Perspectives on the current state of Nigeria’s emergency care system among participants of an emergency medicine symposium: a qualitative appraisal

Introduction Emergency care systems provide timely and relevant care to the acutely ill and injured. Published commentaries have characterised deficiencies in the Nigerian emergency care system and offered potential solutions but have not included the perspectives of the Nigerian public. A more incl...

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Main Authors: Agnes Usoro, Benjamin Aiwonodagbon, Jonathan Strong, Sean Kivlehan, Babatunde A Akodu, Ayobami Olufadeji
Format: Article
Language:English
Published: BMJ Publishing Group 2021-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/8/e043869.full
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author Agnes Usoro
Benjamin Aiwonodagbon
Jonathan Strong
Sean Kivlehan
Babatunde A Akodu
Ayobami Olufadeji
author_facet Agnes Usoro
Benjamin Aiwonodagbon
Jonathan Strong
Sean Kivlehan
Babatunde A Akodu
Ayobami Olufadeji
author_sort Agnes Usoro
collection DOAJ
description Introduction Emergency care systems provide timely and relevant care to the acutely ill and injured. Published commentaries have characterised deficiencies in the Nigerian emergency care system and offered potential solutions but have not included the perspectives of the Nigerian public. A more inclusive approach that includes feedback from the public may help improve the Nigerian emergency care system through better understanding of the needs, values and expectations of the community.Methods Participants of an emergency medicine symposium participated in focus group discussions that were randomly divided into small groups led by two trained facilitators. These facilitators asked open-ended, semistructured questions to lead discussions in the English language. Participant responses were audio-recorded and transcribed verbatim into transcripts. Two independent investigators employed conventional content analysis to code the transcripts until thematic saturation was achieved.Results Three descriptive themes emerged characterising the current state of Nigeria’s emergency care system as it relates to prehospital care delivery, hospital care delivery and health system governance: rudimentary, vulnerable and disconnected. At the prehospital level, concepts revolved around emergency recognition and response, ambulance and frontline providers, and cultural norms. At the hospital level, concepts centred around the health workforce, clinical competency, hospital capacity and the burden of financial hardship. At the health system level, concepts concentrated on healthcare access and healthcare financing. Opportunities for emergency care system improvement at each component level were identified and explored.Conclusions The participants in this study identified shortcomings and opportunities to improve prehospital care, hospital care and health system governance. The results of this study may help healthcare professionals, policy makers and community leaders identify gaps in the emergency care system and offer solutions in harmony with the needs, values and expectations of the community. If successful, these community-informed interventions may serve as a model to improve emergency care systems throughout Africa.
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spelling doaj-art-87cfec9ffb5f42839d8e2031124b2f022025-08-20T02:21:17ZengBMJ Publishing GroupBMJ Open2044-60552021-08-0111810.1136/bmjopen-2020-043869Perspectives on the current state of Nigeria’s emergency care system among participants of an emergency medicine symposium: a qualitative appraisalAgnes Usoro0Benjamin Aiwonodagbon1Jonathan Strong2Sean Kivlehan3Babatunde A Akodu4Ayobami Olufadeji5Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USADepartment of Communicable and Non-Communicable Disease (CND) Cluster of the Country Office, World Health Organization Regional Office for Africa, Abuja, Federal Capital Territory, NigeriaDepartment of Emergency Medicine, Brigham and Women`s Hospital, Boston, Massachusetts, USADepartment of Emergency Medicine, Brigham and Womens Hospital, Boston, Massachusetts, USADepartment of Family Medicine, Lagos University Teaching Hospital, Idi-Araba, Lagos, NigeriaDepartment of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USAIntroduction Emergency care systems provide timely and relevant care to the acutely ill and injured. Published commentaries have characterised deficiencies in the Nigerian emergency care system and offered potential solutions but have not included the perspectives of the Nigerian public. A more inclusive approach that includes feedback from the public may help improve the Nigerian emergency care system through better understanding of the needs, values and expectations of the community.Methods Participants of an emergency medicine symposium participated in focus group discussions that were randomly divided into small groups led by two trained facilitators. These facilitators asked open-ended, semistructured questions to lead discussions in the English language. Participant responses were audio-recorded and transcribed verbatim into transcripts. Two independent investigators employed conventional content analysis to code the transcripts until thematic saturation was achieved.Results Three descriptive themes emerged characterising the current state of Nigeria’s emergency care system as it relates to prehospital care delivery, hospital care delivery and health system governance: rudimentary, vulnerable and disconnected. At the prehospital level, concepts revolved around emergency recognition and response, ambulance and frontline providers, and cultural norms. At the hospital level, concepts centred around the health workforce, clinical competency, hospital capacity and the burden of financial hardship. At the health system level, concepts concentrated on healthcare access and healthcare financing. Opportunities for emergency care system improvement at each component level were identified and explored.Conclusions The participants in this study identified shortcomings and opportunities to improve prehospital care, hospital care and health system governance. The results of this study may help healthcare professionals, policy makers and community leaders identify gaps in the emergency care system and offer solutions in harmony with the needs, values and expectations of the community. If successful, these community-informed interventions may serve as a model to improve emergency care systems throughout Africa.https://bmjopen.bmj.com/content/11/8/e043869.full
spellingShingle Agnes Usoro
Benjamin Aiwonodagbon
Jonathan Strong
Sean Kivlehan
Babatunde A Akodu
Ayobami Olufadeji
Perspectives on the current state of Nigeria’s emergency care system among participants of an emergency medicine symposium: a qualitative appraisal
BMJ Open
title Perspectives on the current state of Nigeria’s emergency care system among participants of an emergency medicine symposium: a qualitative appraisal
title_full Perspectives on the current state of Nigeria’s emergency care system among participants of an emergency medicine symposium: a qualitative appraisal
title_fullStr Perspectives on the current state of Nigeria’s emergency care system among participants of an emergency medicine symposium: a qualitative appraisal
title_full_unstemmed Perspectives on the current state of Nigeria’s emergency care system among participants of an emergency medicine symposium: a qualitative appraisal
title_short Perspectives on the current state of Nigeria’s emergency care system among participants of an emergency medicine symposium: a qualitative appraisal
title_sort perspectives on the current state of nigeria s emergency care system among participants of an emergency medicine symposium a qualitative appraisal
url https://bmjopen.bmj.com/content/11/8/e043869.full
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