Evidence map›Paper›PMID 41558760›Full record

ArticleBMJ global health2026

The intersection of emergency care, human resources and health equity: a comparative mapping of policy and systems in Australia, Canada, Rwanda and South Africa.

Veena Sriram, Stephanie M Topp, Heike Geduld, Menelas Nkeshimana, Dylan Collins, Phoebe Tuyishime, Gerard Fitzgerald, René English, Gabriela Carolus, Simon Pulfrey and 1 more

Abstract readComparative Study
In one paragraph

Article in BMJ global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Veena SriramSchool of Public Policy and Global Affairs, University of British Columbia, Vancouver, British Columbia, Canada veena.sriram@ubc.ca.ORCID 0000-0002-7465-5881
Stephanie M ToppSchool of Medicine and Dentistry, James Cook University, Townsville City, Queensland, Australia.
Heike GeduldWestern Cape Department of Health and Wellness, Western Cape Government, Cape Town, Western Cape, South Africa.
Menelas NkeshimanaAccident & Emergency Department, University Teaching Hospital of Kigali, Kigali, Rwanda.ORCID 0000-0003-3573-8075
Dylan CollinsDepartment of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Phoebe TuyishimeSchool of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
Gerard FitzgeraldQueensland University of Technology, Brisbane, Queensland, Australia.
René EnglishDivision of Health Systems and Public Health, Department of Global Health, Stellenbosch University, Stellenbosch, Western Cape, South Africa.
Gabriela CarolusStellenbosch University, Stellenbosch, Western Cape, South Africa.
Simon PulfreyDepartment of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Riyad Abu-LabanDepartment of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Strengthening systems of emergency healthcare is crucial to achieving global and national health goals. One of the key challenges in improving emergency care systems is the insufficient attention given to human resources for health (HRH) tasked with delivering this care. The intersection of emergency care policy and systems, human resources and health equity is an underdeveloped area of research and practice. In this project, we used HRH frameworks to conduct an exploratory and comparative mapping of emergency healthcare workforce policy and systems in four countries-Canada, Australia, Rwanda and South Africa-and to explore its intersection with health equity. We conducted a mapping exercise drawing on published peer-reviewed and grey literature (n=209), supplemented by expert consultations (n=8) in Rwanda given limited published literature in that context. We analysed these data using conceptual frameworks on HRH, particularly one framework that focused on HRH and health equity. Our findings suggest persistent limitations in the translation of equity principles into actionable HRH strategies for emergency care across all four contexts. Governance fragmentation for emergency care workforces was common, with responsibilities for workforce training, distribution, regulation and retention split among multiple governmental and non-governmental actors, typically without any high-level oversight of equity-related outcomes. The comparative nature of this project facilitated an exploration of labour market interdependencies across the countries, such as the impact of burnout and attrition in fuelling international migration of emergency care workers. Further research, analysis and policy attention is needed to understand the intersection of emergency care, workforce policy and systems, and health equity, and that comparative research has an important role to play in surfacing key learnings at the national and global level.

Indexed as

Emergency Medical ServicesHealth EquityHealth PolicyHealth WorkforceAustraliaCanadaHumansPublic Health InfrastructureRwandaSouth AfricaGlobal HealthHealth PersonnelHealth services researchHealth systemsInterdisciplinary Research

Identifiers

PMID41558760
PMCPMC12820834

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.