LFR International

Last updated
LFR International
Founders Peter G. Delaney [1]
Zachary J. Eisner [1]
Founded at Los Angeles, California
Type Nonprofit
Non-governmental organization
83-3568251
Legal status501(c)(3)
Headquarters Makeni, Sierra Leone
Region
Sub-Saharan Africa
Fields Emergency medical services development in LMICs
Volunteers5,393 LFRs
Award(s) Prince Michael International Road Safety Award
Website www.lfrinternational.org

LFR International (Lay First Responders) [1] is an American international nonprofit organization focused on prehospital emergency medical research and emergency medical services development in sub-Saharan Africa. LFR launches sustainable prehospital emergency care programs in resource-limited settings of low-income countries without formal emergency medical services by collaborating with local governments and stakeholders to train lay first responders. [2]

Contents

History

More than 5,000 pre-existing transportation providers have been trained as lay first responders by LFR since 2016 to care for road traffic injuries and affordably scale up prehospital emergency care in resource-limited African settings. [3] [4]

LFR's model of locally-informed rapid emergency care deployment has been launched and studied by researchers in Uganda, Chad, Guatemala, and Sierra Leone. [2] [5] [6] [7] LFR was a founding organization of the First Responder Coalition of Sierra Leone in 2019 to expand prehospital emergency care and develop emergency medical services in Sierra Leone. [8] [9] [10] LFR launched trainings with the Coalition in Makeni. [11]

Locations

Uganda

In 2016, Delaney launched an early iteration of what would eventually become the LFR model with the Uganda Red Cross Society in Iganga, Uganda. [12] A lay first responder program of 154 motorcycle taxi responders was created to explore its capacity to provide prehospital emergency care for victims of road traffic injury in a municipality of 100,000 people. [5] Encountering nearly 10% mortality, first responders assisted 250 victims in the first few months (83% of which were road traffic injury-related) and utilized bleeding control skills in over half of encounters. [5]

Three years later in 2019, LFR investigators explored the social and financial implications of first responder trainings for initial participants. Though the World Health Organization had recommended training laypeople as the first step toward developing formal emergency medical services since 2004, there had previously been no investigations of the effects of trainings for laypeople. As the first to do so, LFR researchers found 75% of initial participants continued to voluntarily participate and described various apparent benefits to training, namely in an increase in social stature and income, in Emergency Medicine Journal . [4]

In 2022, LFR returned to Uganda to establish an LFR program in Mukono District with Vision for Trauma Care in Africa (VTCA), a Ugandan NGO, and conduct a pilot implementation of an advanced medical and obstetric curriculum. [13]

Chad

In 2018, LFR collaborated with trainers from the Red Cross of Chad to develop a lay first responder program in Am Timan, located in the rural Salamat Region, which had previously claimed the title of “poorest region” globally as measured by a multidimensional poverty index by the World Bank and International Monetary Fund. [14] Under extreme resource limitations, an LFR program was launched by training 108 motorcycle taxi drivers to provide care for 36,000 people. Curriculum efficacy was evaluated using pre- and post-course tests, which demonstrated significant knowledge acquisition in participants. [6]

In 2019, during follow-up interviews with initial participants after 12 months of providing emergency care, trainees reported sustained voluntary participation due the ability to care for the injured, new knowledge/skills, and the resultant gain in social stature and customer acquisition. Findings suggested LFR programs appear feasible and cost-effective in rural, resource-limited sub-Saharan African settings. [6]

Guatemala

LFR training DIFEP in Chimaltenango 2019.jpg
LFR training PNC in Sacatepequez 2019.jpg
Prehospital trauma management training with DIFEP (Division of Special Police Forces) and PNC (Policia Nacional Civil) in Guatemala, 2019

In 2019, LFR deployed to Guatemala to investigate the development of first responder programs in a middle-income, Central American setting. LFR worked with affiliates of the Guatemalan Ministry of the Interior to train hundreds of members of the Policia Nacional Civil and CVB across the Escuintla, Sacatepéquez, and Chimaltenango departments in prehospital trauma management. [15] A study conducted alongside the trainings found a single-day, five-hour training course effectively trained participants to provide effective prehospital emergency care. [2]

