Task-shifting and system readiness: a narrative review of strategies for pediatric emergency care in low-resource settings
Dublin Core
Title
Task-shifting and system readiness: a narrative review of strategies for pediatric emergency care in low-resource settings
Subject
Pediatric emergency care, Low-resource settings, Task-shifting, Emergency triage assessment and
treatment (ETAT), Global health, Mortality reduction
treatment (ETAT), Global health, Mortality reduction
Description
Abstract
Background In various low- and middle-income countries (LMICs), non-specialist healthcare providers (HCPs), such
as general practitioners, nurses, and community health workers (CHWs), often manage acute pediatric emergencies.
HCPs in these settings may face challenges due to limited training in emergency care and a lack of ongoing
educational opportunities. Additionally, they often operate in clinical environments that lack dedicated emergency
departments (EDs), child-specific care protocols, or the necessary pediatric equipment required for managing critically
ill children. This is concerning, considering that acute illnesses and injuries are significant contributors to the high
rates of preventable childhood deaths in low-and middle-income countries.
Objective This review synthesizes evidence on pediatric emergency care strategies to improve fidelity to evidence-
based practice that can be utilized and scaled beyond the conventional ED framework, without relying on Pediatric
Emergency Medicine (PEM)-trained personnel, who may be unavailable in these regions. This includes task shifting,
where community and non-physician HCPs learn how to provide emergency triage and acute lifesaving interventions
for children in preventing morbidity and mortality, and other strategies, framed within the established concept of
“pediatric readiness”, which is a systems-based approach encompassing staff competencies, protocols, equipment,
and quality improvement. Additionally, this review explores practical examples from international real-world
applications of such strategies.
Methods A narrative review of literature from 2000 to 2024 covering task-shifting, protocols, simulation training, and
system approaches for pediatric emergency care in low-resource settings.
Results Our synthesis of the literature suggests that low-dose, low-fidelity simulation-based training can effectively
enhance confidence and competence in pediatric resuscitation. By recognizing the roles of community-based and
non-specialist providers within a pediatric readiness framework, standardizing relevant protocols, and providing
appropriate tools and education, we can substantially improve pediatric emergency care systems on a broader scale.
Background In various low- and middle-income countries (LMICs), non-specialist healthcare providers (HCPs), such
as general practitioners, nurses, and community health workers (CHWs), often manage acute pediatric emergencies.
HCPs in these settings may face challenges due to limited training in emergency care and a lack of ongoing
educational opportunities. Additionally, they often operate in clinical environments that lack dedicated emergency
departments (EDs), child-specific care protocols, or the necessary pediatric equipment required for managing critically
ill children. This is concerning, considering that acute illnesses and injuries are significant contributors to the high
rates of preventable childhood deaths in low-and middle-income countries.
Objective This review synthesizes evidence on pediatric emergency care strategies to improve fidelity to evidence-
based practice that can be utilized and scaled beyond the conventional ED framework, without relying on Pediatric
Emergency Medicine (PEM)-trained personnel, who may be unavailable in these regions. This includes task shifting,
where community and non-physician HCPs learn how to provide emergency triage and acute lifesaving interventions
for children in preventing morbidity and mortality, and other strategies, framed within the established concept of
“pediatric readiness”, which is a systems-based approach encompassing staff competencies, protocols, equipment,
and quality improvement. Additionally, this review explores practical examples from international real-world
applications of such strategies.
Methods A narrative review of literature from 2000 to 2024 covering task-shifting, protocols, simulation training, and
system approaches for pediatric emergency care in low-resource settings.
Results Our synthesis of the literature suggests that low-dose, low-fidelity simulation-based training can effectively
enhance confidence and competence in pediatric resuscitation. By recognizing the roles of community-based and
non-specialist providers within a pediatric readiness framework, standardizing relevant protocols, and providing
appropriate tools and education, we can substantially improve pediatric emergency care systems on a broader scale.
Creator
Mohammed Alsabri1,2*, Israa Magdy Ata3 , Joseph Alhaddad4 , Eslam Abady5 , Muhammad Azan Shahid6 ,
Aanal Patel7
, Dalia Atef Abouda8 , Sohaila Mohamed Mohamed Abdelbar9 , Victor N. Oboli10 ,
Muhammad Waseem11 and Luis L. Gamboa12,13
Aanal Patel7
, Dalia Atef Abouda8 , Sohaila Mohamed Mohamed Abdelbar9 , Victor N. Oboli10 ,
Muhammad Waseem11 and Luis L. Gamboa12,13
Source
https://doi.org/10.1186/s12245-025-01050-8
Date
2025
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Mohammed Alsabri1,2*, Israa Magdy Ata3 , Joseph Alhaddad4 , Eslam Abady5 , Muhammad Azan Shahid6 ,
Aanal Patel7
, Dalia Atef Abouda8 , Sohaila Mohamed Mohamed Abdelbar9 , Victor N. Oboli10 ,
Muhammad Waseem11 and Luis L. Gamboa12,13, “Task-shifting and system readiness: a narrative review of strategies for pediatric emergency care in low-resource settings,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12887.