Building emergency care capacity in Kenya

Emergency health specialists from The University of Manchester are collaborating with partners in Kisii County, Kenya to ensure emergency healthcare for the region meets national standards.

Effective emergency care systems that provide care for all in their time of need are critical components of any integrated patient journey.

The World Health Organisation Emergency Care System Framework (2018) considers the injured or suddenly unwell patient and explores their need at each stage of the journey through the health system.

This includes the call for help, the delivery of first aid from bystanders, ambulance transport by qualified ambulance professionals, and being received at a hospital ready to assess and expertly manage the presenting condition.

Professor Darren Walter

Darren is Clinical Professor of International Emergency Medicine at The University of Manchester.

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The whole system must work smoothly and seamlessly to deliver the best outcome for the patient.

Underdeveloped systems

In many countries, however, systems are rudimentary and there are gaps in the 'chain of survival' through which patients fall. People die or suffer excessively because of these deficiencies.

Rural Kenya is one such place where emergency care systems do not meet international standards. Despite the Kenyan government publishing a national emergency care strategy describing a route to delivering the WHO emergency agenda and providing effective emergency, trauma and acute care services, delivery is slow.

Kisii, located in the southwestern part of Kenya, is one rural area which currently has an extremely limited emergency health system.

Creating new standards

Leading emergency health specialists from The University of Manchester are working with partners in Kisii to build a robust emergency healthcare system for the region that will meet the standards set out in the Kenyan Emergency Medical Care Strategy 2020-2025. It is intended that this could then be rolled out more widely across Kenya.

Ambulance personnel from the North West Ambulance Service have volunteered their time to travel to Kisii between 2025 and 2028 to engage in a range of activities:

Ambulance training

A cohort of 72 ambulance officers will be trained to enable the county to fully utilise its fleet of 11 ambulances. This training will include equipping these officers with the knowledge, skills and experience to provide care and develop a curriculum to potentially deliver this training independently and sustainably from 2029.

First aid/response training

Training will take place to enable 750 members of the public to undertake life-saving first aid, and establish a recognised, self-sustaining Community First Response training programme at Kisii University, in collaboration with the St John Ambulance Kenya.

Supporting emergency call handling

North West Ambulance Service personnel will support the implementation of a sophisticated call handling and ambulance dispatch system, and equip local emergency call handlers to use it.

Enabling accredited training

Kisii University will be supported in becoming a centre for training accredited specialists in emergency medicine, including developing a master's programme in emergency medicine, supported by partnerships with The University of Manchester and training visits from UK experts.

Next steps

The initial Kisii County Ambulance Service training programme has seen 24 Kisii ambulance officers graduate from the programme, with additional training programmes set to be rolled out later in 2025.

"A functioning emergency care system is at the heart of an effective health system and, whilst Kisii does not yet have one, we have now taken the initial steps towards the development of the region’s first professional ambulance service," says Professor Darren Walter, Clinical Professor of International Emergency Medicine at The University of Manchester.

"From an initial group of disparate individuals who had different skill sets, from backgrounds ranging from taxi drivers to nurses, we have created a cohesive team. The journey starts here."