Advancing access to care: An assessment of the prehospital system in Senegal

Author:

Michalski Kamil1ORCID,Diedhiou Moustapha23,Kerachian Matin1,Grushka Jeremy14,Tendeng Jacques Noel23,Diao Mohamed Lamine5,Beye Mamadou D.6,Montero Ortiz Johana1,Razek Tarek14,Deckelbaum Dan L.14,Konate Ibrahim23

Affiliation:

1. Center for Global Surgery McGill University Montreal Quebec Canada

2. Unité de Formation et de Recherche des Sciences de la Santé Université de Thiès Thiès Sénégal

3. Université de Gaston Berger Saint‐Louis Sénégal

4. Department of Surgery Montreal General Hospital McGill University Montreal Quebec Canada

5. Centre Hospitalier Régional de Saint‐Louis Saint‐Louis Sénégal

6. Service d'Assistance Médicale d'Urgence (SAMU) Saint‐Louis Sénégal

Abstract

AbstractBackgroundMost low‐ and middle‐income countries do not have a mature prehospital system limiting access to definitive care. This study sought to describe the current state of the prehospital system in Senegal and offer recommendations aimed at improving system capacity and population access to definitive care.MethodsStructured interviews were conducted with key informants in various regions throughout the country using qualitative and quantitative techniques. A standardized questionnaire was generated using needs assessment forms and system frameworks. Descriptive statistics were performed for quantitative data analysis, and qualitative data was consolidated and presented using ATLAS.ti.ResultsTwo (20%) of the studied regions, Dakar and Saint‐Louis, had a mature prehospital system in place, including dispatch centers and teams of trained personnel utilizing equipped ambulances. 80% of the studied regions lacked an established prehospital system. The vast majority of the population relied on the fire department for transport to a healthcare facility. The ambulances in rural regions were not part of a formal prehospital system, were not equipped with life‐support supplies, and were limited to inter‐facility transfers.ConclusionsWhile Dakar and Saint‐Louis have mature prehospital systems, the rest of the country is served by the fire department. There are significant opportunities to further strengthen the prehospital system in rural Senegal by training the fire department in basic life support and first aid, maintaining cost efficiency, and building on existing national resources. This has the potential to significantly improve access to definitive care and outcomes of emergent illness in the Senegalese community.

Publisher

Wiley

Reference27 articles.

1. WHO R by the D‐G. Seventy‐second World Health Assembly provisional agenda item 12.9.Emergency and Trauma Care ‐ Emergency Care Systems for Universal Health Coverage: Ensuring Timely Care for the Acutely Ill and Injured.2019.http://apps.who.int/gb/ebwha/pdf_files/WHA71/A71_4‐en.pdf?ua=1or

2. World Health Organization: Sixtieth World Health Assembly.2007.Resolution WHA 60.22: Emergency‐Care Systems.

3. Strengthening Health Systems to Provide Emergency Care

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