Teaching first aid to African versus Belgian children: how contextualization of the same evidence results in different guidelines


Oral session: Understanding and using evidence (3)


Wednesday 23 October 2019 - 14:00 to 15:30


All authors in correct order:

Laermans J1, De Buck E2, Vanhove A3, Dockx K1, Vandekerckhove P4
1 Centre for Evidence-Based Practice, Belgian Red Cross, Belgium
2 Centre for Evidence-Based Practice, Belgian Red Cross; Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven; Cochrane First Aid, Belgium
3 Centre for Evidence-Based Practice, Belgian Red Cross; Cochrane Belgium; Cochrane First Aid, Belgium
4 Belgian Red Cross; Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven, Belgium
Presenting author and contact person

Presenting author:

Jorien Laermans

Contact person:

Abstract text
Background: evidence shows that children can learn first aid from a young age. Moreover, the World Bank promotes first aid training of laypeople as a very cost-effective way to decrease disease burden in low- and middle-income countries. As a result, first aid education is slowly making its way into several countries’ school curricula. To support this integration, the Belgian Red Cross developed the 'educational pathway in first aid', an evidence-based tool for first aid trainers indicating the age at which children can acquire certain first aid competences.

Objectives: to assess the impact of context diversity in adapting the educational pathway in first aid, by comparing the final pathways for Belgium and sub-Saharan Africa.

Methods: based on 51 studies on first aid training to children, identified via a systematic Medline and Embase search, we developed a draft educational pathway, which we adapted to either the Belgian or African context, using the input of two separate panels of local experts in health, education and first aid training.

Results: contextual diversity between Belgium and Africa impacted the final educational pathways in several ways. First, as first aid education is integrated in the Belgian curriculum, this pathway was fitted to the school context (organized by grade). In contrast, as first aid training in Africa is mostly introduced in extra-curricular activities, the African expert panel opted to use two-year age categories (age 5 to 6, 7 to 8, and so on). Second, six contextually highly relevant topics, including fever and diarrhoea, were added to the African pathway. Third, limited resource availability influenced several first aid interventions; for example, splinting a broken bone was added in Africa, as it might take several hours to reach medical care. Fourth, first aid competences and/or the age to acquire them were impacted by cultural differences. Figure 1 shows the example of how the African panel adapted the pathway for the topic burns, to ensure early awareness on the dangers of playing or being in the vicinity of open fires, commonly used for cooking.

Conclusions: adapting the same evidence to two highly diverse contexts has resulted in very diverse educational pathways. Using the evidence and translating it to real life has increased the chances of local implementation and effective first training of children in these areas.

Patient or healthcare consumer involvement: involving a Belgian and an African multidisciplinary expert panel resulted in the best possible contextual adaptation of the evidence.