Please describe the goal of your initiative; outline what you are trying to achieve
PER will improve time to appropriate care, reduce resources spent by families on ineffective treatments, and ultimately save lives.
PER is a societal component for GECC's current hospital-based emergency programming and supports it’s collaborations with the Ministry of Health and Ugandan universities to scale the ECP program nationally. By developing a system for the appropriate use of emergency services, PER can effectively integrate the services of the new ECP health worker cadre into existing public and private health sectors.
PER also ensures the sustainability of emergency care in Uganda with an effective peer-to-peer process for educating lay-people and clinic providers and allows the integration of ECP services into the social, economic and politic fabric of communities.
What has been the impact of your solution to date?
In two years, the GECC ECP program has recruited 13 ECPs and has 5 graduated ECP trainers, and effectively treated more than 11,000 patients in the Nyakibale Emergency Department (serving a rural impoverished population of over 300,000). The outcomes for these patients are impressive, with the mortality of admitted children at only 2.2% (comparable hospital in Kenya = 9.9%). Similarly, the case-fatality for children <5yo admitted through the our ED with malaria is 0.9%, compared to Uganda’s published case fatality of 3%. Additionally, GECC’s data shows that 15% of all ED patients are screened for new diagnoses of HIV/AIDS with 9% screening positive. Once found to be positive, patients are then referred to the HIV clinic for additional care. GECC expects that with the PER project, the numbers of patients from the hospital’s catchment presenting for treatment at the ED will increase significantly, and that delays in care that increase morbidity/mortality will be further minimized.
What is your projected impact over the next five years?
In 5 years GECC will be training 30 new ECPs per year in a national certification program at Mbarara University and will have expanded to two additional training hospitals. It is projected that each new ECP can treat over 312,000 children during his/her career for as little investment as $1.60 per child. The PER program will integrate into this expansion. Community education will have directly touched the lives of tens of thousands of people, and provider workshops will have raised awareness of and participation in a new type of health service. Ongoing radio programming will have reached listeners numbering into the hundreds of thousands. PER can create a network that will connect over one million residents of rural Uganda to these previously unknown, life saving emergency services
What barriers might hinder the success of your project? How do you plan to overcome them?
Building trust and maintaining collegial relationships with local is the biggest barrier to the success of the PER pilot phase. Overcoming cultural differences in areas of communication and role expectations will be actively addressed to move forward collaboratively. Our participatory approach has ensured that the pilot addresses goals that are common to all stakeholders. Additionally, GECC has a long standing administrative and personal relationship with the pilot Hospital and has strong support from the Hospital Management Team. Continued personal and cultural dialogue, and a participatory approach to design and implementation, will continue to be essential, given that the deeper into the community the program reaches, the more complex relationships and cultural differences may be.
Winning entries present a strong plan for how they will achieve and track growth. Identify your six-month milestone for growing your impact
Complete 20 community outreaches, 5 CME workshops, 3 hours of radio. Initiate referral protocol and monitoring.
Now think bigger! Identify your 12-month impact milestone
Integration of PER into GECC’s overall model, administratively and clinically, to streamline logistics and assure sustainability