Ka la 9 Phupu 2020, MAkerere University, Sekolo sa Bophelo bo Botle ba sechaba se ile sa etsa tlhahlobo e ikhethileng mabapi le boemo ba EMS le tlhokomelo ea bophelo bo botle ba sepolesa sa Uganda. Ba fumane hore maemong a boroa a naha, ho na le khaello ea lisebelisoa tsa ambulense haholo, joalo ka li-ambulense, liboto tsa lesapo la mokokotlo, le tlhokahalo ea litsebi tse koetlisitsoeng.

Ke 16 (30.8%) feela ea bafani ba pele ho sepetlele ba 52 ba hlahlobiloeng ba nang le likoloi tse tloaelehileng tsa maemo a tšohanyetso le ambulense e hlokahalang thepa, meriana le basebetsi ho arabela maemong a tšohanyetso hantle. Sena ke seo Univesithi ea Makerere e se utloisitseng kamora phuputso ea eona ho pholletsa le Uganda. Sena se bolela hore hoo e ka bang 70% ea li ambulense naheng ea Uganda ha ba na matla a tlhokomelo ea bongaka maemong a pele ho sepetlele.

Ka morao ho tlhahlobo, ba tlaleha hore Lekala la Bophelo (MoH) le hlokometse tlhoko ea ho ntlafatsa lits'ebeletso tsa ambulense. Boithuto bona bo na le sepheo sa ho theha boemo ba litšebeletso tsa bongaka tsa tšohanyetso (EMS) le tlhokomelo ea bophelo bo botle ba bongaka Uganda. Ba entse tlhahlobo e latelang maemong ohle a naha le a naha e tlase, ba nahanela maemo a EMS lipetleleng tsa pele le sepetlele ba sebelisa sesebelisoa sa World Health Organisation (WHO) Emergency Care Systems Test (ECSSA).

Le ha ho entsoe liphuputso tse 'maloa ho lekola tlhokomelo ea sepetlele sepetleleng sa Kampala [7,8,9], ha ho phuputso e shebahalang eka e entsoe ho lekola boemo ba EMS le tlhokomelo ea bophelo bo botle setsing sa bophelo ba boemo bo botle ba naha naheng ea Uganda.

 

Morero oa thuto le lithuto tsa mantlha: karolo ea litsebi le lisebelisoa tsa ambulense tsa Uganda EMS

Joaloka ts'ebeletso ea bongaka ba tšohanyetso (EMS), le litšebeletso tsa ambulense tsa Uganda li lokela ho hlophisa likarolo tsohle tsa tlhokomelo e fuoang bakuli maemong a pele ho sepetlele kapa sepetleleng sa sepetlele [1]. Paramedics le EMTs (hape e le karolo ea bakhanni ba ambulense), ba tlameha ho hlokomela bakuli ba nang le lisebelisoa tse khethehileng tsa ambulense. Morero e lokela ho ba ntlafatso ea sephetho ho bakuli ba maemong a mahlonoko, joalo ka litšitiso, maemo a tšohanyetso a tsa bongaka, likotsi tse mpe le mafu a mang a tebileng a amanang le nako.

Tlhokomelo ea pele ho sepetlele ha e felle feela lekaleng la bophelo bo botle, athe e ka kenyelletsa mafapha a mang joalo ka mapolesa le lefapha la litima-mollo. Ntle le tlhokomelo ea pele ho sepetlele, liphello tsa mokuli li ameha haholo ke tlhokomelo e matla e fanoang setsing sa bophelo bo botle [4]. Ho phela le ho hlaphoheloa ha mokuli ho itšetlehile ka boteng ba basebetsi ba bongaka ba koetlisitsoeng ka nepo, le boteng ba lisebelisoa tse hlokahalang tsa ambulense, joalo ka li-stretcher, Mokokotlo liboto, tsamaiso ea oksijene joalo-joalo, meriana, le lisebelisoa ka metsotso le lihora tse latelang ho fihla ha mokuli ea kulang haholo setsing sa tlhokomelo ea bophelo [5].

 

EMS naheng ea Uganda: lisebelisoa tsa ambulense le litsebi tse koetlisitsoeng li haella - Boholo ba sampole le mekhoa ea sampole

Sistimi ea tlhokomelo ea bophelo ea Uganda e hlophisitsoe ka likarolo tse tharo tse kholo:

• lipetlele tsa naha
• lipetlele tse fetisetsang tikolohong
• kakaretso (setereke) lipetlele

Kahare ho setereke, ho na le litsi tsa bophelo tse nang le bokhoni bo fapaneng:

Setsi sa Bophelo I le II: setsi sa mantlha sa tlhokomelo ea bophelo. Ha e tšoanelehe bakeng sa maemo a tebileng a bongaka [11];

Setsi sa Bophelo II le IV: lits'ebeletso tse fumanehang ka ho fetisisa tsa bongaka.

