Submission ID 117031
| Issue/Objective | Emergency Medical Services (EMS) are vital for reducing morbidity and mortality in low- and middle-income countries (LMICs), yet rural-urban disparities persist in access and quality. Rivers State, Nigeria, exemplifies these challenges, with about 45% of its 9.4 million residents in rural areas facing geographic and systemic barriers. This study aimed to identify systemic barriers and opportunities in EMS utilization, focusing on accessibility, acceptability, availability, affordability, and appropriateness. Addressing these disparities is critical to improving health equity and outcomes in LMICs. |
|---|---|
| Methodology/Approach | A qualitative study was conducted using the Levesque framework to explore healthcare access from both health system and patient perspectives. Twenty purposively selected stakeholders; healthcare providers, policymakers, community leaders, and EMS users, participated in focus group discussions in Port Harcourt. Thematic analysis of transcribed discussions was performed using ATLAS.ti, with codes grouped into recurring themes. |
| Results | Thematic analysis identified barriers across five dimensions: accessibility (delayed response times, poor communication, geographic isolation); acceptability (cultural preferences for faith-based interventions); availability (inadequate infrastructure, staffing shortages); affordability (high out-of-pocket costs, corruption); and appropriateness (gender and mental health disparities). Rural areas faced compounded challenges, including limited ambulance coverage. Opportunities included community first-responder training, technology integration (e.g., GPS tracking), and partnerships with NGOs to bridge service gaps. |
| Discussion/Conclusion | The findings underscore the urgent need for policy reforms to decentralize EMS management, enhance funding, and integrate multi-sectoral collaborations. It is also important to prioritize public awareness campaigns, subsidize costs, and leverage technology in mitigating rural-urban disparities. Scaling community-led initiatives and NGO partnerships offers a sustainable pathway to equitable EMS access. This study contributes actionable insights for policymakers and stakeholders to strengthen Nigeria's EMS systems, aligning with global efforts to achieve universal health coverage and reduce preventable mortality in LMICs. |
| Presenters and affiliations | Adaeze Oreh Rivers State Ministry of Health Oluwaseun Adewunmi Emergency Response Africa Ihuoma Opelia-Ezeh Rivers State Ministry of Health Olatunde Raimi Rivers State Ministry of Health Olufemi Onasanya Emergency Response Africa Sylvanus Ojum Rivers State Ministry of Health Dede Siyeofori Rivers State Ministry of Health Kinikanwo Green Rivers State Ministry of Health Folake Owodunni Emergency Response Africa |
