Barriers to access prehospital care in Jimma City, Oromiya Region of Ethiopia

Abstract

Background: African nations experience a significant proportion of the global burden of death and disability. The provision of prehospital emergency care has been shown to partially reduce excess morbidity and mortality. However, access to prehospital care in Africa is still limited. This study sought to identify barriers to access prehospital care in the city of Jimma, Ethiopia. Methods: This is phenomenological qualitative study conducted in February 2018, among key stakeholders for prehospital care in Jimma. A purposive sample of individuals from the community and local ambulance organizations were selected for interviews. Interviews were conducted in local languages, translated into English, and then coded for consistent themes.  Results: All respondents felt that prehospital care was difficult to access and therefore infrequently utilized. This was due to a combination of a fragmented and under-resourced system, including lack of single dial number and limited number of ambulances; providers availability and practice; poor road infrastructure; and poor public awareness, misconception and mistrust of the existing service. Respondents suggested that establishment of a formalized system of prehospital care operating on a single dial toll-free number, improved resource allocation, awareness raising and capacity building in the community, improving road infrastructure, and improved emergency medical training would improve access.   Conclusion: Multiple barriers to accessing prehospital care were identified in Jimma. Establishing a formalized and well-resourced prehospital system in parallel with improving community capacity and knowledge building were suggested solutions to improve access. Hence, interventions to improve prehospital emergency care delivery should ideally target these identified barriers and proposed solutions.