Univesithi ea Makerere e ile ea fumana sampole ea meaho eohle ea bophelo bo botle naheng ea Uganda ho MoH mme ea ntlafatsa lenane lena ka libaka tsa bophelo. Libaka tsa bophelo bo botle li ile tsa hlophisoa hape ka libaka tsa 4 tsa tsamaiso ea geo [Uganda] (ke hore, Leboea, Bochabela, Bophirima le Bohareng) ho etsa bonnete ba hore sebaka ka seng sa tsamaiso ea libaka se emetse sampole. Karolong e 'ngoe le e' ngoe ea tsamaiso ea geo, sehlopha sa boithuto se ile sa khetha sebaka se le seng sa bophelo (sa feiga 12 - tlase).

 

Ka boomo ba kenyellelitse libaka tse tharo tsa bophelo bo botle: tikoloho ea Arua e West West kaha e na le baphaphathehi ba bangata, e leng se ka amang ho fihlella le ho fumaneha ha EMS. E 'ngoe ke sebaka sa bophelo bo botle sa Karamoja kaha se na le ntoa ea likhohlano ebile se ne se sotlehile ka lebaka la phihlello e mpe ea lits'ebeletso tsohle tsa sechaba. La boraro ke setereke sa Kalangala se entsoeng ka lihlekehleke tse 84 ka hona se na le mathata a ikhethang a phallo ea lipalangoang.

Sehlopha sa bafuputsi ba Univesithi ea Makerere ba hlophisitse li-HC tsohle libakeng tse khethiloeng tsa bophelo bo botle ke baikarabelli ba mmuso, e seng tsa phaello / e seng tsa mmuso (PNFP / NGO) le li-HC tse ikemetseng. Sebakeng se seng le se seng sa bophelo bo botle, ka boikhethelo ba khethile litsi tse peli tsa bophelo bo ikemetseng (ke hore, 2 HC IV le 1 HC III), litsi tsa bophelo tsa 1 PNFP / NGO (ke hore, 4 HC IV le 2 HC III), le 2 tsa mmuso litsi tsa bophelo bo botle (ke hore, 4 HC IV le 2 HC III). Moo chelete e ikemetseng ea phaello kapa PNFP / NGO HC III kapa HC IV e neng e le sieo libakeng tse khethiloeng tsa bophelo bo botle, ba ne ba tlatsa marang-rang ana ka HC III kapa ea HC IV ea mmuso.

Leano la bona la ho etsa sampole le fane ka mohlala oa boholo ba sampole bo nang le lipetlele tse 7 tsa sepetlele, lipetlele tse 24 (kakaretso) tsa setereke, 30 HC IV le 30 HC III. Ntle le moo, Setereke sa Kampala se ne se nkuoa e le setereke se ikhethang ka lebaka la boemo ba sona e le motse-moholo ba nang le lisebelisoa tse ngata tsa bophelo bo botle. Ho tsoa ho li-RRH tse tharo (ke hore, Rubaga, Nsambya, le Naguru) toropong, RRH e le ngoe (Naguru) e ekelitsoe sampole ea thuto.

Ho feta moo, ba kenyelelitse mapolesa joalo ka bahlokomeli ba tlhokomelo ea sepetlele hobane hangata ke bona ba arabelang maemong a kotsi 'me ba fana ka lipalangoang ho bahlaseluoa. Boithuto bona ke boithuto ba naha bo akaretsang bo kenyeletsang libaka tse 7 tsa bophelo bo botle, litereke tse 38 (sa feiga. 2) [13], litsing tsa bophelo bo botle ba 111, le ba fanang ka tlhokomelo ea bophelo ba liketelo tse 52 pele. Ho tsoa ho e 'ngoe le e' ngoe ea litereke tse 38, bafuputsi ba ile ba buisana le ofisiri e le 'ngoe ea setereke se phahameng, hangata Ofisiri ea Bophelo ea Setereke e etsang qeto ea setereke, le basebeletsi ba bohlokoa ba 202 ba amehang ho EMS le tlhokomelo ea bophelo bo bobebe.

