Barriers and Priorities for Strengthening Prehospital Trauma Care in Hawassa, Ethiopia.
The Journal of surgical research · 2026-10-28 · Observational study
Abstract
INTRODUCTION: Prehospital emergency care remains underdeveloped in Ethiopia, particularly outside Addis Ababa. This study assessed frontline provider perspectives on barriers and priorities for strengthening prehospital trauma care in Hawassa. METHODS: We surveyed 57 emergency care personnel at Hawassa University Comprehensive Specialized Hospital and Hawassa Dispatch Center in April-May 2025. The 35-question survey, adapted from the World Health Organization Prehospital Emergency Care Assessment Tool, assessed infrastructure, workforce, protocols, communication, and governance. Direct operational questions were analyzed among prehospital personnel only. Questions addressing the prehospital-hospital interface were summarized separately for prehospital and hospital-based personnel. RESULTS: Among prehospital personnel, long distances to facilities were the leading infrastructure challenge (47%, 7/15), whereas inadequate training (47%, 7/15) and burnout (40%, 6/15) were the main workforce concerns. Airway management was the top training priority (67%, 10/15 first choice). Top protocol gaps were poor adherence (40%, 6/15) and inadequate training (27%, 4/15). Among prehospital and hospital-based personnel, respectively, equipment use and maintenance was selected as the leading training need by 40% (6/15) and 33% (14/42), whereas emergency medical procedures were selected by 33% (5/15) and 29% (12/42). Staff recruitment and retention was the leading funding priority in both groups, selected by 47% (7/15) and 45% (19/42), respectively. Improved infrastructure and road conditions were selected as the highest priority for addressing ambulance response times among 67% (10/15) and 62% (26/42), respectively. CONCLUSIONS: Emergency care personnel identified gaps in infrastructure, equipment, training, protocols, and coordination. Priorities for intervention included restoring the emergency hotline, standardizing ambulance equipment, providing xABCDE-focused training, and implementing standardized handover protocols.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Implementation · Interagency collaboration · Low- and middle-income settings · Rural & remote
Related articles
- Assessment of the status of prehospital care in 13 low- and middle-income countries. (Prehosp Emerg Care, 2012)
- Perceptions of leadership, motivation, structure, and assurance for implementation of emergency medical services in Ethiopia: Perspectives of emergency medical services case teams based on focus group discussions. (Hum Antibodies, 2019)
- Benefits and Limitations of a Community-Engaged Emergency Referral System in a Remote, Impoverished Setting of Northern Ghana. (Glob Health Sci Pract, 2016)
- Development of emergency medical services in Guatemala. (Prehosp Emerg Care, 2004)
- Evaluation of a Rural Emergency Medical Service Project in Germany: Protocol for a Multimethod and Multiperspective Longitudinal Analysis. (JMIR Res Protoc, 2020)
- Developing emergency medical care policy across Kenya: A framework for policy development. (Afr J Emerg Med, 2024)