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Evaluation of a First Responders Course in Rural North India.

Srivarshini Cherukupalli Mohan1, Manisha Bhagwan Bhatia2, Carlos Ranjan Martinez3

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Summary

The Basic Emergency Care Course (BECC) significantly improved knowledge for Accredited Social Health Activists (ASHAs) in Nanakpur. However, knowledge retention declined after one year, indicating a need for refresher training in prehospital emergency care.

Keywords:
Community health workerFirst responderGlobal surgery

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Area of Science:

  • Emergency Medicine
  • Public Health
  • Medical Education

Background:

  • Prehospital trauma mortality is high, exacerbated by limited healthcare access in rural areas like Nanakpur, India.
  • The All-India Institute of Medical Sciences (AIIMS) developed the Basic Emergency Care Course (BECC) to address these prehospital care deficiencies.
  • The study evaluated the effectiveness of the BECC program in a rural Indian setting.

Purpose of the Study:

  • To assess the efficacy of the Basic Emergency Care Course (BECC) in improving prehospital emergency care knowledge.
  • To evaluate the knowledge retention of healthcare workers one year after completing the BECC training.
  • To determine the feasibility of using BECC for training community health workers as first responders.

Main Methods:

  • The Basic Emergency Care Course (BECC) was delivered in Nanakpur in 2017 to local health workers, including Accredited Social Health Activists (ASHAs).
  • Participants completed pre- and post-course evaluations to measure immediate knowledge improvement.
  • A one-year post-course assessment was conducted to evaluate knowledge retention among ASHAs.

Main Results:

  • A total of 204 individuals participated, with 109 being ASHAs.
  • Pre- and post-course assessments for 70 participants showed a statistically significant improvement in knowledge (P < 0.0001).
  • Knowledge retention after one year, assessed in 53 ASHAs, revealed a significant decline (P < 0.0001) compared to initial post-course levels.

Conclusions:

  • The BECC program is feasible for training ASHAs as first responders in rural Indian communities like Nanakpur.
  • Immediate post-course knowledge gains were significant, but long-term retention was limited.
  • Regular refresher courses are necessary to maintain knowledge and improve India's prehospital care system nationwide.