Development Principles in Global Emergency Care

COR875 V1.1

 

Timeframe for review:                 Every five years, or earlier if required

Document authorisation:            Council of Advocacy, Practice and Partnerships

Document implementation:        Global Emergency Care Committee and GEC Desk

Document maintenance:             GEC Desk

 

Version	Date	Pages revised / Brief Explanation of Revision
v1	Nov-2022	Approved by the Council of Advocacy, Practice and Partnerships
v1.1	Apr-2025	Removal of terms EMC, EMD, EMAD, and DipPHRM to reflect changes to training program titles

 

Copyright

2025. Australasian College for Emergency Medicine. All rights reserved.

 

The Development Principles in ACEM Global Emergency Care policy (“the Policy”) outlines the guiding principles for management and delivery of development activities under ACEM’s Global Emergency Care (GEC) Desk and the Global Emergency Care Committee (GECCo). 

ACEM’s GEC Desk-managed international development projects are distinct from other international development and humanitarian activities in which College Fellows may be independently engaged.

 

ACEM/the College

means the Australasian College for Emergency Medicine.

College member

means a person admitted as a member of the College pursuant to the provisions of the ACEM Constitution and associated regulations.

Governing body

means the ACEM Board, the Council of Advocacy, Practice and Partnerships (CAPP), or the Council
of Education (COE).

Trainee

means an individual enrolled in an ACEM training program and, for the purposes of this policy, undertaking College requirements for the purpose of attaining eligibility for election to Fellowship
of the College.

Global Emergency Care

means the integration of emergency care with the field of global health. Global Emergency Care (GEC) emphasises the transnational aspects of disease and healthcare, the synthesis of public health and clinical care, and the pursuit of equity across populations. GEC practice incorporates clinical service provision, capacity building and health systems strengthening for time-sensitive healthcare, and it includes development activities as well as aspects of disaster health, humanitarian assistance and
surge response. 

Restricted/tied funding

means funding that is provided with a specific purpose, usually defined by the funding provider, and therefore can be used (expended) for that purpose only.

Non-restricted funding

means funding that can be used for any purpose or activity.

Development activities

means activities supported by ACEM that support development objectives. ACEM undertakes due diligence to ensure it is not contributing to non-development activities. These are defined in ACEM’s Development and Non-Development Policy.

Low- and Middle- Income Country

Low- and Middle-Income Countries (LMICs) are countries classified by the World Bank as low, lower-middle or upper-middle income based on gross national income (GNI) per capita in current USD of the previous year. These classifications are updated annually.

High Income Country

High Income Countries (HICs) are countries classified by the World Bank as high income based on gross national income (GNI) per capita in current USD of the previous year. These classifications are updated annually.

Majority World

means those countries combined which hold most of the world’s population. Majority World is the counter-term to Minority World, which refers to those countries described as ‘The West’.

Equality

means each individual or group of people is provided the same (equal) resources or opportunities for participation.

Equity

means each individual or group of people is allocated the resources and opportunities needed to ensure an equal outcome. Equity recognises that each person has different circumstances and therefore requires different levels of support.

Intersectionality

means the interconnected nature of social categorisations such as race, class, gender identity, sexual identity as they apply to an individual or group. Intersectionality is regarded as creating overlapping and interdependent systems of discrimination/privilege and disadvantage/advantage.

Emergency care workforce

means clinicians, including nurses, doctors and other healthcare workers contributing to the provision of emergency care.

Humanitarian response

means action intended to preserve life, alleviate suffering and maintain human dignity during and in the aftermath of conflict, disasters and other humanitarian crises, as well as to prevent and strengthen preparedness for the occurrence of such situations. Humanitarian response is guided and governed by the key principles of humanity, impartiality, neutrality and independence. This is distinct from development activities defined in ACEM’s Development and Non-Development Definitions Policy.

Sustainability / sustainable development

means development that meets the needs of the present without compromising the ability of future generations to meet their own needs, while ensuring a balance between economic stability, environmental care and social well-being.

 

The College’s development principles apply to its activities promoting improved and universal access to timely and effective emergency care in Low- and Middle-Income Countries (LMICs). These activities are aimed at improving the health and well-being of partner communities and contribute to poverty reduction.

3.1 Principles of Development

Development is characterised by the following principles:

1. Participation: Strengths based approaches which encourage and provide opportunities for people and communities to create solutions for themselves, and recognise that solutions must be appropriate and acceptable;
2. Collaboration and partnership: Working in equal partnership with people and communities for mutual learning and collaborative participation;
3. Addresses the cause of structural inequality: Seek to address social and structural determinants of health, and support systems and structures which enable people to move out of poverty; and
4. Rights-based: Seek to empower rights holders to claim their rights and ensure that duty bearers exercise their duties. Activities uphold international human rights and ensure dignity.

