Emergency medical systems in low- and middle-income countries: Recommendations for action

Olive C. Kobusingye, Adnan A. Hyder, David Bishai, Eduardo Romero Hicks, Charles Mock, Manjul Joshipura

Research output: Contribution to journalReview articlepeer-review

200 Scopus citations


Emergency medical care is not a luxury for rich countries or rich individuals in poor countries. This paper makes the point that emergency care can make an important contribution to reducing avoidable death and disability in low- and middle-income countries. But emergency care needs to be planned well and supported at all levels - at the national, provincial and community levels - and take into account the entire spectrum of care, from the occurrence of an acute medical event in the community to the provision of appropriate care at the hospital. The mix of personnel, materials, and health-system infrastructure can be tailored to optimize the provision of emergency care in settings with different levels of resource availability. The misconception that emergency care cannot be cost effective in low-income settings is demonstrably inaccurate. Emergencies occur everywhere, and each day they consume resources regardless of whether there are systems capable of achieving good outcomes. With better planning, the ongoing costs of emergency care can result in better outcomes and better cost-effectiveness. Every country and community can and should provide emergency care regardless of their place in the ratings of developmental indices. We make the case for universal access to emergency care and lay out a research agenda to fill the gaps in knowledge in emergency care.

Original languageEnglish (US)
Pages (from-to)626-631
Number of pages6
JournalBulletin of the World Health Organization
Issue number8
StatePublished - Aug 2005


  • Allied health personnel/education
  • Cost-benefit analysis
  • Developing countries
  • Emergency medical services/organization and administration
  • Emergency treatment/organization and administration
  • Evidence-based medicine
  • Transportation of patients
  • Triage

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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