Advancing emergency medical team classification in MENA region: a qualitative study

Emergency Medical Teams (EMTs) provide critical surge capacity during health emergencies. While the WHO EMT Strategy 2030 envisions a world in which every country can respond rapidly, effectively, and flexibly to national emergencies, a significant gap persists in the Middle East and North Africa (MENA) region. In this region, low- and middle-income countries (LMICs) lag in the development of classified Emergency Medical Teams (EMTs). The WHO classification system ensures quality-assured medical responses according to the World Health Organization's classification system. A study was conducted to understand the specific barriers and facilitators of EMT classification in the MENA region to inform strategies for strengthening local and regional preparedness.

We conducted a qualitative study involving semi-structured interviews with 17 EMTs stakeholders. Participants were purposefully selected from five LMICs in the MENA region (Yemen, Syria, Jordan, Egypt, and Tunisia) and the IFRC regional office, representing a range of roles including EMT process including EMT focal points, project coordinators, and organizational leadership. The data were analyzed using an inductive thematic approach to identify the core themes emerging from the interview transcripts.

Our study identified four principal themes: participants acknowledged the significance of classification in maintaining quality and credibility, however described the process as lengthy, unclear, and challenging. Significant challenges included the perceived rigidity of global standards, particularly in non-clinical logistics and self-sufficiency requirements, the lack of formal training and clear guidance, and inconsistent mentorship. Bureaucracy and inadequate resources were two significant challenges that emerged within the organization. Conversely, robust leadership commitment, specialized technical expertise, and prior deployment experience were regarded as significant enabling factors.

Advancing EMT classification in the MENA region requires a tailored approach that adapts global standards to the local context. Strengthening institutional capacity through training, focused mentorship, and leadership commitment is critical for process completion. To establish a resilient EMT network in LMICs and achieve the EMT strategy, it is imperative to address the challenges and promote the enabling factors.