Explosive ordnance (EO) and explosive weapons (EW) inflict significant suffering on civilian populations in conflict and post-conflict settings. At present, there is limited coordination between humanitarian mine action (HMA) and emergency care for civilian victims of EO/EW. Key informant interviews with sector experts were conducted to evaluate strategies for enhanced engagement between HMA and emergency care capacity-building in EO/EW-affected settings.

A cross-sectional qualitative study was conducted to interview HMA and health sector experts. Data were analyzed in Dedoose using deductive and inductive coding methods.

Nineteen key informants were interviewed representing sector experts in HMA, health, and policy domains intersecting with the care of EO/EW casualties. Recommendations included integration of layperson first responder trainings with EO risk education, development of prehospital casualty notification systems with standardized health facility capacity mapping, and refresher trainings for HMA medics at local health facilities.

Medical capabilities within the HMA sector hold potential to strengthen emergency care for civilian EO/EW casualties yet in the absence of structured coordination strategies is underutilized for this purpose. Increased HMA engagement in emergency care may enhance implementation of evidence-based emergency care interventions to decrease preventable death and disability among civilian victims of EO/EW in low-resource settings.

Humanitarian mine action (HMA) stakeholders have an organized presence with well-resourced medical capability in many conflict and post-conflict settings. Humanitarian mine action has the potential to positively augment local trauma care capacity for civilian casualties of explosive ordnance (EO) and explosive weapons (EWs). Yet at present, few strategies exist for coordinated engagement between HMA and the health sector to support emergency care system strengthening to improve outcomes among EO/EW casualties.

A scoping literature review was conducted to identify records that described trauma care interventions pertinent to civilian casualties of EO/EW in resource-constrained settings using structured searches of indexed databases and grey literature. A 2017 World Health Organization (WHO) review on trauma systems components in low- and middle-income countries (LMICs) was updated with additional eligible reports describing trauma care interventions in LMICs or among civilian casualties of EO/EWs after 2001.

A total of 14,195 non-duplicative records were retrieved, of which 48 reports met eligibility criteria. Seventy-four reports from the 2017 WHO review and 16 reports identified from reference lists yielded 138 reports describing interventions in 47 countries. Intervention efficacy was assessed using heterogenous measures ranging from trainee satisfaction to patient outcomes; only 39 reported mortality differences. Interventions that could feasibly be supported by HMA stakeholders were synthesized into a bundle of opportunities for HMA engagement designated links in a Civilian Casualty Care Chain (C-CCC).

This review identified trauma care interventions with the potential to reduce mortality and disability among civilian EO/EW casualties that could be feasibly supported by HMA stakeholders. In partnership with local and multi-lateral health authorities, HMA can leverage their medical capabilities and expertise to strengthen emergency care capacity to improve trauma outcomes in settings affected by EO/EWs.