Speaker
Description
Background: Despite growing government concerns in Ethiopia over the recent years to improve utilization of Emergency Medical Services (EMS), it is still unmet need of the community. Moreover, there is a scarcity of research that has been conducted to assess its utilization in Ethiopia.
Objective: This study is aimed at assessing the practice, barriers, community-led perceived solutions, and factors associated with EMS utilization among patients attending to the emergency departments in public hospitals of East Gojjam zone.
Methods: A multi-center, institutional-based, cross-sectional study design using a mixed sequential explanatory approach was conducted. Systematic random and purposive sampling techniques were used to select the study participants. Interviewer-administered questionnaires, in-depth interviews, and key-informant interviews were used to collect the data. Data were collected using KoboCollect software and then exported to STATA version 17 for analysis. A binary and multivariable logistic regression models were used. The audio records of qualitative data were transcribed, translated, coded, and analyzed using thematic analysis. Finally, the result of qualitative data was summarized with narration.
Results: A total of 428 study participants were included in this study. More than half (54.7%) of the study participants were males and about 187 (43.7%) had no formal education. This study found that only 16.6 % of the study participants used an emergency medical services. Factors positively associated with utilization were knowing the ambulance call (AOR=2.68; 95% CI: 1.05, 6.82), presenting at the emergency department during the night (AOR=6.60; 95% CI: 3.15, 13.83), having a triage score >7 (AOR=9.76; 95% CI:4.07, 23.44), and having prior experience of ambulance use (AOR=2.99; 95CI%: 1.28, 6.99). The presence of armed conflicts, unavailability of road infrastructure, delayed responses from ambulance drivers, and a lack of ambulance vehicles in kebele were the major barriers for ambulance utilization. The participants suggested that improving community awareness, deploying ambulances at health facilities, and resolving of the current conflict were the perceived solutions.
**Conclusion and recommendations: ** The utilization of emergency medical services in the East Gojjam Zone was low. Thus, resolving the armed conflicts, improving community awareness, and coordination of available resources are essential to improve EMS utilizations.
