the course | the skills


CNIS established the Fundamental Interventions, Referral and Safe Transfer (FIRST) course because too many low risk cases are referred, while high-risk conditions are being delayed or not transferred safely to referral centers. This course is designed for Health Officers, who are the first people to see a patient, even in serious cases.

The Course

FIRST course in Sengerema, Tanzania 2012. Photo © R. Lett

FIRST was piloted in Awassa, Ethiopia in August, 2009. Content and organization were changed and re-tested in Jimma, Ethiopia in September, 2009.

The purpose of the course is to enable health officers to prepare appropriate priority management plans for their patients and to obtain fundamental skills in first line, basic surgical care. The FIRST course has been developed to meet the specific learning needs of health professionals at health centres throughout Africa and is adapted from the content of CNIS’ Essential Surgical Skills and Trauma Team Training courses.

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The Skills

FIRST casting lesson in Sengerema, 2012. Photo © R. Lett

During the course, health officers will learn to perform the following skills: Scrubbing, gloving and draping techniques, knot tying, small procedures, field block, suturing lacerations, ketamine, basic life support, casting, splinting, and skin traction, inserting tubes, normal and breech delivery and vacuum extraction. The students will also learn to assess patients to determine who needs priority referral and prepare patients for safe transfer.

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