BACKGROUND: @entity130 systems in resource-rich countries have decreased mortality for @entity130 @entity1 through centralizing resources and standardizing treatment. Rapid industrialization and urbanization have increased the demand for formalized emergency medical services and @entity130 services (EMS and @entity1950 ) in low- and middle-income countries (LMICs). This systematic review examines initiatives to develop EMS and @entity1950 systems in LMICs to inform the development of comprehensive prehospital care systems in resource-poor settings. MATERIALS AND METHODS: EMS and @entity1950 system development publications were identified using MEDLINE, PubMed, and Scopus databases. Articles addressing subspecialty skill sets, public policy, or physicians were excluded. Two independent reviewers assessed titles, abstracts, and full texts in a hierarchical manner. RESULTS: A total of 12 publications met inclusion criteria, and 10 unique LMIC EMS and @entity1950 programs were identified. Common initiatives included the integration of existing EMS and @entity1950 services and provision of standardized training and formalized certification processes for prehospital care providers, as well as the construction of a conceptual framework for system development through the public health model. CONCLUSIONS: There is no single model of EMS and @entity1950 systems, and successful programs are heterogeneous across regions. Successful EMS and @entity1950 systems share common characteristics. A predevelopment needs assessment is critical in identifying existing EMS and @entity1950 resources as a foundation for further development. Implementation requires coordination of preexisting resources with cost-effective initiatives that involve local stakeholders. High-impact priority areas are identified to focus improvements. Financial stresses and mismatching of resources in LMICs are common and are more commonly encountered when implementing a high-income model EMS and @entity1950 in an LMIC. Preimplementation and postimplementation evaluations can determine the efficacy of initiatives to strengthen EMS and @entity1950 systems.

XXXX system development in low- and middle-income countries: a review.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity1950 :: ('MESH:C536962', 'Disease') :: ['TS'] @entity130 :: ('MESH:D014947', 'Disease') :: ['trauma', 'Trauma']
@entity130 :: (MESH:D014947,Disease) :: ['Trauma']
