. On the Data Collection Procedures, it wasn’t too clear how the data was collected from the emergency service providers, officials, or other relevant stakeholders in Sub-Saharan Africa. It is a herculean task considering the geographical are of the sub-Saharan Region of Africa. In evaluating the method chosen to achieve the aim of the research, the reviewer believes that, because of the vastness in terms of geographical area of Sub Sahara Africa region, the author was right in consulting mostly secondary data. The difficulty is, there is scanty literature on the field of emergency services. Due to that, it will be very strange for another researcher in pursuing reliability test, conduct research to arrive at the same result. For the accuracy of the of the data, the reviewer believes that if another researcher conducts similar research, the result will not be different.

The author indicated that the results presented dwelled on the challenges of the following:

1. Infrastructure and Resource Limitation
2. Human Resource Challenges
3. Organizational and Policy Challenges
4. Community Engagement and Awareness
5. Financial Sustainability and Investment

He also indicated that they explored 15 journal articles on the topic. He studied the category of the published articles, he looked at the study population, and the study design. In addition, the author mentioned that he look at the sources of data generated as well as the method of analysis used by the author of the 15 published articles. The author did not present a summary of the result which would have given a vivid picture of the gloomy picture painted about the emergency services in the sub-Sahara Africa region. Therefore, it was not necessary to mentioned the result as a sub heading to be discussed only to find out that he presented a list of literature he explored.

The author discussed the research along five thematic areas. These are: Infrastructure and Resource Limitation, Human Resource Challenges, Organizational and Policy Challenges, Community Engagement and Awareness and finally Financial Sustainability and Investment.

The author posit that, bad roads and insufficient power supply seems to be the major challenges facing the emergency services in the subregion. The reviewer agrees with the author as he review many journal articles on that. The author was of the view that communication between dispatching health facility and the receiving health facility in a challenge in many countries in subregion. He looked at secondary data from Ghana and Kenya. He suggested that mobile phone could be used instead of landline phones. The reviewer support his suggestions as any medium that will enhance effective referral system is good for healthcare delivery. However, reviewer believes that the author could have look at attitudes in communication between the dispatching health facilities and the receiving health facilities which also seems to be a challenge. The author also mentioned the lack of adequate ambulances to aid the transportation of emergency cases from one health facility to another health for advance care. The reviewer concur with this finding. However, the reviewer wish the author would have discussed the maintenance of the few ambulances that are available. It is refreshing to know that the author also looked at the new technologies that are helping in the emergency services in the sub-Saharan subregion. He looked at the zipline technology in Rwanda which is used for transportation of medical supplier in a wider geographical area. He also looked at the tracking system in Uganda and then the Rapid SMS technology in Malawi. What was not clear was the vivid description of all these technologies for a reader to appreciate the concept for possible recommendation in other countries.

The author’s studies on the emergency medical practitioners was good. They look at the Emergency Medical Technicians, Paramedic and the Emergency Physicians. The author indicated that, the numbers of these practitioners are not encouraging which the reviewer agrees. The challenge about the discussion on the practitioners was that, he did not define the categories of the practitioners. He did not indicate what constitute an Emergency Medical Technicians, Paramedic and Emergency Physician for the reader to come apar with the discussion. In addition, the author mentioned low knowledge about CPR among the population in South Africa. Throughout the discussion, he did not mention any other training that emergency medical practitioners must know, apart for CPR. This the reviewer think was not the best. A little discussion on controlling hemorrhage, managing fractures etc, in addition to the cardiopulmonary resuscitation would have complemented the discussion. The author acknowledge the strides made in technology including telemedicine in Kenya and other places to support communities that are far from secondary healthcare facilities. The reviewer believes it is good research and indicate that, all is not lost. Some countries are investing heavily in emergency medical services including telemedicine.

The author is of the opinion that, there should be proper coordination which will strengthen the public health workforce preparedness towards emergencies. He seems to suggest that, every health worker must prepare for medical emergencies. The reviewer agrees to his opinion. His concern about the lack of proper regulation is also commendable. The author see this as a challenge between policy and practice. Therefore, his suggestion about holistic policy that will include implementation plan is commendable. His recommendation for a concerted effort to both local and international bodies for policy regulation and standardization is commendable.

The author’s acknowledgement that, community involvement in emergency response is necessary for effective emergency system is commendable. The is refreshing because the agencies in charge of emergencies alone cannot do the work. Therefore, community members should form voluntary groups to stand in readiness to respond to emergencies as first respondents.

