Developing Sustainable Prehospital Pediatric Care in Rwanda

Area of Science:

• Global Health
• Pediatric Emergency Medicine
• Medical Education

Background:

• Unintentional injury is a leading cause of death in children globally, particularly in low- and middle-income countries.
• Effective prehospital care is crucial for improving outcomes in pediatric emergencies.
• Rwanda's public emergency medical service, Service d'Aide Medicale Urgente, sought to enhance its pediatric emergency care capabilities.

Purpose of the Study:

• To develop and implement a sustainable, context-specific prehospital emergency pediatrics care course (EPCC) in Rwanda.
• To assess the effectiveness of the EPCC program in improving knowledge and skills of healthcare providers.
• To establish a local cadre of instructors for future training sessions.

Main Methods:

• A 1-day context-specific EPCC was designed using international best practices and local input.
• Two cohorts of healthcare providers participated: EPCC 1 (train-the-trainer) and EPCC 2 (general providers).
• Participants completed a 50-question assessment pre- and post-course to measure knowledge gain.

Main Results:

• Both EPCC 1 and EPCC 2 showed significant improvements in post-course assessment scores (58% to 98% and 49% to 98%, respectively).
• The mean change in scores was statistically significant for both groups (P < 0.0001), with EPCC 2 showing a slightly larger increase (46% vs 40%).
• Analysis indicated that baseline training level did not affect post-assessment scores, suggesting universal effectiveness.

Conclusions:

• The implemented EPCC program was effectively delivered in Kigali, Rwanda.
• The context-appropriate training program demonstrates success in building prehospital pediatric care capacity.
• Utilizing qualified local instructors offers a sustainable model for future prehospital care development in Rwanda.