title: First Responders and Prehospital Care for Road Traffic Injuries in Malawi.
abstract: Introduction Road traffic collisions are a common cause of injuries and injury-related deaths in sub-Saharan Africa (SSA). Basic prehospital care can be the difference between life and death for injured drivers, passengers, and pedestrians. Problem This study examined the challenges associated with current first response practices in Malawi.
  
  
  METHODS
  In April 2014, focus groups were conducted in two areas of Malawi: Karonga (in the Northern Region) and Blantyre (in the Southern Region; both are along the M1 highway), and a qualitative synthesis approach was used to identify themes. All governmental and nongovernmental first response organizations identified by key informants were contacted, and a checklist was used to identify the services they offer.
  
  
  RESULTS
  Access to professional prehospital care in Malawi is almost nonexistent, aside from a few city fire departments and private ambulance services. Rapid transportation to a hospital is usually the primary goal of roadside care because of limited first aid knowledge and a lack of access to basic safety equipment. The key informants recommended: expanding community-based first aid training; emphasizing umunthu (shared humanity) to inspire bystander involvement in roadside care; empowering local leaders to coordinate on-site responses; improving emergency communication systems; equipping traffic police with road safety gear; and expanding access to ambulance services.
  
  
  CONCLUSIONS
  Prehospital care in Malawi would be improved by the creation of a formal network of community leaders, police, commercial drivers, and other lay volunteers who are trained in basic first aid and are equipped to respond to crash sites to provide roadside care to trauma patients and prepare them for safe transport to hospitals. Chokotho L , Mulwafu W , Singini I , Njalale Y , Maliwichi-Senganimalunje L , Jacobsen KH . First responders and prehospital care for road traffic injuries in Malawi. Prehosp Disaster Med. 2017;32(1):14-19.
authors.affiliation: 1Beit Cure Hospital,Blantyre,Malawi.
authors.forename: Linda
authors.initials: L
authors.lastname: Chokotho
authors.affiliation: 2Department of Surgery,College of Medicine,University of Malawi,Blantyre,Malawi.
authors.forename: Wakisa
authors.initials: W
authors.lastname: Mulwafu
authors.affiliation: 3John Hopkins Project,Blantyre,Malawi.
authors.forename: Isaac
authors.initials: I
authors.lastname: Singini
authors.affiliation: 4Blantyre Adventist Hospital,Blantyre,Malawi.
authors.forename: Yasin
authors.initials: Y
authors.lastname: Njalale
authors.affiliation: 5Department of Psychology,Chancellor College,Zomba,Malawi.
authors.forename: Limbika
authors.initials: L
authors.lastname: Maliwichi-Senganimalunje
authors.affiliation: 6Department of Global & Community Health,George Mason University,Fairfax,Virginia,USA.
authors.forename: Kathryn H
authors.identifier: http://orcid.org/0000-0002-4198-6246
authors.initials: KH
authors.lastname: Jacobsen
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D004632:Emergency Medical Services / Q000458:organization & administration; D060731:Emergency Responders; D005260:Female; D017144:Focus Groups; D006301:Health Services Needs and Demand; D006801:Humans; D008295:Malawi / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000628:therapy*; D014187:Transportation of Patients; D000078329:Workforce
keywords:  EFAR emergency first aid responder;  EMT emergency medical technician;  NGO nongovernmental organization;  SSA sub-Saharan Africa; Emergency Medical Services; Malawi; developing countries; first aid; prehospital emergency care; qualitative research; sub-Saharan Africa; traffic accidents