Establishing Pediatric Trauma Programs in Low- and Middle-Income Countries

Purpose of Review Childhood injury is one of the leading global health concerns. Although trauma is a major concern worldwide, it is the leading cause of pediatric morbidity and mortality in low- and middle-income countries (LMICs), with sub-Saharan Africa disproportionately affected. At present, pediatric trauma care in LMICs remains poorly coordinated. Most health facilities lack pediatric trauma programs or protocols to provide safe, timely, and appropriate care for the injured child. There is a persistent lack of sufficiently trained personnel; shortages of proper infrastructure, equipment, and supplies; limited financial support; and insufficient or, in many cases, no political will to address this largely preventable public health problem. Recent Findings In many high-income countries (HICs), a functioning pediatric trauma program reduces the morbidity and mortality of pediatric trauma and improves the quality of care provided. However, very few formal pediatric trauma programs are currently in place in LMIC-based health facilities. Establishing a successful program necessitates diligent planning, a commitment to education and training, and a long-term approach. This approach involves performing a detailed needs assessment of the facility and catchment area; identifying individual champions; building collaborations with general surgeons and other institutions; obtaining administrative and leadership support; starting small and being consistent; and prioritizing education, training, and quality improvement. If these essential elements are appropriately implemented, they will lead to the establishment of a robust and sustainable pediatric trauma program that leads to the improved and timely surgical care of injured children in the LMIC setting. Summary Establishing a successful pediatric trauma program in a resource-limited setting is possible. Doing so requires a dedicated team, a focus on simple and early wins, and a long horizon with an eye toward sustainability.