African Countries Lagging Behind in Post-crash Response

By Sharon Atieno

Though timely and effective emergency care is an important part of road safety and can help prevent consequences of injuries as well as reduce deaths and disabilities, African countries are performing poorly in post-crash response.

The recently released report on the status of road safety in the World Health Organization (WHO) African region 2023 shows.

According to the report, the key elements of post- crash response are: a system to activate post-crash response and bystanders and lay responders (non-medical professionals) with the capacity to provide lifesaving interventions.

Others include professional medical care, with trauma registries and integrated prehospital, hospital and rehabilitation services that are accessible 24 hours, regardless of ability to pay, and multidisciplinary, post-crash investigation, including appropriate financing mechanism, such as mandatory third-party liability motor vehicle insurance and social, judicial and, where appropriate financial support to bereaved families and survivors.

Based on these elements, the report found that out of 45 countries surveyed only seven countries conduct assessments of prehospital and facility-based emergency care which are necessary to design adequate services that respond to need.

Only five countries have national laws requiring training, licensing or other certification processes for first health responders.

Additionally, certified specialists or subspecialist programmes for emergency medicine physicians were reported in 21 countries. 24 countries had programmes for trauma surgeons while 13 have specialization in emergency care/trauma for nurses.

The report also found that countries with trauma registries have decreased since the Global Status Report 2018 from 32 to 19. However, 11 countries aggregate facility-based trauma data nationally while eight aggregate data only in selected facilities.

Countries also reported uneven distribution of emergency care services between urban and rural settings. Only three countries reported that the number and level of emergency care facilities were adequate and responded to the needs of the population .

Minimal to no emergency services in rural settings was noted in 26 countries. Urban emergency services were deemed adequate in nine countries while in 17 they were considered inadequate.

With regards to emergency care numbers, only 12 countries have a national single emergency number. 17 countries have multiple numbers with national coverage while eight have numbers with partial coverage.

In post-crash response legislation, the report covers five key areas. Of the countries surveyed, none had laws providing protection from civil liability to lay bystanders.

17 countries had laws requiring lay bystanders to help anyone involved in a vehicle crash while 10 were found to have national laws requiring healthcare facilities to take care of anyone who arrives with health emergency.

The report found four countries with national laws requiring rehabilitative care for all injured while only three had laws requiring psychosocial support for road traffic crash victims and their families regardless of ability to pay.

Further, 26 countries have national road safety strategies while only eight have set targets to ensure that professional care is provided within one hour of an accident.