Surgeons need to know that a five-year collaboration in Ethiopia significantly improved trauma care capacity at Hawassa University Hospital.

• Trauma care scores rose in provider knowledge, infrastructure, supplies, and hospital processes.
• Clinical gains for specific injuries were limited, pointing to room for improvement.

Investing in human resources remains critical, as this area saw no improvement and is still the weakest domain.

• Effective prehospital systems play a vital role in enhancing trauma outcomes in low-resource settings.