The finding of the author that the lack of financial sustainability of activities, training and provision of equipment among others, are the overarching issue that is affecting emergency services in sub-Saharan Africa corroborate with a lot of researchers. The author looked at the COVID 19, which came as a serious emergency and needed available financial resources, suggest that, there should always be money readily available for contingencies. The reviewer agrees with the author. Again, the suggestion state agencies in charge of emergencies should collaborate with the private sector in a form of Public-Private-Partnership, corroborates with work done by a lot of researchers.

The author aimed at presenting the challenges and opportunities of emergencies services in sub-Saharan Africa. He did this by focusing on five thematic areas. His conclusion captured the four thematic areas well which include: Infrastructure and Resource Limitation, Human Resource Challenges, Organizational and Policy Challenges, Community Engagement and Awareness as well as Financial Sustainability and Investment. The author summarised the opportunities and the challenges well in his conclusion. Finally, he recommended that if the opportunities are considered, there will be a good emergencies services in the sub-Sahara Arica. The reviewer concurs with his conclusion.

The references were complete. The author did full citation. However, the journals reviewed were not so current. On average, the journals were about 10 years old. This may be because, there are little journal on the topic under discussion.

Major Strengths of the article is that, is offers comprehensive analysis of the challenges and opportunities in emergency services, incorporating both qualitative and quantitative data where applicable. The article addresses critical issues surrounding emergency services in Sub-Saharan Africa, shedding light on challenges and exploring potential opportunities for improvement. By focusing on a region often underserved and facing unique challenges in healthcare infrastructure and resource allocation, the study contributes significantly to the field of emergency management and healthcare delivery in developing contexts. It also provides valuable insights into the specific obstacles faced by emergency services, such as inadequate infrastructure, limited resources, and logistical difficulties, which are crucial for policymakers, healthcare providers, and researchers seeking to enhance emergency response systems in similar settings. In addition, by discussing potential solutions and opportunities for improvement, such as leveraging technological advancements or advocating for policy reforms, the article offers actionable recommendations that could potentially alleviate the identified challenges and improve emergency service outcomes in Sub-Saharan Africa. One of the importing things about the article is that, it addresses an important gap in the literature by focusing on a region often underrepresented in academic research on emergency services, thereby providing valuable insights for both academic discourse and practical application. The discussion of practical implications and recommendations for policymakers and healthcare providers enhances the article’s relevance and potential impact on improving emergency service delivery. However, without specific details from the article, potential weaknesses could include limitations in sample size, data collection methods, or generalizability of findings due to regional variations within Sub-Saharan Africa.

The author done his part contributing to knowledge. But because research in emergency services in Sahara has become topical issue the reviewer recommends that there should be more research on emergency services taking into consideration the following:

To consider expanding a wider scope to include more countries or regions within Sub-Saharan Africa. This would provide a more nuanced understanding of regional variations in emergency service challenges and opportunities, thereby enhancing the study’s applicability across diverse contexts.

Where possible, future researchers should incorporate longitudinal data collection methods to track changes in emergency service provision over time. This would enable researchers to assess the effectiveness of interventions or policy changes and capture evolving trends in healthcare infrastructure and resource allocation.

The future research should again, look at strengthening the methodological approach by ensuring robust sampling techniques, rigorous data collection procedures, and appropriate statistical analyses. Addressing methodological limitations, such as sample size constraints or potential biases in data collection, will improve the reliability and validity of the study’s findings.

It will be great if future researchers will engage with diverse stakeholders, including emergency service providers, policymakers, and community representatives, to gather insights into local perspectives and priorities. This participatory approach can enrich the study’s findings and ensure that recommendations are informed by on-the-ground realities.

The reviewer recommends that future researchers should look vividly at the potential role of technology in improving emergency services, consider exploring innovative solutions such as telemedicine, mobile health applications, or digital communication platforms. Investigate how these technologies can overcome infrastructural challenges and enhance the efficiency and effectiveness of emergency responses.

Future researchers should again look at providing a clearer and actionable recommendations for policymakers, healthcare providers, and other stakeholders based on the study’s findings. Emphasize strategies for improving infrastructure, resource allocation, training programs, and policy frameworks to strengthen emergency service delivery in Sub-Saharan Africa. The reviewer believes that, by incorporating these recommendations, future research can build upon the foundation laid by the author of this article and contribute to meaningful advancements in emergency healthcare services in Sub-Saharan Africa.