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Implementing the WHO/ICRC Basic Emergency Care course training for health workers in conflict-affected regions in
Barkhad Mohamed Ismail1, Mohamed Mukhtar Ali2, Meaghan M Sydlowski3
1General physician, Hargeisa Group Hospital, Gacan libah district, Hargeisa, Somalia.
Introduction:
Emergency care is critical in regions affected by humanitarian crises. Somalia's prolonged conflict has strained the health system, leaving health workers under-prepared and limiting access to training. The Basic Emergency Care (BEC) course was developed to address gaps in emergency care by training healthcare providers to stabilize critically ill and injured patients. This study evaluates the implementation of BEC in Somalia, focusing on strategies to adapt this course to a conflict-affected setting.
Methods:
Two consecutive 5-day BEC courses and a 1-day Training-of-Trainers course were conducted in Mogadishu, Somalia (October 2023). Participants were doctors and nurses providing first-contact emergency care at health facilities in Mogadishu, Jowhar, Baidoa, and Gaalkayo, selected by the Somalia Federal Ministry of Health (FMOH) in collaboration with International Medical Corps (IMC). Knowledge was assessed with multiple choice pre- and post-course exams, and confidence was assessed with pre- and post-course Likert-scale surveys. Data were analysed using paired t-test and McNemar's test. Qualitative feedback was analyzed thematically.
Results:
A total of 55 participants enrolled in BEC, 54 completed the post-test and were included in paired pre/post knowledge analyses. Post-course examination scores (90.6 %) showed a significant improvement (p < 0.001) compared to pre-course examination scores (53.6 %). Self-reported confidence in providing emergency care increased across multiple domains (p < 0.05). Participants expressed strong interest in conflict-related injury modules and recommended extending the duration of the course.
Conclusion:
The BEC course increased emergency care knowledge and confidence among Somali health workers. Centralized training, peer-teaching, and the integration of conflict-related modules can address issues of feasibility, sustainability, and relevance in a conflict setting. Further studies are needed to evaluate the conflict-related injury modules, assess the clinical impact of BEC training in this setting, and determine the effectiveness of sustainability strategies.
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