Developing trauma care education in low, middle-income countries: Sequential Trauma Education Programs, challenges, and lessons learned

Abstract

Background: As one of the leading causes of death and disability in the world, human trauma and injury disproportionately affects individuals in developing countries. During initial program development, senior MOHP physicians stated there was a critical need for a portable and flexible educational course on the clinical care of injured patients. To meet the need for improved trauma care in Egypt, the Sequential Trauma Emergency/Education ProgramS (STEPS) course was created through the collaborative effort of Egyptian and US expert physicians. The objective of course development was to create a high-quality, modular, adaptable, and sustainable trauma care course that could be readily adopted by a lower- or middle-income country. Methods: We describes the course development from 2006 to 2015, highlighting the challenges and solutions of creating a successful, flexible and sustainable in-country trauma care training program that suits low and middle-income countries. Results: STEPS was developed at the University of Maryland, based in part on World Health Organization's Emergency and Trauma Care materials, and introduced to the Egyptian Ministry of Health and Population and Ain Shams University in May 2006. The program is designed to adapt low cost and limited resources with maintaining high fidelity and unified standard. In 2008, the course transitioned completely to the leadership of Egyptian academic physicians. To date, more than 700 physicians from 8 countries have taken the course through the Ministry of Health and Population or public/governmental universities. For the first time the course will be held in Sudan on January 2016. Conclusion: STEPS has rapidly become a desired trauma care training program proved by sustainability based on 7 years of course conduct. Success of this collaborative educational program is demonstrated by the numbers of physicians trained, and program continuance after transitioning to in-country leadership and trainers.