 

Lisebelisoa tsa ambulense le litsebi tse koetlisitsoeng li hloka Uganda: pokello ea data

Bafuputsi ba tsoang Univesithing ea Makerere ba ile ba fetola mochini oa WHO Emergency Care Systems [14] e ntlafalitsoeng ke Teri Reynolds le ba bang [10]. Sena se ba thusitse ho bokella datha ho EMS litsing tsa pele ho sepetlele le litsing tsa bophelo. Sesebelisoa se ne se entsoe ka lethathamo le lipotso tse hlophisitsoeng, tse neng li lekola litšiea tse ts'eletseng tsa bophelo bo botle: boetapele le taolo; lichelete; tlhahisoleseling; basebeletsi ba bophelo bo botle; lihlahisoa tsa bongaka; le phano ea lits'ebeletso. Ba boetse ba lekola litlaleho tse tsoang lithutong tsa pejana tsa EMS tsa Uganda [7,8,9] mme ba tlatsa likheo linthong tsa tlhahiso-leseling ho sefahleho sa senotlolo sa sefahleho sa ho buisana le ofisiri e kholo ea MOH.

 

 

EMS naheng ea Uganda: Kakaretso ea sephetho sa lisebelisoa tsa ambulense le litsebi tse koetlisitsoeng li haelloa

Lethathamo le latelang le akaretsa liphetho tse fumanehang masimong a fapaneng maemong a naha le a naha e ka tlase. Liphetho tse qaqileng haholoanyane lihokahanong tse qetellong ea sengoloa.

 

Lintlha ka EMS naheng ea Uganda: lipuisano

Uganda e ile ea fetoha le khaello e tebileng ea leano la naha, litataiso le litekanyetso lefapheng la bongaka la tšohanyetso. Ho hloka hona ho bonts'a karolo efe kapa efe ea lefapha la tlhokomelo ea bophelo bo botle: chelete; lihlahisoa tsa bongaka, le khokahano.

Libaka tsa maemo a tšohanyetso litsing tsa bophelo bo botle li ne li se na lisebelisoa tsa mantlha tsa ambulense le meriana ho hlokomela le ho alafa maemo a fapaneng a tšohanyetso a bongaka. Khaello ena e matla ea lisebelisoa le meriana e ile ea bonoa maemong ohle a sistimi ea bophelo bo botle. Leha, litsi tsa bophelo bo ikemetseng le liambulense li ne li hlometse hamolemo ho feta tsa mmuso. Ho fumaneha ho fokolang le ts'ebetso ea lisebelisoa tsa ambulense bakeng sa ho arabela maemong a tšohanyetso a kalafo ho bolela hore bakuli ba ne ba fumana tlhokomelo e fokolang haholo sehlopheng sa pele ho sepetlele, ebe ba fetisetsoa litsing tsa bophelo tse neng li fumaneha hantle ho feta ho sebetsana le liketsahalo tsa bona tse mpe haholo.

Litšebeletso tsa ambulense li ne li hlasetsoe ke lisebelisoa tse mpe, khokahano le puisano. Bonyane 50% ea bafani ba EMS bao ho buisanoeng le bona ba boletse hore ha ho mohla ba tsebisang litsi tsa bophelo pele ba fetisetsa maemo a tšohanyetso moo. Lits'ebeletso tsa lipetlele, ho kenyelletsa le lipetlele tsa lebatooa tsa tikoloho, li ne li se na EMS e fumanehang ka li 24 ha. Ha e le hantle, batho ba shebeletseng le beng ka bona hangata ke bona feela ba thusang bakuli. Likoloi tsa ho paterola mapolesa e ne e le mokhoa o tloaelehileng (bakeng sa baithaopi ba 36 ho ba 52) oa ho tsamaisa bakuli ba hlokang tlhokomelo ea tšohanyetso.

Boithuto bo ne bo hlalositse ambulense e le koloi ea tšohanyetso e fanang ka lipalangoang tsa tlhokomelo ea tšohanyetso le tlhokomelo ha li le sebakeng sa pele ho sepetlele, ho bolela hore boholo ba bafani ba pele ho sepetlele ha ba na li-ambulense, empa e ne e le bahlahisi ba lipalamo tsa maemo a tšohanyetso. Ho feta moo, maemong ohle, ho ne ho e-na le bopaki ba lichelete tse sa lekaneng tsa EMS.

Meeli ea thuto ena ke liphoso tsa tekanyo ho tloha ho itšetleha ka litlaleho tsa boithati bakeng sa tse ling tsa liphetho (mohlala, tšebeliso ea data bakeng sa ho rala). Leha ho le joalo, boholo ba liphetho tsa bohlokoa (ho fumaneha le ts'ebetso ea lihlahisoa tsa bongaka) thutong li ile tsa lekanngoa ka tlhaiso e tobileng. Liphumano tsa bafuputsi li tiisa ba tsoang liphuputsong tse ling ba sebelisa mokhoa o ts'oanang o ileng oa fumana ho hloka boetapele, molao le chelete e le litšitiso tsa bohlokoa ntlafatsong ea EMS linaheng tse tsoelang pele [16].