Sierra Leone

In 2019, LFR was a co-founding member of the First Responder Coalition of Sierra Leone (FRCSL) with the Sierra Leone Red Cross Society, Agency for Rural Community Transformation, the Holy Spirit Hospital of Makeni, and the University of Makeni, its national partners. [9] With the launch of the coalition, the FRCSL committed to training more than 1,000 community members in Makeni as LFRs. [8] Between July and December 2019, 4,529 LFRs were trained by local LFR instructors. LFRs were later found to have treated 1,850 patients over the following six months, demonstrating significant emergency care knowledge improvement and retention in LFR participants. [7]

Over a 14-month period, impact was assessed using the Prehospital Emergency Trauma Care Assessment Tool (PETCAT), a novel survey instrument LFR designed and administered to first-line hospital-based healthcare providers, to independently assess the frequency and quality of prehospital intervention by LFRs. [16] Change in emergency care was controlled for by using a difference-in-differences approach and comparing change in Makeni, where the intervention had been launched, to Kenema, a control city 125 miles away without an LFR program. While controlling for secular trends, prehospital care in Makeni was demonstrated to have improved significantly over the 14-month study period, while also validating PETCAT as a robust tool for independent EMS quality assessment in resource-limited settings. [16]

Nigeria

In 2022, LFR announced its partnership with Health Emergency Initiative (HEI) to deploy LFR programs in Lagos, Nigeria. [17] [18] The LFR/HEI program aims to train and evaluate the performance of 350 first responders to improve outcomes in the prehospital setting prior to hospital admission in Lagos, "to reduce fatalities from road traffic accidents, which are currently the leading cause of youth casualties in Nigeria." [19] [20] Later in 2022, the Lagos State Command of the Federal Road Safety Corps (FRSC) partnered with HEI and LFR to train 1,000 commercial transporters as lay first responders in Lagos State in order to support FRSC's initiative to reduce road crash fatalities by 15%, with the goal to train additional thousands of first responders in Nigeria in 2023. [21] [22]

Honors

In 2020, LFR was awarded the Prince Michael International Road Safety Award by Prince Michael of Kent in recognition of "exemplary achievement and innovation" in improving road safety and post-crash response globally. [23] [24] [25] [1] [26]

In 2022, LFR was invited to join the Global Alliance of NGOs for Road Safety as a full member. [27]

In 2024, LFR was awarded funding by the United States Agency for International Development (USAID) through the Development Innovation Ventures (DIV) program to conduct a three-year randomized controlled trial in Sierra Leone. [28]

Related Research Articles

<span class="mw-page-title-main">Emergency medical services</span> Services providing acute medical care

Emergency medical services (EMS), also known as ambulance services or paramedic services, are emergency services that provide urgent pre-hospital treatment and stabilisation for serious illness and injuries and transport to definitive care. They may also be known as a first aid squad, FAST squad, emergency squad, ambulance squad, ambulance corps, life squad or by other initialisms such as EMAS or EMARS.

<span class="mw-page-title-main">Am Timan</span> Place in Salamat Region, Chad

Am Timan is a city in Chad and is the capital of the region of Salamat. Most of economy comes from Salamat region such as fish, vegetables and anomalies meat, etc. In Arabic, Am Timan means "mother of twins". As the capital of the prefecture, it has the area of many towns and villages around it, including the Zakouma National Park. The city has no university but there are schools and colleges, and a clinic, and hosts a large market day and holiday celebrations.

<span class="mw-page-title-main">Makeni</span> Place in Northern Province, Sierra Leone

Makeni is the largest city in the Northern Province of Sierra Leone. The city is the capital of Bombali District, and is the economic center of the Northern Province. Makeni is the fifth largest city in Sierra Leone by population. The city of Makeni had a population of 85,116 in the 2021 census. Makeni lies approximately 110 miles east of Freetown. Makeni is home to the University of Makeni, the largest private university in Sierra Leone.

<span class="mw-page-title-main">Bombali District</span> Place in Northern Province, Sierra Leone

Bombali is a district in the Northern Province of Sierra Leone. Its capital and largest city is Makeni, which is also the largest city in the north. The Bombali district is one of the sixteen districts of Sierra Leone. Bombali is one of the largest districts in Sierra Leone by geographical area, after Koinadugu District, and is the second most populous district in the Northern part of Sierra Leone, after Port Loko district. In the 2015 Sierra Leone national census, the population of Bombali District was 606,183. Other major towns in Bombali District include Kamabai, Karina and Binkolo.

