The RTrT Partnership: Reducing Traffic-related TraumA - A community-based prevention and first-response programme intervention for Malawi and beyond.

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Injuries resulting from road traffic collisions are a major and growing cause of preventable death in sub-Saharan Africa. Road traffic collisions in low and middle income African countries account for approximately 169,000 deaths and about 6 million healthy years of life lost due to disabilities people are left with. Road traffic collisions also impact on people's ability to work and on community wellbeing. As working aged men are three times more likely than women to be involved in a road traffic collision low and middle income countries lose up to 3% of their earning potential. As a result improving outcomes from road traffic collisions will contribute to the delivery of four of the United National Sustainable Development Goals: no poverty; health and well-being; sustaining cities and communities and partnership working.Malawi has one of the highest rates of road traffic related death, lowest rates of vehicle ownership, and lowest income levels per person in the world. Consequently the Malawian Government have identified road traffic related trauma as a major barrier to improving the health and finances of the nation. However it faces considerable challenges in making improvements. Malawi has no formal prehospital care system, no universal emergency telephone number, and almost no ambulance service. Care of injured people is haphazard and often provided by passers-by who have very little or no training in basic first aid. As a result people who have survivable injuries often die. This has led to doctors from the largest Malawian hospitals recently publishing a Call to Action that highlighted the need to improve trauma care. All of trauma care would benefit from further research and development. However the Call to Action says that research to improve pre-hospital trauma care should be a specific priority. So pre-hospital trauma care is the Partnership's specific focus. This proposal was developed following a 9 day study visit to Malawi by Dr's Duncan and Uny in September 2017, at the invitation of Dr's Chokotho and Mulwafu. During this visit local challenges of road traffic related trauma were discussed with a wide range of different organisations, academics and community members. There was a broad consensus that the first step should be the development of community based programme intervention that is made up of different, but linked, interventions to prevent and respond to collisions. Tackling prevention and response together is likely to lead to bigger improvements in communities than dealing with either separately.Our Road Traffic Related Trauma (RTrT) Partnership brings together experts in applied health science, public health, global health, arts and humanities, pre-hospital and emergency healthcare delivery, community engagement, and local community members. We will use a variety of methods from the different disciplines we represent. These are likely to include creative ways of gathering, sharing and discussing different people's views and ideas on the challenge of road collision, including the use of visual methods and theatre to engage and communicate within the research team, wider stakeholders and the public. Working in Malawi and at a distance between meetings we will develop an intervention to improve community prevention and first-response within local communities highly affected by road traffic collisions. Towards the end of the project we will will look at ways our work can be transferred to other sub-Saharan countries. We will then apply for funding to implement and test our interventions. We will share our work locally, nationally and internationally. We will ensure that our findings are shared with with academics, Government policy makers, organisations involved in road traffic and trauma care, and local community members. Where appropriate these outputs will be developed with local residents and translated into key local languages.