Evaluating the availability, effectiveness, and impact of primary trauma care training in Sub-Saharan Africa: A comprehensive review
Bibliographic record
Abstract
Background: Trauma is a leading cause of morbidity and mortality in sub-Saharan Africa (SSA), contributing to over 90 % of global injury-related deaths. Limited healthcare infrastructure, insufficient access to skilled healthcare professionals, and resource constraints exacerbate the trauma burden. While Advanced Trauma Life Support (ATLS) has demonstrated effectiveness in high-income settings, its high cost and limited adaptability make it less feasible in SSA. The Primary Trauma Care (PTC) course offers a cost-effective and context-appropriate alternative to ATLS. However, its implementation and impact in SSA remain underexplored. This review evaluates the availability, effectiveness, impact, and affordability of PTC courses in SSA. Methods: A comprehensive literature review was conducted across Medline, PubMed, Embase, and African Journals Online to identify studies on PTC training in SSA. Studies examining PTC's impact on injury management, knowledge, skills, patient outcomes, and cost-effectiveness were included. Inclusion criteria focused on studies conducted between 2000 and 2024 in SSA, with a focus on PTC implementation. Results: Four published PTC training studies were identified in both urban and rural settings across SSA, highlighting significant underutilization due to limited funding, infrastructure challenges, and insufficient institutional support. Among 2758 trainees, the majority were nurses (1625, 58.9 %) and clinical officers (1624, 58.8 %), followed by physicians (979, 35.5 %) and medical students (155, 5.6 %). Three studies demonstrated significant improvements in participants' knowledge, confidence, and skills. One study reported a reduction in trauma-related mortality rates. However, only one study directly assessed patient outcomes, indicating a gap in evaluating long-term impacts. Conclusion: To the best of our knowledge, this is the first comprehensive review of PTC training in SSA, offering novel insights into its effectiveness and addressing critical gaps in trauma care research for resource-limited settings. The findings demonstrate that PTC significantly enhances trauma care knowledge, confidence, and departmental capacity, making it a cost-effective and scalable training program for resource-constrained settings. However, the limited scope and frequency of PTC courses call for policymakers to prioritize expanding access to these programs and integrating them into national trauma care strategies. Collaborative efforts are needed to secure funding, increase institutional support, and conduct more institution-based studies to evaluate the long-term impact of PTC on patient outcomes, morbidity, and quality of life in SSA.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.032 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.004 |
| Bibliometrics | 0.011 | 0.013 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".