Abstract
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Abstract; Background; ; There is limited information on the state of emergency medical services (EMS) in Uganda. The available evidence is from studies that focused either on assessing EMS capacity and gaps at the national level especially in Kampala or identifying risk factors for specific emergency medical conditions (e.g., injuries). In this study, we sought to provide a snapshot of the state of EMS in Uganda by assessing EMS capacity (pre-hospital and hospital) at both the national and sub-national (district) levels.; ; Methods; ; We conducted a cross-sectional national survey where we administered structured questionnaires to EMS providers and policy makers from 38 randomly selected districts across seven of the 14 health regions of Uganda. We interviewed district health officers, hospital managers, and pre-hospital EMS providers and collected data on EMS policies and guidelines, medical products, financing, health workforce, service delivery, and information sharing.; ; Results; ; As of the time of data collection, Uganda did not have national or sub-national EMS policies and guidelines to guide emergency health work. In addition, there was no functional universal toll-free number for emergency response in the country. However, Ministry of Health officials indicated that a taskforce has been set up to lead development of national EMS policy, guidelines, and standards including establishment of a toll-free emergency number. At the sub-national level, we found that majority of ambulances lacked the products and supplies needed to provide pre-hospital care, and mainly functioned as emergency transport vehicles, with no capacity for medical care. Only 16 (30.8%) of the 52 pre-hospital providers assessed had standard ambulances, with the remaining 36 (69.2%) providers having improvised ambulances that were not equipped to provide pre-hospital care. In addition, the police and bystanders were the first responders to the majority (>90%) of the emergency cases.; ; Conclusion; ; Our findings reveal weaknesses at every level of what should be a critical component in the health care system – one that deals with the ability to treat life-threatening conditions in a time sensitive manner. The MOH needs to speed up efforts to provide policies and guidelines, and to increase investments for the creation of a functional EMS in Uganda.