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Building Trauma and EMS Systems Capacity in Rwanda: Lessons and Recommendations.

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This study outlines a collaborative model to build trauma and emergency medical services (EMS) capacity in Rwanda. The initiative empowered staff, standardized care, and improved infrastructure, offering a blueprint for other low- and middle-income countries (LMICs).

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Area of Science:

  • Global Health
  • Emergency Medicine
  • Health Systems Strengthening

Background:

  • Access to emergency services is crucial for hospital-level care, particularly in low- and middle-income countries (LMICs).
  • No established model exists for developing integrated trauma and emergency medical services (EMS) systems in LMICs.
  • This manuscript details a collaborative model to enhance trauma and EMS capacity in Rwanda.

Purpose of the Study:

  • To describe a multi-disciplinary collaborative model for advancing trauma and EMS capacity in Rwanda.
  • To share lessons learned and provide recommendations for similar initiatives in other LMICs.
  • To foster improvements in clinical services, quality improvement/research, and leadership within prehospital and emergency settings.

Main Methods:

  • A capacity building plan was developed focusing on clinical services, quality improvement, research, and leadership.
  • A multi-disciplinary immersion program created a shared mental model among Rwandan healthcare leaders.
  • Standardized prehospital care through train-the-trainers programs, new courses, protocols, and the implementation of the WHO Trauma Registry.

Main Results:

  • Over 600 healthcare staff were trained across district and provincial hospitals.
  • Forty-two protocols and checklists were implemented to standardize prehospital care.
  • The WHO Trauma Registry captured data on over 5,000 injured patients, and 11 staff received Master's Degree support for research capacity development.

Conclusions:

  • The collaborative model successfully empowered staff and leadership, standardized clinical service delivery, and invested in systems and infrastructure.
  • This approach provides a valuable framework for trauma and EMS system capacity development in other LMICs.
  • Sustained investment and multi-disciplinary collaboration are key to improving emergency care in resource-limited settings.