Progress to date

A basic premise behind the Essential Trauma Care Project is that improved planning and organization will improve the process and outcome of trauma care. As mentioned throughout this document, these guidelines are intended to serve as a flexible template to assist with such planning. It is also intended to serve as a catalyst to promote improvements in systems for trauma management in individual countries.

In this regard, some progress has taken place, even as the guidelines have been going through the finalization process. The EsTC criteria have served as the basis for needs assessments made in the Hanoi area ofVietnam, in Ghana (nationwide) and in Mexico (nationwide). These needs assessments have been arranged by concerned individuals interacting with their own ministries of health. In the case of Mexico, the needs assessments have involved the participation of a professional society, the Asociación Mexicana de Medicina y Cirugía del Trauma (Mexican Association for the Medicine and Surgery of Trauma—AMMCT). The Guidelines for essential trauma care have been endorsed by the AMMCT and the Ghana Medical Association.

In one case, a group of stakeholders has come together, as outlined in section 6.6 (Interaction and coordination of stakeholders). In the state of Gujarat, India, the following groups have been working together to adapt and implement the EsTC criteria: state government (ministry of health), the Gujarat sub-country office of the WHO, representatives of IATSIC/ISS, local professional groups (including the Indian Academy of Traumatology and the Indian Orthopaedic Association) and several nongovernmental organizations. These groups have: (a) adapted the Guidelines for essential trauma care to local circumstances, which has involved changing the status of some of the items designated as desirable to essential, in keeping with the availability of resources in the area; and (b) creating working groups of representatives of the above stakeholders to develop plans for implementation.

The above-mentioned assessments of needs, local adaptations and interactions of stakeholders provide examples of the use of the Guidelines for essential trauma care in the manner in which the document is intended to be used. The authors hope such activities will continue and expand.

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