Health and Wellness

(1)(a) The Emergency First Aid Responders (EFAR) Programme has trained community members across the Western Cape over a number of years as part of a structured, community-linked emergency response model.

Internal programme records indicate continued training delivery between 2020 and 2025 with a total of 12 624 participates trained.

The 2025 Principal’s Annual Quality Report further confirms that EFAR training was implemented across all EMS districts, with 253 training sessions conducted during the reporting period.*

(1)(b) Participants are recruited through community-based processes informed by local need, context and implementation readiness.

The EFAR model is designed as a community-oriented, context-adaptable system, where local structures and stakeholders play a central role in identifying appropriate participants. This approach supports community ownership and helps ensure that responders are embedded within the environments they serve.

In practice, participants are identified through community organisations, local networks, and stakeholder engagement processes, with a focus on individuals who are well positioned to contribute to early emergency response within their communities.

(1)(c)(i) The EFAR Programme does not have a dedicated standalone budget allocation.
(1)(c) (ii) Implementation is supported through a combination of existing College of Emergency Care and district-level resources, subject to the availability of funds.

As a result, EFAR expenditure is not always recorded as a separate budget line and any formal financial figures would need to be confirmed from the relevant departmental financial records.

(d) The standard EFAR training package consists of four core modules:

• scene management;
• unconscious patients;
• trauma; and
• medical emergencies.

Training includes practical emergency care skills such as scene safety, CPR, airway management, bleeding control, splinting, and recognition of medical emergencies.

The standard course takes about 10 hours over one to two days to complete and includes interactive lectures and group practicals. It is followed by a written multiple-choice and short-answer assessment, live skill assessment, and group patient simulation.

In addition to the core responder training package, the programme also includes EFAR Train-the-Trainer pathways, which help build local instructor capacity by preparing both EMS personnel and suitably experienced community-based responders to support training delivery within their own communities. The programme also introduced online or blended learning support options during the COVID-19 period, and these remain available where applicable.

(2) Yes. There is a published article on the EFAR Programme, namely:

Slingers M, De Vos S, Sun JH. Ten years of the community-based emergency first aid responder (EFAR) system in the Western Cape of South Africa. African Journal of Emergency Medicine. 2022;12:299–306.

This article provides a comprehensive overview of the programme’s development, implementation, reach, lessons learnt, challenges, and future directions. It describes EFAR as a low-cost, adaptable and scalable community-based prehospital emergency care system designed to complement formal EMS services. A copy of the published article can be found here: https://pubmed.ncbi.nlm.nih.gov/35892007/.

(3)(a) Resources provided to EFAR-trained community members primarily include training, certification, and EFAR identity cards.

Upon completion of training, EFARs receive a renewable certificate and verifiable EFAR identity card recognisable by Western Cape Department of Health and Wellness EMS.

The programme also provides refresher and support engagements after training, which help reinforce skills, maintain programme linkage, and support ongoing local responder readiness.

In some areas, local operational arrangements have also been used whereby consumables used by EFARs at an incident scene, such as bandaging materials, may be replaced through ambulance or district support so that responders do not personally carry these costs.

(b) The EFAR Programme operates through partnerships with district EMS structures, community organisations, educational institutions, municipal partners, non-governmental organisations, EFAR Champions, and instructors.

The programme is implemented through collaboration between EMS and communities, with local stakeholders and community structures playing an active role in shaping implementation, identifying participants, and supporting local responder networks.

A key aim is to build sustainable partnerships in which local organisations increasingly take ownership of the programme within their own communities.

For this reason, the programme includes EFAR Train-the-Trainer pathways to develop local instructor capacity, including among community-based individuals already embedded in the areas served, so that training and support can increasingly be sustained at local level.

The broader EFAR model also includes the EFAR Learnership Programme, which supports longer-term system strengthening by creating progression opportunities for selected EFARs to access formal emergency care training pathways through the College of Emergency Care.

(4) Yes. The EFAR Programme continues to expand across communities in the Western Cape.

Expansion is guided by community need, stakeholder engagement, operational feasibility, and available resources. The programme is implemented across all EMS districts and remains actively growing, with sustained training demand and continued community uptake.

Current provincial planning confirms that expansion is request-driven, district-implemented, and centrally coordinated, ensuring that growth remains structured, sustainable, and aligned with institutional capacity.

The 2026/27 Provincial EFAR Training Plan provides a structured basis for provincial coordination, budgeting, monitoring, and reporting, while recognising that actual training volumes depend on requests, community readiness, and available resources.

In addition, ongoing programme development initiatives are informing future expansion, including efforts to further standardise training delivery across different settings and to enhance accessibility for diverse participant groups, including persons with disabilities. These developments are intended to support more context-appropriate, sustainable, and inclusive programme expansion over time.

*Please note: Cumulative totals may include repeat participation across years.