E tlalehiloeng sengoliloeng sena e ne e le phuputso ea naha kahoo lintlha tse fumanoeng li ka akaretsoa naheng eohle ea Uganda. Liphumano li ka boela tsa akaretsoa ho linaha tse ling tse kenang chelete e tlase le tse bohareng ka hare ho Afrika tse se nang litsamaiso tsa EMS [1] mme ka hona, li ka sebelisoa ho tataisa boiteko bo reretsoeng ho ntlafatsa lits'ebetso tsa EMS ka har'a litlhophiso tsena.

 

Ha re phethela…

Uganda e na le mefuta e mengata ea lits'ebeletso tsa bophelo bo botle tseo bakuli ba ka eang ho tsona bakeng sa tlhokomelo ea bongaka. Leha ho le joalo, ho tsoa liphumantsong tse kaholimo ba bangata ba ka botsa 'Na Uganda e na le EMS?'. Re tlameha ho hlakisa hore thuto ena e entsoe ka nako eo ho neng ho se na leano la EMS, litekanyetso, le tšebelisano e mpe haholo maemong a naha le a naha e ka tlase.

Ho latela liphumano tsa Yunivesithi ea Makerere, ka hona, ho bonahala e le bohlale ho fihlela qeto ea hore, ka 'nete, ho ne ho se na EMS, empa likarolo tse' maloa tsa bohlokoa sebakeng tse ka ntlafalitsoeng e le sebaka sa ho qala ts'ebetso ea sisteme. Sena se ka hlalosa lebaka la lisebelisoa tsa ambulense le tlhokahalo ea basebetsi ba koetlisitsoeng hantle. Leha ho le joalo, ho bile le ts'ebetso e ntseng e tsoela pele ea ho ntšetsa pele maano le tataiso bakeng sa ho theha EMS.

 

LITLHAHISO

1. Mistovich JJ, Hafen BQ, Karren KJ, Werman HA, Hafen B. Tlhokomelo ea tšohanyetso ea tlhokomelo ea tšohanyetso: Bophelo bo botle ba holo ea Brady; 2004.
2. Mold-Millman NK, Dixon JM, Sefa N, Yancey A, Hollong BG, Hagahmed M, et al. Boemo ba lits'ebeletso tsa bongaka tsa ts'ohanyetso (EMS) Afrika. Likoluoa ​​tsa Prehosp 2017; 32 (3): 273-83.
3. Mechini ea Plummer V, ea Boyle M. EMS linaheng tse kenang chelete e tlase: tlhahlobo ea lingoliloeng. Likoluoa ​​tsa Prehosp 2017; 32 (1): 64-70.
4. Hirshon JM, Risko N, Calvello EJ, SSd R, Narayan M, Theodosis C, et al. Sistimi le lits'ebeletso tsa bophelo bo botle: karolo ea tlhokomelo e boima. Bull World Health Organ. 2013; 91: 386-8.
5. Mock C, Lormand JD, Goosen J, Joshipura M, Tataiso ea tataiso ea bophelo bo botle ba maiketsetso. Geneva: Mokhatlo oa Lefatše oa Bophelo; 2004.
6. Kobusingye OC, Hyder AA, Bishai D, Joshipura M, Hicks ER, Mock C. Litšebeletso tsa bongaka tsa tšohanyetso. Dis laola Lintho tsa Bohlokoa Boemong ba Naha. 2006; 2 (68): 626-8.
7. Bayiga Zziwa E, Muhumuza C, Muni KM, Atuyambe L, Bachani AM, Kobusingye OC. Likotsi tsa sephethephethe tseleng ea Uganda: nako ea tlhokomelo ea pele ho sepetlele e tloha sebakeng sa koluoa ​​ho ea sepetlele le mabaka a amanang le ona ke mapolesa a Uganda. Int J Inj Contr Saf Promot. 2019; 26 (2): 170-5.
8. Mehmood A, Paichadze N, Bayiga E, et al. Nts'etsopele ea 594 le tlhahlobo ea tlhahlobo ea lithulusi tsa tlhahlobo ea pele ho sepetlele sepetleleng sa Kampala, Uganda. Thibelo e kotsi. 2016; 22: A213.
9. Balikuddembe JK, Ardalan A, Khorasani-Zavareh D, Nejati A, Raza O. Bofokoli le matla a amang tlhokomelo ea tšohanyetso ea Prehospital bakeng sa bahlaseluoa ba liketsahalo tsa sephethephethe sa tseleng tseleng e kholo ea toropo ea Kampala: thuto ea sefapano. BMC Emerg Med. 2017; 17 (1): 29.
10. Reynolds TA, Sawe H, Rubiano AM, Do Shin S, Wallis L, Mock CN. Ho matlafatsa lits'ebeletso tsa bophelo bo botle ho fana ka tlhokomelo ea tšohanyetso. Litabatabelo tsa Taolo ea Maloetse: Ho Ntlafatsa Bophelo le Phokotso ea Bofuma ba 3: Banka ea Machabeng bakeng sa ho aha bocha le nts'etsopele / Banka ea Lefatše; 2017.
11. Acup C, Bardosh KL, Picozzi K, Waiswa C, Welburn SC. Lintlha tse susumetsang ho beha leihlo ha T. b. Rhodesiense human african trypanosomiasis naheng ea Uganda. Acta Trop. 2017; 165: 230-9.
12. Wang H, Kilmartin L. Ho bapisa boits'oaro ba bophelo ba mahaeng le ba litoropong ho la Uganda: lintlha tse tsoang tšebelisong ea litšebeletso tsa lentsoe la selefouno. J Urban Technol. 2014; 21 (2): 61-89.
13. Sehlopha sa Nts'etsopele ea QGIS. QGIS Geographic Information System 2018. E fumaneha ho: http://qgis.osgeo.org.
14. Mokgatlo wa Lefatshe wa Bophelo bo Botle. Boemo ba tšohanyetso le ba ho sithabela mahloko Geneva, Switzerland. 2018. E fumaneha ho tloha: https://www.who.int/emergencycare/activities/en/.
15. Hartung C, Lerer A, Anokwa Y, Tseng C, Brunette W, Borriello G. Open data kit: lisebelisoa tsa ho aha litšebeletso tsa tlhahisoleseling bakeng sa libaka tse tsoelang pele. Ho: Ts'ebetso ea Seboka sa Bone sa Machaba sa ACM / IEEE mabapi le Litsebi tsa Tlhahisoleseling le Khokahano. London: ACM; 4. leq. 2010-1.
16. Nielsen K, Mock C, Joshipura M, Rubiano AM, Zakariya A, Rivara F. Tlhahlobo ea boemo ba tlhokomelo ea pele ho tikoloho linaheng tse 13 tse amohelang chelete e tlase. Tlhokomelo ea Prehosp Emerg. 2012; 16 (3): 381-9.

