World Journal of Surgery

, Volume 30, Issue 6, pp 946–956 | Cite as

Evaluation of Trauma Care Capabilities in Four Countries Using the WHO-IATSIC Guidelines for Essential Trauma Care

  • Charles MockEmail author
  • Son Nguyen
  • Robert Quansah
  • Carlos Arreola-Risa
  • Ramesh Viradia
  • Manjul Joshipura



We sought to identify affordable and sustainable methods to strengthen trauma care capabilities globally, especially in developing countries, using the Guidelines for Essential Trauma Care. These guidelines were created by the World Health Organization (WHO) and the International Society of Surgery and provide recommendations on elements of trauma care that should be in place at the range of health facilities globally.


The guidelines were used as a basis for needs assessments in 4 countries selected to represent the world’s range of geographic and economic conditions: Mexico (middle income; Latin America); Vietnam (low income; east Asia); India (low income; south Asia); and Ghana (low income; Africa). One hundred sites were assessed, including rural clinics (n = 51), small hospitals (n = 34), and large hospitals (n = 15). Site visits utilized direct inspection and interviews with administrative and clinical staff.


Resources were partly adequate or adequate at most large hospitals, but there were gaps that could be improved, especially in low-income settings, such as shortages of airway equipment, chest tubes, and trauma-related medications; and prolonged periods where critical equipment (e.g., X-ray, laboratory) were unavailable while awaiting repairs. Rural clinics everywhere had difficulties with basic supplies for resuscitation even though some received significant trauma volumes. In all settings, there was a dearth of administrative functions to assure quality trauma care, including trauma registries, trauma-related quality improvement programs, and regular in-service training.


This study identified several low-cost ways in which to strengthen trauma care globally. It also has demonstrated the usefulness of the Guidelines for Essential Trauma Care in providing an internationally applicable, standardized template by which to assess trauma care capabilities.


Trauma Care Large Hospital Trauma Registry Small Hospital Preventable Death 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We thank all who took part in the study for their time, helpfulness, and insights.


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Copyright information

© Société Internationale de Chirurgie 2006

Authors and Affiliations

  • Charles Mock
    • 1
    Email author
  • Son Nguyen
    • 2
  • Robert Quansah
    • 3
  • Carlos Arreola-Risa
    • 4
  • Ramesh Viradia
    • 5
  • Manjul Joshipura
    • 6
  1. 1.Harborview Injury Prevention and Research CenterUniversity of WashingtonSeattleUSA
  2. 2.Hanoi Health DepartmentHanoiVietnam
  3. 3.Kwame Nkrumah University of Science and TechnologyKumasiGhana
  4. 4.Sistema Estatal de Atencion de Emergencias MedicasSecretaría de SaludNuevo LeonMexico
  5. 5.Public Health SystemBhavnagarIndia
  6. 6.Academy of Traumatology (India)AhmedabadIndia

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