Adapting the emergency first aid responder course for Zambia through curriculum mapping and blueprinting

Abstract

ObjectivesCommunity members are often the first to witness and respond to medical and traumatic emergencies, making them an essential first link to emergency care systems. The Emergency First Aid Responder (EFAR) programme is short course originally developed to help South Africans manage emergencies at the community level, pending arrival of formal care providers. EFAR was implemented in two rural regions of Zambia in 2015, but no changes were originally made to tailor the course to the new setting. We undertook this study to identify potential refinements in the original EFAR curriculum, and to adapt it to the local context in Zambia.DesignThe EFAR curriculum was mapped against available chief complaint data. An expert group used information from the map, in tandem with personal knowledge, to rank each course topic for potential impact on patient outcomes and frequency of use in practice. Individual blueprints were compiled to generate a refined EFAR curriculum, the time breakdown of which reflects the relative weight of each topic.SettingThis study was conducted based on data collected in Kasama, a rural region of Zambia’s Northern Province.ParticipantsAn expert group of five physicians practising emergency medicine was selected; all reviewers have expertise in the Zambian context, EFAR programme and/or curriculum development.ResultsThe range of emergencies that Zambian EFARs encounter indicates that the course must be broad in scope. The refined curriculum covers 54 topics (seven new) and 25 practical skills (five new). Practical and didactic time devoted to general patient care and scene management increased significantly, while time devoted to most other clinical, presentation-based categories (eg, trauma care) decreased.ConclusionsDiscrepancies between original and refined curricula highlight a mismatch between the external curriculum and local context. Even with limited data and resources, curriculum mapping and blueprinting are possible means of resolving these contextual issues.

Development and Implementation of Short Courses to Support the Establishment of a Prehospital System in Sub-Saharan Africa: Lessons Learned from Tanzania

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Implementation and evaluation of a pilot WHO community first aid responder training in Kinshasa, DR Congo: A mixed method study

“…The CFAR course emphasises community participation and empowers people to initiate emergency care in the community; its strategy is to train targeted community members and integrate them into a despatch and response system, reducing time to arrival of a trained responder at the scene of an emergency [ 7 , 8 ]. Similar short courses can meaningfully impact emergency care and training layperson responders has proven effective in LMIC [9] , [10] , [11] . As is commonly observed in LMICs, the Democratic Republic of Congo (DRC) suffers from a significant burden of ill health across all age groups and disease categories, and health indicators point towards an urgent need for health system strengthening [ 12 , 13 ].…”

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