Building critical care capacity for resource-limited countries with complex emergencies in the World Health Organization Eastern Mediterranean Region: Developing and Implementing a Critical Care National Training Program in Yemen

Abstract

Background: Caring for critically ill patients is challenging in resource-limited and complex emergency settings such as Yemen, where the burden of disease and mortality from potentially treatable illnesses and injuries is higher than in resource-rich areas. Barriers to delivering quality critical care in these settings are numerous and include deficiencies in health systems structure, a limited capable healthcare workforce, insufficient financial resources, and access constraints due to insecurity, among many other factors. Methods: Potential solutions include the development of focused practical and educational programs for capacity building of national healthcare professionals’ knowledge and skill sets in the care of critically ill patients. This requires adaptation of proven curricula into a national training program to promote implementation of evidence-based critical care. Results: Yemen successfully introduced a 9-week national critical care training program that targeted both physicians and nurses from 11 of 12 southern governorates from 5th June to 11th August 2022. The procedures for its development and its implementation are described in this report. Successful continued development and implementation are contingent on ongoing adaptation, secured financial resources, and support from academic institutions such as the Faculty of Medicine and Health Sciences University of Aden (Yemen), the Oman Medical Specialty Board (Sultanate of Oman), health care authorities and partners. Technologies utilized included tele-education and a simulation skills center using high fidelity manikins, in addition to the lectures and bed-side training sessions in Intensive Care Unit (ICU). Conclusion: Critical care training is a vital need and of paramount importance in resource-limited and complex emergency settings such as Yemen and programs should be developed and sustained under country ownership with support from internal and external partners. The current challenges and shortfalls require new approaches such as a comprehensive, focused critical care/ICU national training program to build a cadre of critical care professionals in the country together with the provision of human, material, and financial resources support. Through producing a cadre of critical care/ICU national professionals, this course is contributing to enhancing the emergency preparedness and response capacities in Yemen, as well as building sustainable critical care capabilities within the national health system that will further save many lives in Yemen.