Impact case study: Advancing trauma recovery through early rehabilitation in humanitarian settings

Background

Trauma injuries are a major burden in humanitarian crises, but trauma care has traditionally focused on survival rather than recovery. Evidence on early rehabilitation was limited, and existing tools for measuring patient functioning were not designed for humanitarian settings. This limited the integration of rehabilitation into trauma programmes and created a need forpractical, context‑appropriate evidence and tools.

The study

Conducted by Humanity & Inclusion, Médecins Sans Frontières and Karolinska Institutet across Burundi, Cameroon, Central African Republic, Haiti, Iraq and Yemen, the study assessed the Activity Independence Measure for Trauma and tracked recovery among 554 trauma patients over six months. It tested the tool’s relevance, validity and reliability, and examined factors linked to recovery, including early physiotherapy.

Findings and impact

• Refined the AIM‑T from 20to 12 activities, improving its usability and contextual relevance.
• Validated AIM‑T as a reliable tool for measuring independence after trauma in humanitarian settings.
• Showed that many patients still faced pain, reliance on assistance and delayed return to work six months after injury.
• Found that early physiotherapy within 48 hours of admission was associated with greater independence at discharge and after three months.
• Supported adoption of AIM‑T in MSF and HI trauma programmes, improving monitoring for more than 7,000 patients.
• Contributed to stronger organisational focus on early rehabilitation, including new guidance, training and technical roles.
• Generated wider sector interest, including from WHO Emergency Medical Teams and the International Committee of the Red Cross.

Lessons learnt

• The AIM-T and research outputs, particularly clinical guidance and online training, responded directly to practitioner demand and was informed by operational, field and clinical realities, making them more relevant and more likely to be used.
• The complementarity between the two phases – one validating the tool rigorously and the second demonstrating the value of early rehabilitation in practice by applying the tool – developed a robust evidence base for change.
• Embedding the lead researcher within a humanitarian organisation through a funded role strengthened partnership quality, co-production and trust.

Partners

Humanity & Inclusion, Médecins Sans Frontières and Karolinska Institutet.

Methodology

R2HC captures detailed case studies through a process that triangulates and validates evidence on uptake and impact. The case study methodology and full version of this summary case study including references are available on request. Outputs and resources from this study are available on the project page.