The course Fundamental Intervention, Referral, and Safe Transfer (FIRST) has been developed to meet the specific learning needs of health professionals at health centers throughout Africa. The course was originally adapted from the content of three CNIS courses:


  • Essential Surgical Skills Instructor’s Manual (2008) by Dr. Ronald Lett, revised by Dr. Robert H. Taylor
  • Essential Surgical Skills Providers Handbook (2007) by Dr. Robert H. Taylor
  • Trauma Team Training Course – Instructor’s Manual (2005) by Dr. Ronald Lett and Dr. Olive Kobusingye


Day 1              Session 1: Introduction 

1.1 Referral and Safe Transfer

1.2 Patient Priority Management Form

1.2.1 Patient Transfer Form

1.3 Case Studies – Practice exercise


                     Session 2: Wound Management                                                               

2.1 Basic Wound Management Quizzes and Case Studies

2.2 Skill: Hand Washing, Scrubbing, Gloving and Draping Technique

2.3 Skill: Knot Tying

2.4 Skill: Minor Procedures and Field Block

2.5 Skill: Suturing Lacerations


Day 2              Session 3: Obstetrics

3.1 Obstetrics Quizzes and Case studies

3.2 Vaginal   Delivery Cephalic and Breech

3.3 Skill: Vacuum Assisted Delivery and Shoulder Dystocia

3.4 Skill: Retained Placenta, Cervical Laceration

3.5 Skill: Perineal Tear & Episiotomy