Published: 28 April 2022
Experts are launching a major study to help reduce the likelihood of people in developing countries dying unnecessarily from injuries caused by accidents or violence.
Every year, over three million people die due to injuries like road traffic accidents, burns, falls, or violence - with 90% of these deaths in low or middle income countries (LMICs).
Backed by £2.9 million of NIHR funding, University of Birmingham (UK) and University of Stellenbosch (South Africa) researchers will build on partnerships with experts in Ghana, South Africa, Rwanda, and Pakistan to explore how to overcome barriers to accessing quality care after injury and reduce the likelihood of death or disability.
Experts will use a ‘four delays framework’, which looks at where delays occur in people seeking, reaching, receiving, and remaining in good quality care after injuries, to collect information on delays and their effects on patient outcomes. They will develop maps for policy makers to see where to intervene, to reduce delays suffered after injury and produce maximum health benefits.
The project builds on a recent study funded by the NIHR, published in the BMJ, led by University of Birmingham and experts in Rwanda. This study identified 121 barriers to accessing quality injury care in three countries across sub-Saharan Africa: Ghana, South Africa and Rwanda.
Researchers discovered that while there were a large number of barriers in total, only 31 (25.6%) of these were shared across all three countries. This suggested that solutions to improve access to quality care after injuries may be highly contextually dependent. Also, only just over half of these common factors (18 out of31) were related to delays in receiving quality care at the healthcare facility, suggesting that investment needs to be made in overcoming delays in seeking or reaching care.
Professor Justine Davies, Professor of Global Health Research at the University of Birmingham, said: “Injuries in LMICs are common and their number is expected to increase, but death and disability after injury can be substantially reduced if people reach healthcare facilities in a timely manner.
“Understanding access to quality injury care is critical to improving patient outcomes. By partnering with organisations in Ghana, South Africa, Rwanda, and Pakistan, we will develop solutions for future study in these, and similar countries.
“Our research has already identified many barriers to quality care in Rwanda, Ghana and South Africa. However, as few of these are shared across countries, solutions to reduce the risk of post-injury death and disability will need to reflect circumstances in each country.”
The diversity of cultures, economies, and injuries in partner countries will allow researchers to identify delays and solutions that can be applied across different settings and others that are transferable outside of the four countries of this study.
Study leaders will also train four PhD students and 14 junior researchers in countries with low resources. Training will be done through the development of research hubs in partner countries – these hubs will continue and train future LMIC researchers beyond the project’s end.
Researchers will also work closely with patients, community members and leaders, healthcare providers, and policy makers to understand how to translate the findings of the study into real world solutions.
The study was funded by the NIHR Global Health Research Programme.
Find out more about the study on the NIHR funding and Awards website.