Turkana County has rolled out a plan to save lives within the first 24 hours of admission to public health facilities by boosting universal access to emergency medical care.
The Turkana Emergency Medical Care (EMC) plan seeks to address essential emergency care functions at the scene of injury or illness, during transport, and through to an emergency unit.
The local government is expected to activate the plan and set up the required structures to address gaps in regulation, standards and norms of emergency medical care in the expansive arid and semi-arid county.
Health executive Jane Ajele said they had established that patients with medical emergencies who visit public hospitals for treatment without staying overnight account for 30 percent of the outpatient visits.
Though every Kenyan has a constitutional right to get emergency treatment, she said, lack of infrastructure, human resources and technological support hinder universal access to emergency medical care.
“The EMC will serve as a framework for the county to establish a working and supportive emergency medical care system in line with the Kenya Emergency Medical Care Policy 2020-2030 and a 2019 World Health Organization resolution that called for countries to institutionalise emergency services in their health systems,” she said.
Turkana, she said, wants to improve infrastructure at all public health facilities and reach out to development partners for resources that are critical in implementing Universal Health Care.
“EMC practitioners are responsible for initiating interventions to diagnose and/or treat patients in the acute phase (including initial resuscitation and stabilisation), coordinating care with other healthcare providers, and making decisions regarding a patient’s need for transportation, hospital admission, observation or discharge,” she said.
“Successful implementation of EMC forms the base of a functioning healthcare system and eases pressure on every other branch of that system.”
County Director of Medical Services Dr Gilchrist Lokoel said that while emergencies will cost the system in both human and financial terms, creating a dedicated EMC system can increase the effectiveness and efficiency of the referral network, which has been shown to improve survival from acute illness and injury.
Dr Lokoel said data from seven sub-counties from January 2020 to April 2021 highlighted the burden of medical, surgical and obstetric emergencies in the county. The emergency types were common medical (29.3 percent), common surgical (21.3 percent), obstetrics (18.6 percent) and medico-surgical (11.3).
“Improving EMC systems will not only be high-impact and cost- effective but also critical for overall health systems strengthening,” he said.
Besides investing in infrastructure, he said, the capacity of frontline health workers should also be enhanced to ensure they offer quality services in emergency departments.
He explained that a functional emergency department is a dedicated area in a hospital that has a functional operating theatre, is marked as such and is specifically designed, staffed and equipped to take in acutely ill and injured patients 24 hours a day.
It was established that the current health system has challenges and gaps in emergency medical care that include lack of legislation and an institutional framework and guidelines on EMC at the county level.
There is also inadequate financing of EMC in the county as there is no specific budget set aside for emergency medical care. There is also an inadequate number of EMC practitioners at all levels, including the pre-hospital system.
The EMC plan will be financed by the county and the national government. It will also mobilise donor funding and adopt sustainable financing options targeting the private sector while maximising efficiencies.
A long-term goal is to push for private financing of emergency medical care by households through a pooling mechanism, specifically through the National Hospital Insurance Fund (NHIF).
Faith-based run facilities in the county promised to embrace the plan.
The Catholic Diocese of Lodwar pledged that it would implement the plan at all its health facilities so that through the EMC system they could potentially decrease deaths associated with trauma and perinatal and acute medical conditions by providing basic and advanced emergency medical care with trained personnel, and transportation to designated emergency facilities.
Residents welcomed the change of tack, saying that it will be a relief for those affected by neglected tropical diseases in remote areas.
Residents rely on boda boda operators to get to the few health facilities treating illness such as kala-azar and trachoma.
Losike Lokure 12, for instance, was herding his family’s camels in Namoruputh, Loima sub-county when he was bitten by an infected sand fly.
He was admitted with a hemoglobin level of 5.4 grams per decilitre at Lodwar County Referral Hospital on December 11. His father Lokure Ekidor knew about the symptoms because of a public awareness programme by the kala-azar unit of the county health department.
“I realised that he was weak, had a fever, couldn’t eat as normal, and through palpation I realised his spleen was enlarging. That is why I immediately hired a boda boda and took him to the main hospital as an emergency, where they confirmed that he had kala-azar,” Mr Ekidor said. BY DAILY NATION