Consensus-based research priorities for post-collision care in the Western Cape province of South Africa.

Introduction: Road traffic injuries constitute a significant global health burden, causing 1.3 million deaths and 50 million injuries annually, with 92 % of fatalities occurring in low-and middle-income countries (LMICs). Despite this disproportionate impact, research priorities in post-collision care often reflect high-income country contexts, creating a critical misalignment between evidence generation and contextual realities in LMICs. Methods: This mixed-methods study employed a three-phase approach to identify research priorities for post-collision care in the Western Cape, South Africa. Phase 1 consisted of a comprehensive literature review to identify preliminary thematic areas and research questions. Phase 2 involved a stakeholder engagement workshop using modified nominal group techniques (NGT) with purposively sampled participants representing emergency medical services, fire services, law enforcement, community members and academia. Phase 3 entailed systematic prioritisation, where participants independently scored each theme and associated research questions on a Likert scale. Results: Eight thematic domains were identified and ranked in order of priority. EMS safety (highest priority), communication and coordination, public awareness and prevention, transportation and access to care, first-responder capabilities, training implementation, resource optimisation, disaster and mass casualty management, and specialised care accessibility. The highest-ranked individual research question concerned the minimum set of practical skills and resources required by first responders to effectively provide immediate post-collision care. Technological integration emerged as a cross-cutting priority across multiple themes. Conclusion: The study represents the first published systematic approach to identifying post-collision care research priorities in South Africa. Diverging from previous exercises that emphasise advanced interventions or system integration, this study highlights foundational challenges of EMS safety and communication as top priorities, reflecting the contextual realities of emergency service delivery in South Africa. The findings provide a strategic roadmap for researchers, funders, and policymakers to direct resources toward questions with maximal potential to improve post-collision care and strengthen health systems in similar LMIC contexts.