Hitchins R1, Alves de Jesus G2, de Amaral S2, Edelman A3, Francis J1, Russell D3
1Menzies School Of Health Research, 2Ministry of Health, Ministério da Saúde, 3Menzies School of Health Research
Biography:
Ruth is a PhD candidate with Menzies School of Health Research and Charles Darwin University studying the characteristics and outcomes of aeromedical retrievals in Timor-Leste. She is privileged to have recently lived in this remarkable country for four years, working with Mission Aviation Fellowship and contributing to health systems strengthening through community engagement, quality improvement initiatives, strategic partnerships, and continuity-of-care programme co-design. Ruth is based on Yidinji Country in Cairns, and hopes her PhD will facilitate improved quality of care for aeromedically-retrieved patients in Timor-Leste and further afield.
Abstract
Aims:
Limited evidence exists on the characteristics of emergency civilian aeromedical retrieval (AR) services in low-resource contexts globally. This scoping review addressed this evidence gap, examining domestic civilian AR models operating across low, low- to middle-income, and upper-middle income countries (“majority world”) countries.
Methods:
The review systematically mapped literature on civilian primary or modified primary AR services in majority world contexts, following Joanna Briggs Institute methodology and reported according to PRISMA-ScR guidelines. The SPIDER framework (Sample, Phenomenon of Interest, Design, Evaluation and Research type) informed the search strategy. Databases searched included PubMed, MEDLINE, Web of Science, and Scopus, using combined MeSH terms and free-text keywords. Grey literature was identified via Web of Science and Google Scholar.
Results:
AR services in majority world settings predominantly manage high-acuity cases, reflecting infrastructure limitations that hinder or preclude access to emergency healthcare. Resource deficits impede both pre-flight and in-flight patient stabilisation. Additional constraints—such as absence of radar, rudimentary weather reporting systems, and lack of dedicated AR aircraft—restrict operational reach and affect prehospital care quality and survival outcomes. Diverse logistical and funding approaches are used; however, few services offer ARs free of charge to civilians.
Conclusions:
This published review is the first to map ARs in low-resource, majority world settings. It highlights the essential role of ARs for high acuity cases and demonstrates the significant infrastructure gaps in these environments which affect service delivery and patient outcomes.