. 2025 Jun;37(3):e70063.

doi: 10.1111/1742-6723.70063.

Using a Partnership-Based Approach to Strengthen Acute Care Systems in the Pacific and Timor-Leste

Sarah Bornstein^{1

2}, Rob Mitchell^{1

2

3}, Steven McGloughlin^{1

2

4

5

6

7}, Melanie Wratten², Karen Hammad^{8

9

10}, Colin Banks^{2

11

12}, Peter Cameron^{1

3}, Benjamin Dingle^{2

13

14}, Ann-Maree Guirguis¹⁵, Chris Guy^{2

16}, Lamour Hansell⁸, Jennifer Jamieson^{17

18}, Arabella Koliwan¹⁹, Lewis McLean^{2

20

21

22

23

24}, Naomi McLean², Silina Motofaga⁸, Georgina Phillips^{1

2

25

26}, Sally Reid^{2

27}, Cath Tacon²⁸, Gerard O'Reilly^{1

3

29}

Affiliations

¹ School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
² Regional Emergency and Critical Care Systems Strengthening Initiative, Melbourne, Australia.
³ Emergency and Trauma Centre, Alfred Health, Melbourne, Australia.
⁴ Department of Intensive Care & Hyperbaric Medicine Alfred Health, Melbourne, Australia.
⁵ Australian Living Evidence Collaboration, Melbourne, Australia.
⁶ College of Intensive Care Medicine (CICM), Melbourne, Australia.
⁷ World Health Organization Health Emergencies Programme, Geneva, Switzerland.
⁸ Pacific Community, Suva, Fiji.
⁹ Fiji National University, Suva, Fiji.
¹⁰ School of Nursing and Midwifery, Griffith University, Queensland, Australia.
¹¹ Townsville University Hospital, Townsville, Australia.
¹² James Cook University, Townsville, Australia.
¹³ Australian Catholic University, Melbourne, Australia.
¹⁴ Top End Health Service, Royal Darwin Hospital, Darwin, Australia.
¹⁵ Alfred Emergency Academic Centre, Alfred Health, Melbourne, Australia.
¹⁶ Department of Intensive Care, Austin Health, Melbourne, Australia.
¹⁷ Emergency Department, Royal Hobart Hospital, Hobart, Australia.
¹⁸ Trauma Service, Royal Hobart Hospital, Hobart, Australia.
¹⁹ National St John Ambulance Papua New Guinea, Port Moresby, Papua New Guinea.
²⁰ Department of Intensive Care Medicine, Nepean Hospital, Sydney, Australia.
²¹ Division of Critical Care, John Hunter Hospital, Newcastle, Australia.
²² ANZICS Global Intensive Care Initiative, Melbourne, Australia.
²³ University of Sydney, Sydney, Australia.
²⁴ Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
²⁵ Department of Critical Care, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.
²⁶ St Vincent's Hospital, Melbourne, Australia.
²⁷ Australasian College for Emergency Medicine, Melbourne, Australia.
²⁸ Cairns Hospital, Cairns, Australia.
²⁹ National Trauma Research Institute, Alfred Health, Melbourne, Australia.

PMID: 40462693
PMCID: PMC12134838
DOI: 10.1111/1742-6723.70063

Using a Partnership-Based Approach to Strengthen Acute Care Systems in the Pacific and Timor-Leste

Sarah Bornstein et al. Emerg Med Australas. 2025 Jun.

. 2025 Jun;37(3):e70063.

doi: 10.1111/1742-6723.70063.

