In delivering the second pillar of our work, the Centre will work in partnership with Interburns, and a network of overseas partners across Nepal, Occupied Palestinian Territories (OPT), and Ethiopia –Sagun, Medical Aid for Palestinians (MAP) and AMREF (formerly the African Medical and research Foundation)– to conduct research into a programme of burn care and prevention on community-level practices.

Prevention is key to reducing the burden of burns in low and middle-income countries (LMICs). To this end, primary prevention efforts have to take place at the community level and in the lower level primary health care facilities like health centres, health posts, dispensaries or clinics. These efforts should be based on a local understanding of the burden and cause of burns and led primarily by the community itself, however, there is limited evidence of effective approaches in community-led prevention efforts for injuries and burns, in particular in LMICs. There is a need to explore and define what works and consider feasibility for scale-up.

This research project has assessed and evaluated the burden of burns in selected communities in all three countries. Using the survey results on the local cause and incidence of burn injuries, and led by ideas and initiatives form the local communities, Sagun, MAP and AMREF developed burn prevention programmes in Nepal, OPT, and Ethiopia. In addition, more formal training is provided to improve basic burn care at two levels in defined communities; by training primary health care providers (PHCP) and by training these primary health care workers to facilitate prevention and first aid training in their communities.

Findings from these programmes will be used to develop policy and framework recommendations that can be used in other LMICs.

Community surveys

The key aim – To ensure that any burn prevention or first aid strategy is needs-driven tailored to the specific context of the area, community surveys were conducted to collect baseline data in each location.

The surveys collected information of the cause of burns as well as the severity and consequent treatment. Additionally, it captured the participant’s knowledge, attitudes and practices around burn injuries. These surveys have been successfully conducted in all three partner countries, providing valuable data to better understand burn epidemiology and incidence, as well as inform burn prevention and burn care strategies. The survey results were disseminated to local stakeholders and the local community, using a combination of formal reporting and visual infographics and posters to make it easy for all to understand despite language barriers.

In summary – understanding local perceptions of causes of burn injuries and how to treat them to establish community-led, participatory change.

Community led prevention

The key aim – To use the survey data to develop community-led, contextual burn prevention and first aid strategies, and deliver them in pilot programmes, a process which has already had great success in Nepal.

All pilot interventions will be closely monitored and continuously evaluated to allow for feedback to be incorporated within the intervention dynamically. These process evaluations will be useful for future burn prevention programmes, to illustrate some of the barriers and facilitators that were faced when implementing the various interventions. Examples of programme elements being undertaken in Nepal, Ethiopia and OPT are school lessons in burn prevention and first aid; spreading awareness with messages through radio and TV; social media campaigns; distributing magazines and calendars specifically designed with burn prevention messages; house-to-house pamphlets and information sessions; and working with local groups, such as women’s cooperatives, mosques and churches.

This project will also pilot a Basic Burn Care (BBC) module for PHCPs and community burn prevention and first aid programme. Trainers in BBC have been trained in all three partner countries, and 600 health professionals will be trained in BBC within this project.

In summary – Developing burn prevention and first aid pilot programmes and training primary health care providers in the community

National Models

The key aim – to work with in-country partners to develop a model for country–specific national burn care and prevention strategies.

The pilot programmes in Ethiopia, Nepal and OPT will be carefully evaluated and lessons learnt shared between partners and the CGBIPR. The Centre will take the lead in developing a resource that captures the successful aspects of the burn prevention programmes to provide a strategy for scale up and adoption in other LMICs. Although every burn prevention and first aid programme will have locally specific elements, the data from the pilot projects would provide a framework for LMICs.

In summary reviewing the pilot projects to develop a framework for burn prevention work in other LMICs.

Developing effective national systems of burn prevention at the primary health care and community levels

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