Globally, 90% of healthcare emergencies occur in low- and middle-income countries (LMICs), particularly affecting children and working-age adults. Following trauma and serious injuries that require emergency care, including those from road traffic crashes, people living in LMICs are nearly twice as likely to die compared to those in high-income countries. Furthermore, estimates from the World Bank show that more than half of the deaths in LMICs could be prevented with access to emergency care.1
Emergency care plays a vital role in universal health coverage (UHC) and serves as the primary point of contact with the healthcare system for many individuals. However, a significant portion of people around the world still lack timely access to high-quality essential emergency care services, leading to substantial disparities in outcomes. UHC implies that everyone can access the complete range of necessary and high-quality healthcare services without facing financial difficulties, when and where they require them.
In May this year, the 76th World Health Assembly passed a resolution WHA 76.2 on Integrated emergency, critical and operative care for universal health coverage and protection from health emergencies. It calls on governments to enhance planning and provision of Emergency, Critical, and Operative Care (ECO) systems as part of universal health coverage. It builds upon previous resolutions and highlights the importance of national policies ensuring sustainable funding, effective governance, and universal access to ECO care for all individuals. This resolution shows the growing demand from Member States for leadership and technical support to strengthen their ECO systems.
To get a better sense of the significance of this resolution to road safety NGOs and how they can contribute to advancing UHC for ECO systems, we spoke to Antoinette Vanessa Naidoo, Technical Officer, WHO, Clinical Services and Systems, Department of Integrated Health Services. According to Vanessa, “achieving these actions geared towards improving ECO requires strong advocacy, especially from civil society organizations operating within the road safety space, since ECO is a critical component of post-crash response following road traffic crashes.”
“Civil society organizations possess significant knowledge and skills that can aid the implementation of evidence-based actions and policy measures required to reduce road-related injuries and deaths by promoting ECO systems and ensuring that they are universally accessible” says Vanessa.
The resolution emphasizes the integration of ECO care within national health system assessments and strategies and data collection mechanisms to improve the coordination, safety, and quality of ECO services.
Thus, NGOs can “support the countries they operate in identifying high-priority services and evaluating the implications of integrating them into universal health coverage. They can also support data collection, research, monitoring and evaluation to inform planning to improve the quality and cost effectiveness of emergency care for road crash victims”.
NGOs can add significant value to decision making by representing and bringing forward community needs and perspectives. Just as in road safety, the resolution seeks an integrated people-centered approach. To achieve this, it is important to establish effective health systems that respond to people’s requirements for time-sensitive and out-of-hours emergency care and ensuring access to critical care and operative services. It requires strong governance and funding commitments, and engagement between governments, communities, civil society, and a range of other stakeholders.
“NGOs can help advocate for the community involvement, effective governance and sustainable funding required to ensure universal access to emergency care by supporting capacity building for pre-hospital and community first responders, and engaging with subnational and district level planners, and regional and national governments for policies and plans that ensure strong commitment and accountability, effective governance and sustainable financing” says Vanessa.
On 21 September 2023, there will be a High-Level Meeting on UHC which presents a crucial opportunity to emphasize the importance of improved emergency care within the broader context of UHC. It is imperative that emergency care be given priority in global discussions on UHC and be included in health benefits packages. The HLM serves as a gathering of influential global leaders convened by the UN General Assembly (UNGA) to tackle specific global issues, facilitate political dialogue, and foster international cooperation and solutions. As preparations for the upcoming HLM on UHC are underway, NGOs can increase their advocacy efforts to ensure that global leaders prioritize prevention, allocate resources, and ensure fair access to high-quality healthcare. These efforts are essential in improving emergency care and promoting healthier societies for all.
1Lecky, F.E., Reynolds, T., Otesile, O. et al. Harnessing inter-disciplinary collaboration to improve emergency care in low- and middle-income countries (LMICs): results of research prioritisation setting exercise. BMC Emerg Med 20, 68 (2020)