<span class="mw-page-title-main">Iganga</span> Ugandan town

Iganga is a town in the Eastern Region of Uganda. It is the main municipal, administrative, and commercial center of Iganga District.

<span class="mw-page-title-main">Paramedics in the United States</span> Overview of paramedics in the United States of America

In the United States, the paramedic is an allied health professional whose primary focus is to provide advanced emergency medical care for patients who access Emergency Medical Services (EMS). This individual possesses the complex knowledge and skills necessary to provide patient care and transportation. Paramedics function as part of a comprehensive EMS response under physician medical direction. Paramedics often serve in a prehospital role, responding to Public safety answering point (9-1-1) calls in an ambulance. The paramedic serves as the initial entry point into the health care system. A standard requirement for state licensure involves successful completion of a nationally accredited Paramedic program at the certificate or associate degree level.

Sierra Leone Red Cross Society (SLRCS) was established in 1962 by an act of the Parliament of Sierra Leone and is a national society. It has its headquarters in Freetown.

Available healthcare and health status in Sierra Leone is rated very poorly. Globally, infant and maternal mortality rates remain among the highest. The major causes of illness within the country are preventable with modern technology and medical advances. Most deaths within the country are attributed to nutritional deficiencies, lack of access to clean water, pneumonia, diarrheal diseases, anemia, malaria, tuberculosis and HIV/AIDS.

The Red Cross of Chad was founded in 1983. It has its headquarters in N’Djamena, Chad.

University of Makeni is the first private, Catholic, university located in Makeni, Sierra Leone.

<span class="mw-page-title-main">Bomberos Voluntarios (Guatemala)</span>

The Bomberos Voluntarios (Guatemala) (Spanish: Cuerpo de Bomberos Voluntarios de Guatemala or CVB) is an independent agency partially funded by the Guatemalan Ministry of the Interior (Guatemala) that is headquartered in Guatemala City Guatemala Department and has fire companies in each of the 22 departamentos (States) constituting Guatemala. It is one of three major firefighting organizations in the country, the others being the Bomberos Municipales (serving Guatemala City) and the Asociación Nacional De Bomberos Municipales Departamentales (ASONBOMD), which serves city Fire Departments outside Guatemala City.

The Holy Spirit Hospital is a hospital located in Makeni, Sierra Leone. It is the largest private hospital in the Northern Province of Sierra Leone.

<span class="mw-page-title-main">National Civil Police (Guatemala)</span> Law enforcement agency

The National Civil Police is the police force of Guatemala and is an agency of the Guatemalan Ministry of the Interior. The PNC is in charge of protecting public order.

<span class="mw-page-title-main">First Responder Coalition of Sierra Leone</span>

The First Responder Coalition of Sierra Leone (FRCSL) is a coalition of Sierra Leonean and international organizations dedicated to expanding prehospital emergency care and developing emergency medical services in Sierra Leone. It aims to address the high rates of injury and low rates of prehospital emergency care available in the country.

The Emergency First Aid Responder System Model, or EFAR System Model, was first published by Jared H. Sun and Lee A. Wallis in Emergency Medicine Journal in 2012, describing a system utilizing community members as first responders in low-resource settings to provide immediate basic care during medical emergencies until certified medical personnel arrive. Since its creation, it has been deployed across twenty-three municipalities in South Africa and has been adapted for use in Zambia.

<span class="mw-page-title-main">BASICS Scotland</span>

The British Association for Immediate Care Scotland is an organisation involved with prehospital care. It has the aims of providing encouragement and aid with the formation of immediate care schemes and to provide training to support those working in prehospital care. It shares its origins with the British Association for Immediate Care (BASICS), which has UK wide coverage. In 1993, the British Association for Immediate Care began running prehospital care courses in Scotland, which were met with a warm welcome and it became clear there was a large audience for such education, especially in remote and rural areas of Scotland. This need for training and organisational leadership became clearer after the 1994 Scotland RAF Chinook crash on the Mull of Kintyre. This led to the training provided by BASICS to be modified for a more rural setting, and to the development of BASICS Scotland as a separate organisation in 2002.

