Our country initiatives follow a comprehensive approach based on the needs of individual countries to improve fracture care, which we identify after a thorough needs assessment.


The initiatives combine education and training using curricula recognized by the relevant authorities, and include reverse fellowships, clinical research, and clinical infrastructure development support. This ensures that every healthcare worker recruited and trained has the tools and training to execute their job successfully and efficiently. None of our trained surgeons and local implementation partners have jumped ship for greener pastures. We have country initiatives in Malawi (2016), Ghana (2017), Ethiopia (2017), the Gambia (2019), and Burkina Faso (2021).

The Malawi Country Initiative

The Malawi Country Initiative’s goal is to increase the number of orthopedic surgeons and equip all district hospitals with trained orthopedic clinical officers. We run clinical research to collect data on injuries in two district and two central hospitals. The results are shaping the care needed and influencing national health policies. Two new operating rooms built at the Queen Elizabeth Central Hospital are increasing the number of injured patients that can be treated surgically.

The Ghana Country Initiative

The Ghana Country Initiative was launched in 2017, with the aim of increasing capacity for trauma and orthopedic surgeon training, access to appropriate fracture care education, clinical research, and auditing. In 2020, we launched a three-year vocational training program for plaster technicians, leading to a plaster technician diploma at the Trauma and Orthopaedic Training School at the St John of God Hospital in Duayaw-Nkwanta, Kumasi.

The Ethiopia Country Initiative

The Ethiopia Country Initiative aims to improve the quality of and access to trauma care by training healthcare workers. Since 2015, we, along with our partners, have been supporting the development of a top-notch orthopedic trauma team at the Hawassa University Comprehensive Specialized Hospital (serving a catchment area of 18 million) and building capacity in fracture care management as part of the government’s efforts to decentralize the public trauma system.

The Gambia Country Initiative

The Gambia Country Initiative launched in 2019, with the assistance of AO Trauma, to develop a comprehensive trauma system for improved patient outcomes by fostering an enabling environment for cooperation between the government, researchers, healthcare workers, NGOs, and the WHO.

The Burkina Faso Country Initiative

It is estimated that if the quality of trauma care in LMICs matched that of high-income countries, then one-third of all trauma-related deaths could be avoided. It is with the goal of improving access to timely and appropriate trauma care in Burkina Faso, that the AO Alliance launched the initiative in 2021.

Togo Country Initiative

Launched in January 2024, the AO Alliance Togo Country Initiative has an ambitious goal – to transform fracture care at the national level. Through intensive training and capacity-building programs, the AO Alliance is empowering Togolese trauma and orthopedic surgeons, residents, nurses, and paramedics with the knowledge and skills needed to provide high-quality fracture care.

In addition to the flagship teaching hospital CHU-Sylvanus Olympio in Lomé, the initiative will cover Kara in the north, and nearby rural communities, providing an integrated trauma system for efficient and effective referrals. The expected impacts of the initiative are a reduction in the incidence of untreated fractures, and the improved efficiency of the once overburdened healthcare system.