Our Mission

Our overarching mission is to improve global neurotrauma care. We aim to achieve this through a series of projects and activities focussing on various aspects of traumatic brain injury (TBI) care in low and middle income countries (LMICs).

Our Rationale

According to the WHO, more than 5 million people die every year (14,000 every day) as a result of trauma, accounting for 9% of the world’s deaths. Trauma also results in millions of non-fatal injuries leading to life-long disability. Of all the types of injuries, those to the brain are the most likely to result in death or permanent disability. About 90% of injury-related deaths occur in LMICs.

The WHO recognises that “improving the organization, planning and access to trauma care systems, including prehospital and hospital-based care, can help reduce the effects of injuries”. In addition, it has called for an increased focus on systems thinking for strengthening heath systems in LMICs.

We have made considerable progress in the treatment of traumatic brain injury (TBI) in the UK and other high income countries (HICs) and it now essential that we translate this to LMICs.

The proposed NIHR Global Neurotrauma Group aims to work initially with partners in Colombia, Ethiopia, India, Indonesia, Malaysia, Myanmar, South Africa, Tanzania with the aim of improving the care of patients with traumatic brain injury (TBI). We propose 4 themes to the project.

Our 4 themes

3-year project plan

Theme 1 – Mapping TBI Care

We will define the current landscape of TBI care in LMICs (provision of pre-hospital care, acute hospital care and post-acute care). We will map resources and establish neurotrauma registries of patient demography, treatment and outcome.

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Theme 3 – Generating and Implementing Innovation in TBI

Following data collection and modelling from themes 1 and 2, we will implement strategies to refine the TBI management pathways and apply novel approaches tailored to the LMICs. These will be prioritised based on the analysis undertaken in Themes 1 & 2. However, following discussion with LMIC partners we have already nominated four exemplar projects. These will include improved methods of investigation (early detection of blood clots, measurement of brain pressure and swelling), treatment (including refinements in surgery) and outcome data collection (long-term follow-up by SMS, smartphone).

Theme 2 – Understanding TBI Care

We will use a systems engineering approach to develop an in-depth understanding of the challenges associated with improving TBI care in terms of frameworks, stakeholders and critical issues.

Theme 4 – Measuring and Nurturing Research Capacity

We will determine the types of research output from LMICs and resources available for research, and nurture capacity by various mechanisms including research methods courses in partnership with the BMJ (Research to Publication programme).

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