The Lay First Responder Model, or LFR Model, uses motorcycle taxi drivers trained as first responders to provide basic prehospital emergency care in resource-limited settings of low- and middle-income countries. First published in the World Journal of Surgery in 2018, it was initially demonstrated in Uganda in 2016. Since its creation, the lay first responder model has also been deployed across Chad and Sierra Leone.

<span class="mw-page-title-main">Highland PICT Team</span> Scottish emergency prehospital care team

The Prehospital Immediate Care and Trauma (PICT) Team is a prehospital care team which operates from Raigmore Hospital emergency department in Inverness, Scotland. It receives funding from NHS Highland and the Scottish Trauma Network and initially from BASICS Scotland.

Peter G. Delaney is the Executive Director of LFR International and a road safety researcher responsible for the Lay First Responder Model of emergency medical services development in resource-limited countries, awarded the Prince Michael International Road Safety Award in 2020.

Zachary J. Eisner is the Operations Director of LFR International known for his work on the Lay First Responder Model, which received the Prince Michael International Road Safety Award in 2020.

References

  1. 1 2 3 4 "Student-led NGO that trains lay first responders garners road safety award from British crown". University of Michigan Medical School . 15 December 2020. Retrieved 5 January 2023.
  2. 1 2 3 Delaney, Peter G.; Figueroa, Jose A.; Eisner, Zachary J.; Andrade, Rudy Erik Hernandez; Karmakar, Monita; Scott, John W.; Raghavendran, Krishnan (2020-04-01). "Designing and implementing a practical prehospital emergency trauma care curriculum for lay first responders in Guatemala". Trauma Surgery & Acute Care Open. 5 (1): e000409. doi: 10.1136/tsaco-2019-000409 . ISSN   2397-5776. PMC   7254122 . PMID   32518836.
  3. ↑ "Student project aims to bolster first responder services in Africa | GlobalReach | Michigan Medicine". GlobalReach. 2020-02-13. Retrieved 2020-12-12.
  4. 1 2 Delaney, Peter G.; Eisner, Zachary J.; Blackwell, T. Scott; Ssekalo, Ibrahim; Kazungu, Rauben; Lee, Yang Jae; Scott, John W.; Raghavendran, Krishnan (2020-10-30). "Exploring the factors motivating continued Lay First Responder participation in Uganda: a mixed-methods, 3-year follow-up". Emergency Medicine Journal . 38 (1): 40–46. doi:10.1136/emermed-2020-210076. ISSN   1472-0205. PMID   33127741. S2CID   226217068.
  5. 1 2 3 Delaney, Peter G.; Bamuleke, Richard; Lee, Yang Jae (2018-08-01). "Lay First Responder Training in Eastern Uganda: Leveraging Transportation Infrastructure to Build an Effective Prehospital Emergency Care Training Program". World Journal of Surgery . 42 (8): 2293–2302. doi:10.1007/s00268-018-4467-3. ISSN   1432-2323. PMID   29349487. S2CID   25105908.
  6. 1 2 3 Hancock, Canaan J.; Delaney, Peter G.; Eisner, Zachary J.; Kroner, Eric; Mahamet-Nuur, Issa; Scott, John W.; Raghavendran, Krishnan (October 2020). "Developing a Lay First Responder Program in Chad: A 12-Month Follow-Up Evaluation of a Rural Prehospital Emergency Care Program". Prehospital and Disaster Medicine . 35 (5): 546–553. doi:10.1017/S1049023X20000977. ISSN   1049-023X. PMID   32723421. S2CID   220848454.
  7. 1 2 Eisner, Zachary J.; Delaney, Peter G.; Thullah, Alfred H.; Yu, Amanda J.; Timbo, Sallieu B.; Koroma, Sylvester; Sandy, Kpawuru; Sesay, Abdulai Daniel; Turay, Patrick; Scott, John W.; Raghavendran, Krishnan (2020-11-01). "Evaluation of a Lay First Responder Program in Sierra Leone as a Scalable Model for Prehospital Trauma Care". Injury . 51 (11): 2565–2573. doi:10.1016/j.injury.2020.09.001. ISSN   0020-1383. PMID   32917385. S2CID   221637243.
