KUMJ | VOL. 23 | NO. 3 | ISSUE 91 | JULY-SEPTEMBER, 2025

Enhancing Emergency Medicine Services at Rural Outreach Centers: A Comprehensive Needs Assessment for Project ECHO Education Program
Dangal RK, Barun K, Thapa D, Anderson K, Mendoza A, Shrestha R, House DR

Abstract:
Background Emergency care is a crucial component of Universal Health Coverage; however, Nepal has limited development of emergency services, especially in rural areas. Providers in rural health care facilities have limited experience, emergency training, and resources. The lack of specialized training and resources highlights significant gaps in emergency care delivery, underscoring Nepal’s urgent need for targeted education and capacity building. Objective To assess emergency medicine training needs for rural healthcare providers at Dhulikhel Hospital Outreach Centers. Method A cross-sectional study conducted in October-November 2024 surveyed healthcare providers from Dhulikhel Hospital’s 18 Outreach Centers (ORCs) to assess emergency medicine training needs. Using a structured questionnaire, the study gathered demographics, emergency conditions encountered, barriers to care, and learning topics of interest. Participants completed the survey through in-person and telephone interviews. Data was analyzed using descriptive statistics. Result Sixty providers participated from all 18 ORCs. Participants included midwives (41.7%), health assistants (26.7%) and medical officers (25%). Most providers (58.3%) had < 5 years of experience. Reasons for referral included the need for lab tests, CT scans, and critical care services. The most significant challenges were insufficient training (96.7%) and lack of supplies (95%). Common emergency conditions managed were trauma, COPD exacerbations, and uncontrolled diabetes. Emergency training interests included poisoning, snake bites, airway, and breathing emergencies. Conclusion This assessment describes challenges and needs critical to improve rural emergency care. Focused investments in training, resources, and support aimed to empower providers can bridge critical gaps in emergency care delivery for rural communities.
Keyword : Emergency medicine, Needs assessment, Project ECHO, Rural health services, Telementoring