Provision of Emergency Medical Services in Rural and Urban Saudi Arabia: An overview of personnel experiences

Abstract

Objective: Pre-hospital emergency medical services (EMS) are a vital component of health management, however there are disparities in the provision of EMS between rural and urban locations. While rural people experience lower levels of pre-hospital care, there has been little examination of the reasons underpinning these differences through discussion with the providers of EMS, and particularly in countries other than the USA, UK and Australia. The purpose of this paper is to provide an overview of the lived experience of EMS personnel in Saudi Arabia regarding the key issues they face in their work practice.

Design: This research focussed on frontline workers and middle-level station managers within the Saudi Arabian EMS system and adopted a hermeneutic phenomenology design to better understand the factors contributing to observed disparities between rural and urban areas in Riyadh region in Saudi Arabia. A semi-structured interview approach was used to collect data reflecting realistic experiences of EMS personnel in both urban and rural locations.

Results:20 interviews (10 each with rural and urban personnel) were undertaken. Data analyses identified three primary thematic categories impacting EMS delivery: EMS personnel factors; Patient factors; and Organisational factors. Underpinning each category were sub-themes, including working conditions, stress, education and training, and resources, amongst others.

Conclusions: The quality and efficiency of EMS services, in both rural and urban areas, was affected by a number of over-arching organizational factors. Implementing major policy shifts, such as recruitment of female EMS professionals, will be critical in addressing these challenges, but is acknowledged that this will take time. Quicker changes, such as improving the advanced training options for rural EMS staff, may help to remediate some of the issues. Public awareness campaigns may also be effective in addressing the identified misconceptions about the role of EMS in Saudi Arabia.