  8. 1 2 Thomas, Abdul Rashid (2019-07-05). "Sierra Leone's road accident First Responder Coalition to save thousands of lives". Sierra Leone Telegraph. Retrieved 2020-12-12.
  9. 1 2 "Makeni: Coalition of First Responders formed". The Patriotic Vanguard. 2019-07-04. Retrieved 2020-12-12.
  10. ↑ "LFR International Trains Responders and Creates the 'First Responder Coalition of Sierra Leone | AYV Newspaper News -Sierra Leone News, AYV Sierra Leone, Wake Up Sierra Leone, AYV News, Sierra Leone News, Leone News". 2010-01-10. Retrieved 2020-12-12.
  11. ↑ ""LFR International brings its innovative lay first responder training program to Makeni" | AYV Newspaper News -Sierra Leone News, AYV Sierra Leone, Wake Up Sierra Leone, AYV News, Sierra Leone News, Leone News". 2010-01-10. Retrieved 2020-12-12.
  12. ↑ Keaggy, Diane Toroian (2018-04-20). "An innovation mindset". The Source. Washington University in St. Louis. Retrieved 2021-05-22.
  13. ↑ Buule, Kizito Moses (2022-07-07). "Mukono Boda Boda Riders equipped with skills in managing first aid and accidents on roads". Watchdog Uganda. Retrieved 2022-07-12.
  14. ↑ Global Monitoring Report 2007: Confronting the Challenges of Gender Equality and Fragile States (PDF). Washington, DC USA: The World Bank. 2007. ISBN   978-0-8213-6975-3.
  15. ↑ "LFR International in Guatemala". 2019-08-22. Retrieved 2021-05-22– via YouTube.
  16. 1 2 Delaney, Peter G.; Eisner, Zachary J.; Thullah, Alfred H.; Muller, Benjamin D.; Sandy, Kpawuru; Boonstra, Philip S.; Scott, John W.; Raghavendran, Krishnan (2021-08-01). "Evaluating a Novel Prehospital Emergency Trauma Care Assessment Tool (PETCAT) for Low- and Middle-Income Countries in Sierra Leone". World Journal of Surgery . 45 (8): 2370–2377. doi:10.1007/s00268-021-06140-1. ISSN   1432-2323. PMID   33907897. S2CID   233417002.
  17. ↑ Obinna, Chioma (2022-03-16). "LFR International expands to Nigeria via partnership with HEI". Vanguard News. Retrieved 2022-03-31.
  18. ↑ Adeyemi, Appolonia. "LFR International Expands Into Nigeria Via Partnership with HEI". New Telegraph. Retrieved 2022-03-31.
  19. ↑ "LFR Int'l partners HEI to train 350 emergency responders". Punch Newspapers. 2022-03-17. Retrieved 2022-03-31.
  20. ↑ Olonade, Damilola (2022-03-16). "LFR, HEI Ink Health MoU, Mull Training for 350 First Responders". Platformsafrica. Retrieved 2022-03-31.
  21. ↑ "FRSC partners groups on emergency response at accident scenes". The Guardian Nigeria News - Nigeria and World News. 2022-09-29. Retrieved 2022-10-30.
  22. ↑ Edeme, Victoria (2022-08-02). "FRSC, foundations partner for health training course". Punch Newspapers. Retrieved 2022-10-30.
  23. ↑ "Student, alum win prestigious road safety award". The Source. Washington University in St. Louis. 2020-12-11. Retrieved 2020-12-12.
  24. ↑ "RoadSafe: Lay First Responder International receives Royal Award for Post-Crash Response Innitiative[sic]". www.roadsafe.com. Retrieved 2020-12-26.
  25. ↑ "Road Safety Awards: Lay First Responder International receives Royal Award for Post-Crash Response Innitiative". www.roadsafetyawards.com. Retrieved 2020-12-26.
  26. ↑ Lacey, Danielle (2020-12-11). "Student-led nonprofit wins international road safety prize". McKelvey School of Engineering. Washington University in St. Louis. Retrieved 2020-12-26.
  27. ↑ "Members - Search". Global Alliance of NGOs for Road Safety. Retrieved 2022-03-31.
  28. ↑ "Piloting Digital Training for Lay First Responders". U.S. Agency for International Development (USAID). December 7, 2024.
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