 

BANGATA

Albert Ningwa: Lefapha la Taolo ea Mafu le Bophelo ba Tikoloho, Makerere University School of Public Health, Kampala, Uganda

Kennedy Muni: Lefapha la Epidemiology, Univesithi ea Washington, Seattle, WA, USA

Frederick Oporia: Lefapha la Taolo ea Mafu le Bophelo ba Tikoloho, Makerere University School of Public Health, Kampala, Uganda

Joseph Kalanzi: Lefapha la Litšebeletso tsa Bongaka ba Tšohanyetso, Lekala la Bophelo, Kampala, Uganda

Esther Bayiga Zziwa: Lefapha la Taolo ea Mafu le Bophelo ba Tikoloho, Makerere University School of Public Health, Kampala, Uganda

Claire Biribawa: Lefapha la Taolo ea Mafu le Tikoloho

Olive Kobusingye: Lefapha la Taolo ea Mafu le Bophelo ba Tikoloho, Makerere University School of Public Health, Kampala, Uganda

 

 

BALA LIKENG

EMS naheng ea Uganda - Ts'ebeletso ea Ambulense ea Uganda: Ha Passion E Kopana Sehlabelo

Uganda Bakeng sa Boimana ka Boda-Boda, Litekesi tsa lithuthuthu li sebelisoa e le liambulense tsa lithuthuthu

Uganda: Li-ambulense tse ncha tse 38 bakeng la ketelo ea Mopapa Francis

 

 

SOURCES

BMS: BioMed Central - Sebaka sa lits'ebeletso tsa bongaka tsa ts'ohanyetso le tlhokomelo ea bophelo bo botle Uganda: tse fumanoeng ho tsoa ho Patlisiso e Akaretsang ea Naha

Litlhahlobo tsa Lithaka: Boemo ba litšebeletso tsa bongaka tsa tšohanyetso le tlhokomelo ea litsi tsa bophelo bo botle Uganda: liphuputso ho tsoa ho Patlisiso e Akaretsang ea Naha

Sekolo sa koleche ea bophelo bo botle ea sechaba saense ea bophelo bo botle Univesithing ea Makerere

 

WHO: tlhokomelo ea tšohanyetso