The importance of a multidisciplinary team in developing an evidence-based guideline on first aid for road safety in Africa
2Centre for Evidence-Based Practice (CEBaP), Belgian Red Cross; Department of Public Health and Primary Care, Leuven Institute for Healthcare Policy, KU Leuven; Cochrane First Aid, Belgium
3Belgian Red Cross, Belgium
4Belgian Red Cross; Department of Public Health and Primary Care, Leuven Institute for Healthcare Policy, KU Leuven, Belgium
5Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
Background: According to the World Health Organization, road traffic crashes account for approximately 1.3 million deaths annually, with 93% of fatalities occurring in low- and middle-income countries. Training first responders in providing simple lifesaving interventions at the scene of road traffic crashes is considered essential in decreasing the risk of road traffic–related injury or death, especially in resource-limited settings.
Objectives: To develop an evidence-based first aid guideline and training manual for road safety, aimed at laypeople in sub-Saharan Africa.
Methods: We convened a panel of 10 experts from nine different African countries, including academic researchers and first aid practitioners and trainers of several Red Cross National Societies, to provide input on topics and guideline questions. For each question, we conducted a mini systematic review searching MEDLINE, Embase, and The Cochrane Library. A first draft of the guideline and accompanying training materials, based on the best available evidence, was discussed with the experts during a 2-day panel meeting.
Results: The panel formulated 10 PICO questions not yet covered by existing first aid guidelines, regarding prevention, diagnosis, and management of road traffic injuries. We identified one experimental and 14 observational studies, and one systematic review providing evidence on only four questions, with certainty of evidence ranging from moderate to very low, which led to three recommendations. The panel contributed in two ways: 1) as evidence was scarce, they formulated several additional recommendations based on good practice; 2) as the panel included first aid trainers (i.e., training materials users), they were also able to identify potential barriers and facilitators related to feasibility, acceptability, and equity when implementing the guideline in the local context in sub-Saharan Africa. After another round of expert feedback, the guideline and training materials will be finalised and piloted in Burundi.
Conclusions: Involving a multidisciplinary team including local users of the materials from the start of the project enabled us to develop a guideline and accompanying training materials that are relevant, appropriate, contextualised and supported, which should facilitate implementation.
Patient, public and/or healthcare consumer involvement: The majority of the panel and priorities was driven by the target audience and trainers.