USAID/BASICS Operationalizes Emergency Triage Assessment and Treatment in Afghanistan
July 17, 2009—In Afghanistan, half of all deaths in hospitals occur within 24 hours of patient admission. USAID/BASICS is supporting implementation of a system to prevent many of these deaths by improving rapid identification of very ill children and initiating immediate treatment in health facilities. This effort has started with the introduction of Emergency Triage Assessment and Treatment (ETAT), based on guidelines developed by the World Health Organization.
This month, USAID/BASICS collaborated with the Ministry of Public Health and Tech-Serve to train 35 representatives from 10 hospitals in implementing ETAT. Emergency Triage Assessment and Treatment is a process of rapid triage for all children presenting to a hospital. It comprises a 15 to 20 second assessment to determine whether any emergency or priority signs are present. If so, immediate steps are taken to stabilize and treat them.
Experience in Malawi has shown that a well-implemented ETAT intervention can significantly reduce inpatient mortality for pediatric patients. To benefit from this experience, four Malawian health experts with experience implementing ETAT traveled to Afghanistan to act as a training team.
"ETAT does not stand alone," pointed out Dr. Hedayatullah Stanekzai, USAID/BASICS Team Leader in Afghanistan. "It is a valuable complement to quality improvement processes, such as the Pediatric Hospital Improvement Initiative that lies at the foundation of our facility-level work for newborns and children in Afghanistan," he added. Stanekzai also advised that ETAT often requires changes in the hospital's physical facility or operational procedures in the way health care is delivered. This may mean locating emergency units closer to outpatient units, or ensuring that emergency drugs are available in both types of units. ETAT is the most recent addition to USAID/BASICS' Afghanistan country program, which began in 2008 and specifically works to improve child health in the country by revising and developing child survival and health policies and strategies; improving the delivery of newborn and child health care in communities, in health clinics and in hospitals; and strengthening cross-cutting health system components that promote child health, such as the use of health information system data for decision making or coordinate behavior change communication messages.