Abstract
BackgroundFirst aid training is a cost-effective way to decrease the burden of disease and injury in low- and middle-income countries (LMIC). Since evidence from Western countries has shown that children are able to learn first aid, first aid training of children in LMIC may be a promising way forward. Hence, our project aim was to develop contextualized materials to train sub-Saharan African children in first aid, based on the best available evidence.MethodsSystematic literature searches were conducted to identify studies on first aid education to children up to 18 years old (research question one), and studies investigating different teaching approaches (broader than first aid) in LMIC (research question two). A multidisciplinary expert panel translated the evidence to the context of sub-Saharan Africa, and evidence and expert input were used to develop teaching materials.ResultsFor question one, we identified 58 studies, measuring the effect of training children in resuscitation, first aid for skin wounds, poisoning etc. For question two, two systematic reviews were included from which we selected 36 studies, revealing the effectiveness of several pedagogical methods, such as problem-solving instruction and small-group instruction. However, the certainty of the evidence was low to very low. Hence expert input was necessary to formulate training objectives and age ranges based on “good practice” whenever the quantity or quality of the evidence was limited. The experts also placed the available evidence against the African context.ConclusionsThe above approach resulted in an educational pathway (i.e. a scheme with educational goals concerning first aid for different age groups), a list of recommended educational approaches, and first aid teaching materials for children, based on the best available evidence and adapted to the African context.
Highlights
First aid training is a cost-effective way to decrease the burden of disease and injury in low- and middle-income countries (LMIC)
In sub-Saharan Africa, approximately 5·1 million deaths each year are attributable to conditions that could have potentially been addressed by prehospital and emergency care [1], which is underdeveloped in the majority of low- and middle-income countries (LMIC) [2, 3]
The second systematic review was a PhD thesis of 66experimental studies, conducted in sub-Saharan Africa, that looked at the same interventions as listed above, as well as interventions focused on improving repetition and retention rates [24]
Summary
First aid training is a cost-effective way to decrease the burden of disease and injury in low- and middle-income countries (LMIC). Most studies demonstrating the effectiveness of first aid training programmes for adults were conducted in Western contexts [4,5,6,7,8], some studies from sub-Saharan Africa are available [9,10,11], and several African Red Cross National Societies organize first aid trainings for adult laypeople. These trainings were mostly based on materials from Western former colonisers (e.g. the UK, France), which provided a useful basis, but did not take into account the distinct African context. In an attempt to meet these needs, contextualized and evidence-based African First Aid Materials (AFAM) were developed and released in 2011, providing guidance on up-to-date first aid techniques, as well as injury and disease prevention advice specific for the African context [2]
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