• Annu Rev Public Health · Mar 2017

    Review

    The Impact of Trauma Care Systems in Low- and Middle-Income Countries.

    • Teri A Reynolds, Barclay Stewart, Isobel Drewett, Stacy Salerno, Hendry R Sawe, Tamitza Toroyan, and Charles Mock.
    • Department for the Management of NCDs, Disability, Violence and Injury Prevention, World Health Organization, Geneva CH-1211, Switzerland; email: reynoldst@who.int , stacy.leah.salerno@gmail.com , toroyant@who.int.
    • Annu Rev Public Health. 2017 Mar 20; 38: 507-532.

    AbstractInjury is a leading cause of death globally, and organized trauma care systems have been shown to save lives. However, even though most injuries occur in low- and middle-income countries (LMICs), most trauma care research comes from high-income countries where systems have been implemented with few resource constraints. Little context-relevant guidance exists to help policy makers set priorities in LMICs, where resources are limited and where trauma care may be implemented in distinct ways. We have aimed to review the evidence on the impact of trauma care systems in LMICs through a systematic search of 11 databases. Reports were categorized by intervention and outcome type and summarized. Of 4,284 records retrieved, 71 reports from 32 countries met inclusion criteria. Training, prehospital systems, and overall system organization were the most commonly reported interventions. Quality-improvement, costing, rehabilitation, and legislation and governance were relatively neglected areas. Included reports may inform trauma care system planning in LMICs, and noted gaps may guide research and funding agendas.

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