The paucity of pediatric emergency medicine fellowship training programs in Africa
1Department of Pediatrics, Driscoll Children's Hospital, Texas, USA.
Insights
Sub-Saharan Africa faces high childhood mortality, with pediatric emergency medicine (PEM) training lacking. Investing in PEM programs is crucial for improving child survival rates and emergency care access across the region.
Area of Science:
- Global Health
- Pediatrics
- Emergency Medicine
Background:
- Sub-Saharan Africa (SSA) bears the highest global burden of childhood and adolescent mortality.
- Leading causes include preterm birth, pneumonia, malaria, diarrhea, HIV/AIDS, and road injuries, often necessitating emergency care.
- Critical presentations highlight the urgent need for robust pediatric emergency services in SSA.
Purpose of the Study:
- To address the critical deficit in pediatric emergency medicine (PEM) training programs in Sub-Saharan Africa.
- To emphasize the importance of establishing sustainable PEM training infrastructure.
- To advocate for increased investment and organized efforts from governments and medical education bodies.
Main Methods:
- Review of existing challenges and ongoing interventions in PEM training in SSA.
- Discussion of potential infrastructure for establishing new PEM training programs.
- Analysis of the role of government and graduate medical education in sustainable PEM development.
Main Results:
- A significant paucity of formal PEM training programs exists across Sub-Saharan Africa.
- Current interventions are often isolated, with limited scope and sustainability.
- Existing infrastructure can be leveraged for the development of structured PEM training.
Conclusions:
- Improving pediatric emergency care through enhanced PEM training is vital to reduce childhood mortality in SSA.
- Organized, collaborative efforts involving governments and graduate medical education are essential for sustainable PEM program development.
- Increased investment and strategic planning are urgently needed to expand access to quality PEM training and services.
Abstract:
Sub-Saharan Africa has the highest burden of childhood and adolescent mortality in the world. The leading causes of mortality in pediatric populations in Africa include preterm birth complications, pneumonia, malaria, diarrheal diseases, HIV/AIDS, and road injuries. These causes of childhood and adolescent mortality often lead to emergency room utilization due to critical presentation, placing emphasis on the importance of pediatric emergency services in Africa. Despite the criticality of pediatric emergency medicine (PEM) in the region, there is a paucity of PEM training programs in Africa. Ongoing interventions focused on addressing the poor access to PEM training and services include isolated efforts to provide PEM-specific training to nonemergency medicine (EM)-trained practitioners and expand current EM training to include PEM piloted in a single center in Kenya. Sustainable efforts require organized efforts with government and graduate medical education bodies. We discuss the existing infrastructure that can be utilized in promoting the establishment of PEM training programs and urge local governments' investment as well as other stakeholders, including graduate medical education, to address the issue of childhood mortality in Africa through the improved provision and access to PEM training.
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