The Impact of Trauma Care Systems in Low- and Middle-Income Countries

Abstract

Injury is a leading cause of death globally, and organized trauma care systems have been shown to save lives. However, even though most injuries occur in low-and middle-income countries (LMICs), most trauma care research comes from high-income countries where systems have been implemented with few resource constraints. Little context-relevant guidance exists to help policy makers set priorities in LMICs, where resources are limited and where trauma care may be implemented in distinct ways. We have aimed to review the evidence on the impact of trauma care systems in LMICs through a systematic search of 11 databases. Reports were categorized by intervention and outcome type and summarized. Of 4,284 records retrieved, 71 reports from 32 countries met inclusion criteria. Training, prehospital systems, and overall system organization were the most commonly reported interventions. Quality-improvement, costing, rehabilitation, and legislation and governance were relatively neglected areas. Included reports may inform trauma care system planning in LMICs, and noted gaps may guide research and funding agendas.

Establishment of a road traffic trauma registry for northern Sri Lanka

“…Countries must invest in the elements of a trauma system in order to see improvements in care of the injured. However, each country has unique issues with trauma system development, and these must be acknowledged if success is to be achieved 13 14 24 25…”

Assessment of Local Supply Chains and Stock Management Practices for Trauma Care Resources in Ghana: A Comparative Small Sample Cross-Sectional Study 

“…Although no essential trauma care resources require unique supply chain management practices, trauma care resources have not been prioritized by public health agencies, governments or healthcare systems like other global health priorities (e.g., neglected tropical diseases; maternal neonatal and child health). (15,16) As a result, there may be supply chain vulnerabilities and stock management practices that impact the delivery of care to the injured and require attention.…”

Harnessing Inter-disciplinary Collaboration to Improve Emergency Care in Low- and Middle-income Countries (LMICS): Results of Research Prioritisation Setting Exercise

“…While prevention is ideal, there is no context in which all emergencies can be averted, and prevention strategies may take years or decades to show bene t. [1,2] Globally 90% of healthcare emergencies occur in low-and middle income countries (LMICs) [3,4] especially in children and working age adults. [5] The World Bank Disease Control Priorities Project estimates that over half of deaths in LMICs result from conditions that could be treated with emergency care.…”