Improving The Care of Critically Ill Patients: Lessons Learned from The Promotion of Essential Emergency and Critical Care In Tanzania: A Qualitative Study

Objective To describe the lessons learned during the promotion of a new approach to the care of critically ill patients in Tanzania - Essential Emergency and Critical Care (EECC) Design A descriptive qualitative study using thematic analysis of structured interviews Setting and Participants The study was conducted in Tanzania, involving eleven policy makers, researchers and senior clinicians who participated in the promotion of EECC in the country. Results The five thematic lessons that emerged from the promotion of EECC in Tanzania were: (i) ensure early and close collaboration with the government and stakeholders; (ii) conduct research and utilize evidence; (iii) prioritize advocacy and address misconceptions about EECC; (iv) leverage events and embed activities in other health system interventions and (v) employ a multifaceted implementation strategy. Conclusion The results from this study show the efficacy of a holistic, comprehensive approach in promoting EECC as each strategy reinforces the others. This approach led the to the successful promotion of EECC and the development of a National Strategic Plan for EECC by the government of Tanzania. Article Summary Strengths and Limitations of this study: Strengths Weaknesses ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This work was supported by the Welcome Trust [221571/Z/20/Z], as part of the Innovation in low-and middle-income countries Flagship. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The study was granted ethical approval from the Tanzanian National Institute for Medical Research (NIMR/HQ/R.8a/Vol.IX/3537). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes As the project lacks ethical approval for public data sharing, we are unable to provide access to the data used in this study.