[5] As motorization increases in low- and middle-income countries, the global burden of injury is projected to expand in these settings.
Initial work by Jared Sun and Lee A. Wallis training community members as emergency first aid responders in Manenberg, South Africa eventually led to the creation of the EFAR System Model in 2012.
[9][10] Though it was designed to support the development of formal emergency care systems, the EFAR system model has primarily served to alleviate inconsistent and unreliable response times of emergency services in the Cape Town area, with some expansion into Zambia in 2015.
Motorcycle taxi drivers who were closest to road traffic injuries, possessed a means of transport, and self-dispersed in search of customers (providing wide geographic coverage) were then trained as lay first responders.
[13] In later studies, findings were replicated in Chad and Sierra Leone by LFR International with thousands of other motorcycle taxis,[2][3] with results demonstrating training lay first responders significantly expanded prehospital care availability cost-effectively.