Strengthening Health Workforce Capacity through Global Learning in Emergency Medicine:

The SCALE Emergency PROJECT.

1.0 Background

Emergency Medical Service (EMS) is defined as “a comprehensive system which provides the arrangements of personnel, facilities and equipment for the effective, coordinated and timely delivery of health and safety services to victims of sudden illness or injury.

In Uganda, injury, obstetric and medical emergencies are among the leading causes of morbidity and mortality. Recent studies foristance indicate that Uganda experiences RTI deaths at 28.9 per 100,000 population exceeding the global average of 18.0 per 100,000 population. This burden has cost the country enormously both in terms of human life and resources.

Despite the high emergency toll, the emergency services are clearly insufficient and there is low health system capacity to manage the critically ill and injured. The existing emergency care services are fragmented with a number of stakeholders providing ad hoc and uncoordinated services.

The survival and recovery of patients is at the intersection of coordinated prehospital and hospital care. This requires the availability of the necessary equipment, medicines, and supplies in the minutes and hours following the arrival of a critically ill patient at a health care facility as well as the presence of appropriately trained medical personnel.

The Ministry of Health has made significant investment in setting up infrastructure for emergency care and this has now been accelerated in the wake of the COVID 19 Pandemic.

However, the lack of Skilled Health workers in emergency care remains a major gap for Uganda in delivering comprehensive of hospital emergency care and establishing coordinated prehospital management of Emergencies.

In a bid to address the critical lack of skilled health workers to expand the delivery of comprehensive emergency health services, the Ministry of Health Uganda seeks to implement a capacity building program with the UK –The Strengthening Health Workforce Capacity through Global Learning in Emergency Medicine (SCALE-Emergency Medicine Program); to support training pathways that can increase the number and capacity of these cadres.

The SCALE-Emergency Medicine program will strengthen mutual health workforce capacity development between the UK and Uganda with a focus on developing sub specialty training pathways in Emergency Care.

The program will further provide opportunities for the Placement of UK Health professionals to learn from a rich clinical environment while fostering further opportunities for system and institutional collaboration.

2.0 Proposed Intervention

The overall goal of the program is; to contribute to the collaborative development of critical human resource to improve Emergency care in Uganda. 

Specific Objectives

  1. To develop a distant global learning program in Emergency Care between training institutions in Uganda and the UK.
  2. To enable Ugandan Doctors benefit from the Medical Training Initiative (MTI) Scheme and other pathways to train in Emergency Care in the UK.
  3. To facilitate Global Placement of UK professionals to support Emergency Care training in Uganda.

What SCALE Offers to the Health System

  • Robust Government to Government pathway for health workforce capacity development in Emergency medicine for mutual benefit
  • Proper evaluation of the health system’s impact of professional exchange between Uganda and UK
  • Strengthen bilateral placement, training and collaborative clinical research in Emergency Medicine.

What SCALE Offers to Individual professionals

  • Learn and build clinical competence from the diverse clinical environments and healthcare systems between Uganda and UK
  • Develop fine skills in team work, leadership, communication to support Emergency care & practice
  • Build robust professional global networks to support Emergency care and research
  • Build a career in global Emergency care and health systems improvement


Phase one aims to;

  • Fostering the Virtual Global Clinical learning and knowledge sharing between fellows in Uganda and UK in Emergency Medicine.
  • Build conduits for bilateral collaborative research in Emergency Medicine for care quality improvement and health advancement.
  • Share internationally recognized standards of practice in Emergency medicine to improve quality of care.

SCALE Sites;

Identification of suitable institutions in both Uganda and UK to develop an institutional partnership.

SCALE Fellows and ALS

A maximum of the 15 fellows to be recruited in Uganda and 15 from the UK in Emergency Medicine under the program and these will form Action Learning Sets.

SCALE Mentors

A mentor from Emergency Medicine in both Uganda and UK will be attached to each Action Learning Set.

SCALE Clinical Learning Schedule

A clinical learning schedule developed and agreed to by the ALS will guide the clinical discussions between the fellow.

Phase two aims to;

  • Enable fellows undertake Short, medium and Long term placements in both Uganda and UK under Emergency Medicine through the MTI and GLP schemes for hands on experience.
  • Obtaining subspeciality qualifications where possible in Emergency Medicine under the SCALE program
  • Participating in Bilateral Clinical Patient cantered Research to inform Emergency medical care quality improvement.