Bangladesh is currently undergoing an epidemic of road traffic accidents (RTAs) and hardly a day passes without a report of such an incident in the media. The latest Global Status Report on Road Safety registered some improvements for Bangladesh concerning safer roads and mobility and safer vehicles but poor performance in areas like gathering accident data, safer road users and post-crash care. A recent Rapid Review found the near absence of pre-hospital care and poor hospital-based care for the victims of the Road Traffic Crashes (RTC) which needs to be addressed urgently if we are to reduce morbidity and mortality from the RTAs.
The importance of Trauma Registry ("a collection of data on the incidence, diagnosis, and treatment of trauma victims that (should) drive a performance improvement program for the care of an injured patient,") for improving trauma care from RTIs and reduce mortality and morbidity, especially in the LMICs cannot be overemphasised. The trauma registry has been an invaluable tool for informing the design of quality trauma care system including planned allocation of resources and injury surveillance over time. However, its implementation in the LMICs face many barriers and challenges, the solutions of which need to be contextualised to the particular situation of a country. The commonly identified barriers include: data quality including missing data, lack of resources, insufficient pre-hospital care, and difficulty with administrative duties and hospital organisation. A Trauma System Improvement Programme (TSIP) informed by a Trauma Registry, and which builds on the existing emergency services, has a better chance of success due to buy-in from the relevant stakeholders, incremental changes that are acceptable and less costly, and contextualised to the real-life situation of the country in question. There are many models of TSIPs in the LMICs but all have some common components: systematic needs assessment involving relevant stakeholders, co-ordination of different components, and corrective actions to address system weaknesses to improve current system.