First On Scene: A Scoping Review Of Community-based Prehospital Trauma Response In Uganda

First On Scene: A Scoping Review Of Community-based Prehospital Trauma Response In Uganda

Abaho Abbott , Jonathan Babuya, Charles Luggaju, Felix Oriono, Arnold Atuhaire, Daphine Ampaire, Brian Kasagga
Mbarara University Of Science and Technology, Mbarara City, Uganda; Incision Group Uganda, Gulu, Uganda

Introduction: Access to timely prehospital trauma care (PTC) remains a public health challenge in Uganda. Consequently, communities rely heavily on informal first responders such as bystanders. Despite their critical role, there is no national synthesis of their contributions or integration into the formal health system.

Aim: To synthesize evidence on the roles, outcomes, and system integration of community-based trauma responders in Uganda’s PTC.

Methods: A scoping review was conducted using PubMed and Google Scholar to identify studies describing community responders involved in PTC in Uganda. Studies outside Uganda or hospital-based were excluded. Data extracted included responder types, study characteristics, outcomes, barriers, enablers, and health system integration. Thematic synthesis was guided by the WHO Emergency Care Systems (ECS) Framework.

Results: Of 92 articles screened, 17 met inclusion criteria, spanning 2009-2025. 53% focused on urban areas, mainly Kampala. The most covered ECS domains were Training and Knowledge (59%), Barriers and Enablers (53%), and System Integration (41%). Community Acceptability and Sustainability (24%) and Activation and Coordination (12%) were less frequently addressed. Boda-boda riders and police officers were the most reported responders.

Conclusion: Community-based responders are pivotal yet under-recognized in Uganda’s trauma care. Enhanced training, formal support, and improved system integration are urgently needed to strengthen prehospital emergency response.

Keywords: Community First Responders, Prehospital Care, Emergency Care Systems , Scoping Review , Uganda