Project Lead(s): Abdullah Saleh
The need for strengthened emergency medicine services worldwide to reduce the burden of acute illness/injury in low- and middle-income countries (LMICs) has been emphasized by the World Health Assembly.
Despite the high number of injuries and deaths from trauma in LMICs, preventive efforts are often non-existent and healthcare systems are not prepared to meet the challenge, as trauma care is often poorly developed.
The aim of the Kenya Trauma and Injury Program (KTIP) was to develop the components for a scalable model for decentralized trauma and injury care in the western part of Kenya.
This was to be accomplished by mapping the various health facilities in a 50-kilometer radius around the Moi Teaching and Referral Hospital (MTRH) in the city of Eldoret, creating a trauma registry to capture the number, severity and types of injury, and developing trauma-readiness assessment tools for selected clinics and hospitals in the region.
The program also aimed to introduce Advanced Trauma Life Support education (ATLS – the international gold standard) to those selected facilities that take care of (or could take care of) trauma patients, to prepare them and improve patient outcomes.
A large institutional assessment was performed on MTRH using validated assessment tools.
A comprehensive trauma assessment was also done on the Kenyatta National Hospital (KNH) – the largest hospital in East Africa – to give a more comprehensive understanding of the state of trauma care in the country, and to help set the goals and priorities.
The results of these analyses demonstrated that, while there was significant infrastructure capacity, the weaknesses were in processes, organization, trained manpower and education.
Despite the wide-reaching goals the team set out to achieve, it became immediately clear that the national problem of trauma/injury required a national-level approach.
To this end, collaboration was sought with the major national stakeholders in trauma care across Kenya.
A Geographic Information System (GIS) of the available healthcare infrastructure around Eldoret in a 50-kilometer radius was created, and data for the health facilities for the entire country were compiled through strategic partnerships.
This GIS has been successful at facilitating the visualization and selection of strategic health facilities for assessment to become trauma hubs. Currently, this platform is being developed to be an online national platform that can visualize trauma incidence (through registry integration), as well as health facility proximity.
Trauma care education for front-line healthcare workers has been given priority and full promulgation of the ATLS course is expected – a first for Sub-Saharan Africa.
Perhaps the greatest success over the project grew out of the national and international partnerships developed, and the creation and registration of the Trauma Society of Kenya (TSK).
The TSK will be the platform for all future trauma improvements in Kenya and will serve as a model for future programs globally.
Further plans for the project fall into three areas: training providers and trainers in ATLS; further developing the TSK; and having a real-time, GIS-enabled asset management and trauma registry with an online portal.