Strengthening trauma care in low- and middle-income countries through guideline adaptation and scalable system reforms

Table 2 Successful models and feasible initiatives for strengthening trauma care in low- and middle-income countries

Country/region	Key initiative	Core components	Reported impact
Kenya	National trauma programme with ATLS-based training	Multidisciplinary courses; procurement of WHO-recommended equipment; referral protocols linking district and tertiary hospitals[86]	30-day trauma mortality ↓ from 17% to 6% over 18 months[86]
India	Nationwide ATLS roll-out & tiered trauma-centre network	Government funding; public-private partnerships; faculty exchange across states[87,88]	> 7800 providers certified; model adopted by Nepal, Bangladesh & Sri Lanka[87,88]
Vietnam	PTC cascade training & 1816 satellite-hospital project	Low-cost PTC courses; train-the-trainer cascade; deployment of central-hospital specialists; urban triage pilots[9,76,90-92]	Theoretical knowledge ↑ 17%; confidence ↑ 12%; referral delays and ambulance response times reduced[76,91,92]
Philippines/Singapore hub	Regional training hubs & cross-border faculty development	Shared curricula; simulation workshops; ASEAN-wide scholarship & faculty exchange[96,97]	Sustainable, locally led trauma courses now running in ≥ 6 ASEAN countries[96,97]

ATLS: Advanced trauma life support; WHO: World Health Organization; PTC: Primary trauma care; ASEAN: Association of Southeast Asian Nations.