The initiative for medical equity and global health (IMEGH) resuscitation training program: A model for resuscitation training courses in Africa

Eugene Tuyishime; Alain Irakoze; Celestin Seneza; Bernice Fan; Jean Paul Mvukiyehe; Jackson Kwizera; Noah Rosenberg; Faye M Evans

doi:10.1016/j.afjem.2023.12.003

The initiative for medical equity and global health (IMEGH) resuscitation training program: A model for resuscitation training courses in Africa

Afr J Emerg Med. 2024 Mar;14(1):33-37. doi: 10.1016/j.afjem.2023.12.003. Epub 2023 Dec 30.

Authors

Eugene Tuyishime^{1

2}, Alain Irakoze^{1

3}, Celestin Seneza⁴, Bernice Fan⁵, Jean Paul Mvukiyehe^{1

3}, Jackson Kwizera^{1

3}, Noah Rosenberg⁶, Faye M Evans⁷

Affiliations

¹ Department Anesthesia, Critical Care, and Emergency Medicine, University of Rwanda, Rwanda.
² Department of Anesthesia and Perioperative Medicine, Western University, Canada.
³ Department Anesthesia and Critical Care, King Faisal Hospital, Kigali, Rwanda.
⁴ Department Anesthesia and Critical Care, Kibagabaga District Hospital, Kigali, Rwanda.
⁵ School of Nursing, University of Virginia, USA.
⁶ Department of Emergency Medicine, University of Botswana, Gaborone, Botswana.
⁷ Department of Anesthesia, Critical Care, and Pain Medicine, Boston Children's Hospital & Harvard Medical School, Boston, MA, USA.

Abstract

In high-income countries, outcomes following in hospital cardiac arrest have improved over the last two decades due to the introduction of rapid response teams, cardiac arrest teams, and advanced resuscitation training. However, in low-income countries, such as Rwanda, outcomes are still poor. This is due to multiple factors including lack of adequate resuscitation training, few trainers, and lack of equipment. To address this issue, the Initiative for Medical Equity and Global Health Equity (IMEGH), a training organization founded in 2018 by 5 local anesthesiologists has regularly taught resuscitation courses such as Basic Life Support, Advanced Cardiac Life Support, and Pediatric Advanced Life Support in hospitals throughout Rwanda. The aims of the organization include developing a sustainable model to offer context relevant resuscitation training courses, building a cadre of local instructors to teach on the courses, as well as engaging funding partners to help support the effort. From October 2018 until September 2022, 31 courses were run in 11 hospitals across Rwanda training 1,060 healthcare providers (mainly of non-physician anesthetists, nurses, midwives, and general practitioners). Ongoing challenges include lack of local protocols, inability to tracking resuscitation outcomes, and continued inaccessibility by many healthcare providers. Despite these challenges, the IMEGH program is an example of a successful context-relevant model and has potential to inform the design of resuscitation programs in other similar settings. This article describes the development of the IMEGH program, accomplishments as well as lessons learned, challenges, and next steps for expansion.

Keywords: Low-resource setting; Resuscitation training; Rwanda.