Background: In Sub-Saharan Africa, 40% of the burden of disease and injury can potentially be addressed by emergency care. Adequate pre-hospital care is vital, but often unavailable in Sub-Saharan Africa. Initial help and emergency transport often depends on basic first responders. The World Bank identified first aid training as a cost-effective way to save lives in Sub-Saharan Africa. Although well-intentioned, first aid training in Sub-Saharan Africa often depends on didactical materials from non-African settings. This may lead to misdirected, inadequate or even harmful training instructions.

Objectives: To produce and implement evidence-based guidelines on how to train basic first responders to manage emergency situations in an African context.

Methods: Two authors searched 8 databases (including MEDLINE, EMBASE, The Cochrane Library, AFRICAN INDEX MEDICUS) to identify relevant evidence on the effectiveness, safety, and feasibility of various first aid procedures. A separate search was done for studies on African cultural remedies and preferences. A multidisciplinary panel of eleven African experts discussed each recommendation until they reached agreement. The quality of evidence and strength of recommendations were determined according to GRADE. Four peer reviewers revised the guidelines. To implement the guidelines we developed a flexible didactic materials kit and an implementation guide. Between June and December 2010 we piloted the training materials and implementation guide in Uganda and Swaziland.

Results: Overall we screened 24,000 references and selected 143 publications for the guideline. It is planned to implement AFAM in the Red Cross national societies from Namibia, Mozambique, South Africa, Malawi, Uganda, Swaziland, the Comoros and Kenya. At the colloquium we will present results of the guideline and discuss experiences with its implementation.

Conclusions: This project allowed us to learn about successful first aid practices that made the best use of the limited resources available.