Paving the Way to Expand Emergency Care Services in Uganda

A Comprehensive Facility-Based Assessment for Emergency, Critical and Operative care, 2024

The Government of Uganda, through the Ministry of Health (MOH), has prioritized the expansion of Emergency Medical Services (EMS). This aligns with the National Development Plan III and the MOH Strategic Plan (2021-2025) to improve health outcomes.

In collaboration with Seed Global Health, the MOH conducted a Comprehensive Facility-Based Assessment to evaluate the current EMS landscape. The assessment highlights progress made, key challenges, and recommendations to strengthen Uganda’s emergency response system.

The study covered 33 districts across various regions of Uganda. A total of 74 facilities, including 3 national referral hospitals, 9 regional referral hospitals, 27 general hospitals, 25 health centre IVs, and 10 health centre IIIs were covered.  

Key highlights of the study include:

• Emergency case distribution – In 2023, 133,935 emergency cases were recorded, with the Albertine region reporting the highest share (27.8%), followed by the southwestern and central regions, while trauma and injuries (17%) and infections (14.3%) were the most common emergencies.
• Data management – While 87.5% of regional referral hospitals had emergency registers, coverage was lower in general hospitals (43.5%) and HC IVs (30.4%), with only 49.1% of facilities having dedicated staff for emergency data collection and 28.1% receiving comprehensive training, leading to inaccuracies; additionally, 73.7% lacked essential emergency forms, impacting data quality
• Medicines and supplies – Frequent stock-outs of essential emergency medicines, including norepinephrine injection (unavailable in 75% of facilities for an average of 96 days) and salbutamol aerosol inhalation (short in 65.9% of facilities), alongside the complete absence of nalbuphine IV/IM and methadone in ICUs, were linked to logistical challenges, funding constraints, and supply chain inefficiencies, with inadequate functional blood storage equipment further compounding the issue.
• Human resource capacity – More than 50% of Health Centre IVs had different medical staff, but only 9.1% to 43.5% were deployed full-time in emergency care.  Only 33.3% of health workers at Health Centre IVs had Basic Emergency Care (BEC) training, 47% in general hospitals and up to 75% in regional referral hospitals. In ICUs, only 34% of staff had specialized critical care training.  
• Infrastructure – Many health facilities lacked dedicated emergency units except only a few general hospitals and no Health Centre IVs have separate emergency areas for children and adults. While clean water (80%) and electricity (86.4%) were mostly available, there were deficiencies in communication tools and isolation rooms especially in lower-level facilities.  

While progress has been made in strengthening emergency medical services in Uganda, continued efforts are being made by MOH to improve data management, ensure essential supplies and together with Seed, expand training and enhance emergency response systems to save more lives.

Read full report here.