Authors

Affiliations

¹ School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
² Regional Emergency and Critical Care Systems Strengthening Initiative, Melbourne, Australia.
³ Emergency and Trauma Centre, Alfred Health, Melbourne, Australia.
⁴ Department of Intensive Care & Hyperbaric Medicine Alfred Health, Melbourne, Australia.
⁵ Australian Living Evidence Collaboration, Melbourne, Australia.
⁶ College of Intensive Care Medicine (CICM), Melbourne, Australia.
⁷ World Health Organization Health Emergencies Programme, Geneva, Switzerland.
⁸ Pacific Community, Suva, Fiji.
⁹ Fiji National University, Suva, Fiji.
¹⁰ School of Nursing and Midwifery, Griffith University, Queensland, Australia.
¹¹ Townsville University Hospital, Townsville, Australia.
¹² James Cook University, Townsville, Australia.
¹³ Australian Catholic University, Melbourne, Australia.
¹⁴ Top End Health Service, Royal Darwin Hospital, Darwin, Australia.
¹⁵ Alfred Emergency Academic Centre, Alfred Health, Melbourne, Australia.
¹⁶ Department of Intensive Care, Austin Health, Melbourne, Australia.
¹⁷ Emergency Department, Royal Hobart Hospital, Hobart, Australia.
¹⁸ Trauma Service, Royal Hobart Hospital, Hobart, Australia.
¹⁹ National St John Ambulance Papua New Guinea, Port Moresby, Papua New Guinea.
²⁰ Department of Intensive Care Medicine, Nepean Hospital, Sydney, Australia.
²¹ Division of Critical Care, John Hunter Hospital, Newcastle, Australia.
²² ANZICS Global Intensive Care Initiative, Melbourne, Australia.
²³ University of Sydney, Sydney, Australia.
²⁴ Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
²⁵ Department of Critical Care, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.
²⁶ St Vincent's Hospital, Melbourne, Australia.
²⁷ Australasian College for Emergency Medicine, Melbourne, Australia.
²⁸ Cairns Hospital, Cairns, Australia.
²⁹ National Trauma Research Institute, Alfred Health, Melbourne, Australia.

PMID: 40462693
PMCID: PMC12134838
DOI: 10.1111/1742-6723.70063

Abstract

Emergency and critical care services are essential to universal health coverage. World Health Assembly (WHA) Resolution 76.2, adopted in 2023, outlined the importance of integrated emergency, critical and operative care systems in strengthening primary healthcare capabilities. Recent research has determined that system strengthening and partnership-based approaches to healthcare capacity development have the potential to achieve greater equity and sustainability. The Regional Emergency and Critical Care Systems Strengthening Initiative (RECSI) is an Australian Government funded programme under the Partnerships for a Healthy Region (PHR) initiative. It aims to enhance acute care capacity and healthcare system resilience across the Pacific and Timor Leste. RECSI is led by a consortium of acute care organisations and provides a vehicle for progressing WHA 76.2. The programme focuses on four thematic areas: workforce capacity and training, systems and processes, data and research, and leadership and governance. As part of RECSI's inception, a structured programme logic was developed, which describes programme activities and outputs, and how they contribute to defined intermediate and end-of-programme outcomes. RECSI's monitoring, evaluation and learning (MEL) plan, which supplements the programme logic, incorporates sustainability indicators that are focused on monitoring the impact of mechanisms designed to enable ongoing benefits from programme outcomes. Utilising a partner-led and context-specific programme design, RECSI represents a rigorous approach to acute care system strengthening. This strategy aims to build genuine partnerships to leverage skills, knowledge and opportunity across the Pacific and Timor-Leste.

Keywords: (MeSH); critical care; emergency medicine.

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Conflict of interest statement

P.C., J.J., G.P. and G.O. are all section editors for EMA.

Figures

**FIGURE 2**
Diagrammatic summary of RECSI programme logic.

See this image and copyright information in PMC

References

1. World Health Organization , “Emergency & Critical Care,” (2025).
1. Hirshon J. M., Risko N., Calvello E. J. B., et al., “Health Systems and Services: The Role of Acute Care,” Bulletin of the World Health Organization 91, no. 5 (2013): 386–388. - PMC - PubMed
1. World Health Assembly , “Resolution 72.16. Emergency Care Systems for Universal Health Coverage: Ensuring Timely Care for the Acutely ILL and Injured,” (2019).
1. World Health Organization , “Seventy‐Sixth World Health Assembly,” (2023).
1. Lecky F. E., Reynolds T., Otesile O., et al., “Harnessing Inter‐Disciplinary Collaboration to Improve Emergency Care in Low‐ and Middle‐Income Countries (LMICs): Results of Research Prioritisation Setting Exercise,” BMC Emergency Medicine 20, no. 1 (2020): 68. - PMC - PubMed

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Using a Partnership-Based Approach to Strengthen Acute Care Systems in the Pacific and Timor-Leste

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Using a Partnership-Based Approach to Strengthen Acute Care Systems in the Pacific and Timor-Leste

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