Joy Mackey, MD
Joy Mackey, MD
Emergency Medicine · Houston, TX


ETAT Training of Trainers in Belize


February 3rd
Corozal, Belize

Project Description

Baylor College of Medicine (BCM) and Texas Children's Hospital (TCH) have partnered with the Ministry of Health and Wellness (MOHW) and Karl Heusner Memorial Hospital Authority (KHMH) in Belize since 2015 offering continuing medical education training to nursing and physician staffing focused on pediatric emergencies. The World Health Organization (WHO)’s Emergency Triage Assessment and Treatment (ETAT) is a 2-day, evidenced-based course that teaches pediatric assessment, triage and initial management to healthcare workers (HCWs) in resource-limited settings and includes a 1-hour basic introductory module for support staff. ETAT-based training triage systems paired with training of HCWs have improved pediatric outcomes worldwide. Belize, with an under 5 mortality rate of 1.1%, trained 387 HCWs in ETAT from 2016-2020. After a pause during the Covid pandemic, training resumed in 2022 utilizing a staged regional model of training-of-trainers (ToT). Since 2022, an additional 250 HCWs have been trained in ETAT in a phased manner from region to region. This will be the first training of trainers for the Northern Region.

Population Served

As mentioned above, HCWs in Belize have little training in pediatric emergencies. This kind of training provides a sustainable high-impact to the healthcare system as we are training local HCWs as trainers to train their colleagues. The entire pediatric population in the northern region will benefit from this project. This is the only region in Belize that has yet to have a dedicated training team in the region.

Expected Impact

We expect improvements in pediatric emergency care and outcomes in the northern region of the country. Learnings will carry forward as local HCWs will now be the regional champions and ETAT training team to train their colleagues.


Trip Photos & Recap

We successfully trained 14 new Emergency Triage Assessment and Treatment (ETAT) trainers in the Northern Health Region in Belize. These new trainers will go on to teach their colleagues in the North ETAT to improve pediatric emergency care in the region.