Perceived Use of Health Care Service: Barriers to Access Prehospital Care in Jimma City, Oromia 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 an interview-based qualitative study of key prehospital stakeholders in Jimma, conducted in February 2018. A purposive sample of individuals from the community and local ambulance organizations was 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 limited number of ambulances, the lack of a toll-free emergency number, the lack of a single organized EMS system, a lack of uniform prehospital care protocols, inconsistent and limited training of ambulance crews, public mistrust of the existing system, poor road infrastructure, and limited public understanding of the role of prehospital care. Respondents suggested that establishment of a formalized prehospital care system, investment in infrastructure, establishment of a toll-free emergency number, public awareness campaigns, and more widely available emergency medical training were feasible solutions to these current barriers to access.Conclusion: Multiple barriers to accessing prehospital care were identified in Jimma. Establishing a formalized, 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.