ArticleAfrican journal of emergency medicine : Revue africaine de la medecine d'urgence2026
Strengthening trauma care in South Africa: Tier 1 integration of emergency first aid responder (EFAR) programmes with emergency medical services.
Article in African journal of emergency medicine : Revue africaine de la medecine d'urgence, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Trauma accounts for approximately 4.4 million deaths annually and remains the leading cause of mortality among young adults worldwide. In South Africa, interpersonal violence and road traffic crashes strain already overstretched Emergency Medical Services (EMS). The Emergency First Aid Responder (EFAR) addresses this gap through a community-based Tier 1 prehospital model that delivers early trauma care before formal EMS arrives. Aim: This commentary reflects on the integration of EFAR programmes as a Tier 1 EMS component, drawing on implementation experience across rural and urban communities in the Western Cape, South Africa. Approach: Drawing on a decade of EFAR implementation experience across the province, we describe the Tier 1 integration framework and present operational learnings from two purposively selected, contextually contrasting sites: Merweville (remote rural, Central Karoo) and Kuilsriver (high-density urban, Cape Town). Data from routine programme monitoring and quality assurance are used as illustrative experiences informing the commentary. Key implementation learnings: Both sites highlight the importance of standardised training, defined activation pathways, integration with a formal EMS communication system, support and community ownership. In Merweville, routine programme records documented 112 emergency responses by the EFARs, with 69% of these resulting in ambulance transport and a median time to first care under 10 minutes against a background EMS response exceeding 90 minutes. In Kuilsriver, 58 documented responses between May and December 2024 suggested rapid group activation, with EFARs frequently arriving before the formal EMS. These learnings illustrate how EFARs may strengthen access to early care and coordination with formal EMS. Conclusion: Effective EFAR integration constitutes a context-sensitive framework rather than a one-size-fits-all model. When formalised within EMS regulatory structures, these programmes demonstrably extend system capacity, reduce time to first care, and strengthen community resilience - offering a scalable blueprint for low- and middle-income countries facing prehospital trauma care deficits.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.