Editorial—AfJEM Dec 2024

Emergency care across Africa has developed in leaps and bounds and this was on proud display at the recent, highly successful African Conference on Emergency Medicine hosted in Gaborone, Botswana by the African Federation for Emergency Medicine and the Botswana Society of Emergency Care. Congratulations are due to all the organizers, presenters and attendees of this conference, which had over 600 registered attendees. AfJEM is proud to publish the abstracts of all accepted posters and oral abstracts – please browse through these as a taster of the important research going on around the continent and, hopefully, the publications still to come [1]. The poster area at the conference was buzzing with conversations and networking, far more than at previous conferences – surely a sign of research stepping up. AfJEM invites submissions, especially to our special issues around Triage and Education, and we also remind African authors that there is a waiver of Article Processing Costs (APCs) for African authors – I was surprised by how many African researchers asked at the conference how much it would cost to submit.

This issue of the journal brings you some really diverse topics from around Africa, spanning the whole continuum of emergency care with prehospital papers around motorcycle taxi driver first aid in Tanzania [2], EMS utilization during COVID in Kenya [3] and palliative care delivery by paramedics in South Africa [4]. From an in-hospital perspective, we grapple with workplace violence [5] and access to surgical care in South African [6], and pain management in Rwanda [7], and broader emergency healthcare services in Ethiopia [8]. An important paper from Kenya talks to the mechanisms of driving emergency medical care development in Africa, along with a commentary from Prof Hendry Sawe who asks some key questions as to what we can take from this for the rest of the continent - who should drive the in-country development of emergency medical care? [[9], [10]] Our African Emergency Nursing special issue is now complete, demonstrating the diverse issues, but common drive to improv patient care around the continent (https://www.sciencedirect.com/special-issue/10HNH32HF9H). Authors are using an array of research methodologies and we're seeing a strong African authorship of the articles.

Readers may have noticed an increase in prehospital articles – and this is in part due to the surge of developments in this field and in the research being generated, particularly from South Africa, but also because there is no other journal currently that specifically includes prehospital emergency care in Africa. We invite your submissions big or small (just maybe size them down to an abbreviated article if the scope and impact is small). Our team here in South Africa is proud to share some recent work with the Professional Board for Emergency Care of the Health Professions Council of South Africa in creating a bundle of Clinical Decision Support Tools for prehospital providers. While this is inevitably focused on South African providers in its current form, we believe it has potential for adaption and use around the continent https://bit.ly/41f9Cxa. As evidenced by the articles in this issue, prehospital care is a pressing issue even where EMS systems are nascent. There is an urgent need for evidence based and patient centred guidance that links prehospital and in-hospital care.

It's been a busy year for the journal with the transition of leadership, and a steep learning curve for me. Underlying the editorial decisions are many difficult decisions as we drive towards equitable, ethical research, and to fulfil the aims and scope of the journal. We turn away many submissions without the prerequisite 25% of African authors which is a double-edged sword – we strive to promote African centred and authored research, but we are also cognisant of the reality that a good deal of research on the continent is mentored, funded and driven by high income country partners, and for this we are very grateful.

Wishing you all the best for 2025 and we look forward to your submissions.