Humanitarian Response

ACEM’s development activities are not intended to include humanitarian response, however the College acknowledges the existence of nexus/overlap between humanitarian and development activities.  The length, scale and complicated nature of emergencies often requires a shift from reactive to more sustainable, long-term responses. The College supports surge response activities that:

1. • Deliver rapid systems and process development;
   • Respond to urgent training needs;
   • Provide disaster recovery; and
   • Meet the emergency care needs of refugees, internally displaced people, and people impacted by disasters.

Where ACEM’s activities overlap with humanitarian response, ACEM is committed to recognising and applying the commitments of the Core Humanitarian Standards (2014).

3.2 Principles of Delivery

ACEM’s Core Values define the organisation’s guiding principles and underpin the way ACEM works. These values of equity, respect, integrity and collaboration guide our work in GEC and commit us to working in mutually respectful ways. 

ACEM is committed to improving the capacity of LMICs to deliver safe and effective emergency care, with a focus on the Indo-Pacific Region. The College seeks to do this by supporting locally-led emergency care capacity development that:

1. Is sustainable, by ensuring activities:

1. • Are led by national health and development plans and priorities;
   • Promote reciprocal, sustainable and mutually beneficial partnerships, with a focus on co-learning
   • Ensuring inclusion and representation of those who are vulnerable and those who are affected by the intersecting drivers of marginalisation and exclusion[1];
   • Focus on sustainable delivery of training, education and research that increases local capacity, strengthens local systems and institutions; and
   • Ensures accountability and value learning for all activity partners.

2. Adheres to best-practice in international responsible volunteering for development.
3. Integrates socially and environmentally positive principles in our internal decision-making processes about partnerships that is in keeping with ACEM’s External Funding Application Policy and Investment Policy.

3.3  Sustainability

3.3.1 Engagement of national partners in project management cycle

ACEM carefully considers risks to the sustainability of its initiatives at each stage of the project management cycle. Many factors that contribute to the sustainability of development activities are outside of the control of ACEM GEC. It is therefore essential that GEC partners (national governments, hospitals and national/regional training institutes) have ownership of and are engaged in each stage of the project management cycle. This ensures that ACEM GEC initiatives are aligned with the national health priorities in each country and are responsive to current and emerging emergency care needs and priorities of partner communities. ACEM is committed to enabling the participation and contribution of primary stakeholders at all stages of GEC projects.

3.3.2 Selection of personnel for training

ACEM’s GEC activities deliver training, mentoring and ongoing professional development opportunities to emergency care personnel to enable them to provide safe and effective emergency care.

ACEM works in close consultation with national governments, hospitals and regional training institutions to identify appropriate emergency care leaders and personnel in country to receive training. Candidates from the public sector are actively encouraged to undertake training, to encourage equity in access to emergency care services.

3.3.3 Decolonisation and strengths-based language to promote equity and reciprocity

ACEM recognises the relevance of colonial history to the contemporary practice of global health and the need for organisations to undertake urgent action toward decolonising global health.

The College acknowledges the language used in the sector is one way to critically reflect on its history, identify hierarchies and culturally Eurocentric concepts, in an attempt to overcome the global inequities and injustice that such structures perpetuate.  The list of global health terms that have historical and political problematic connotations is long and a discipline-wide approach to inclusive language is lacking. Similarly, few resources offer definitions and reflection on use, expand defined thematic areas, or critically discuss etymology.

ACEM is committed to collaboration with staff and members to enable development, and shared ownership, of such resources among the global health and global emergency care communities.

3.3.4 Capacity building and knowledge transfer

ACEM aims to support the sustainable development of health skills and services globally, focusing on the Indo-Pacific region, by promoting clinical mentoring, education and training of health workforces. This is facilitated through:

3. • On-the-job training;
   • Formal and informal training workshops;
   • Train-the-trainer programs;
   • Peer support and mentoring;
   • Providing continuing professional development opportunities; and
   • Development of emergency care systems and processes

ACEM aims to increase the capacity of the global emergency care workforce to achieve their own development goals through skills and two-way knowledge transfer.

Further to this, ACEM aims to build research capacity with its partners in order to promote Majority World perspectives in global emergency care. ACEM is committed to disseminating information about the results of its GEC activities and lessons to all stakeholders, including primary stakeholders, partners and donors, and seeking their inputs and feedback.

3.3.5 Environmental Sustainability

ACEM is committed to promoting environmental sustainability and improved environmental outcomes in its development activities.