Emergency Medicine, Johns Hopkins Medicine, Baltimore, Maryland, USA.
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
BMJ Glob Health. 2021 Dec;6(12). doi: 10.1136/bmjgh-2021-006681.
The high burden of emergency medical conditions has not been met with adequate financial and political prioritisation especially in low and middle-income countries. We examined the factors that have shaped the priority of global emergency care and highlight potential responses by emergency care advocates.
We conducted semistructured interviews with key experts in global emergency care practice, public health, health policy and advocacy. We then applied a policy framework based on political ethnography and content analysis to code for underlying themes.
We identified problem definition, coalition building, paucity of data and positioning, as the main challenges faced by emergency care advocates. Problem definition remains the key issue, with divergent ideas on what emergency care is, should be and what solutions are to be prioritised. Proponents have struggled to portray the urgency of the issue in a way that commands action from decision-makers. The lack of data further limits their effectiveness. However, there is much reason for optimism given the network's commitment to the issue, the emerging leadership and the existence of policy windows.
To improve global priority for emergency care, proponents should take advantage of the emerging governance structure and build consensus on definitions, generate data-driven solutions, find strategic framings and engage with non-traditional allies.
紧急医疗状况的负担很高，但在财务和政治方面并没有得到足够的重视，特别是在低收入和中等收入国家。我们研究了影响全球紧急护理优先级的因素，并强调了紧急护理倡导者可能采取的应对措施。
我们对全球紧急护理实践、公共卫生、卫生政策和宣传方面的主要专家进行了半结构式访谈。然后，我们应用了基于政治民族志和内容分析的政策框架，对潜在主题进行了编码。
我们发现，紧急护理倡导者面临的主要挑战包括问题定义、联盟建设、数据匮乏和定位。问题定义仍然是关键问题，对于紧急护理是什么、应该是什么以及应该优先考虑哪些解决方案存在分歧。支持者一直在努力以一种能引起决策者采取行动的方式来描绘问题的紧迫性。数据的缺乏进一步限制了他们的效力。然而，鉴于该网络对这个问题的承诺、新兴的领导力以及政策窗口的存在，有很多理由感到乐观。
为了提高全球对紧急护理的重视，倡导者应该利用新兴的治理结构，就定义达成共识，制定数据驱动的解决方案，寻找战略框架，并与非传统盟友合作。
