Practice of Pre-Hospital Emergency Care and Associated Factors in Addis Ababa, Ethiopia: Facility-Based Cross-Sectional Study Design

Abstract

Background: Medical emergencies require quick field interventions and stabilization before transport, while rapid transportation to definitive healthcare with fewer field interventions improves trauma outcomes. Poor prehospital healthcare practices negatively impact patients’ health, and limited studies exist on providers’ practices in resource-limited areas like Ethiopia. This study aimed to assess the practice of pre-hospital emergency care and associated factors at pre-hospital health facilities in Addis Ababa, Ethiopia. Methods: A facility-based cross-sectional study was conducted 191 pre-hospital healthcare providers, of which 20 randomly selected participants were participated in the observational study from October 2021 to February 2022 in Addis Ababa Ethiopia. Data was collected using a checklist and self-administered questionnaire. Data was cleaned, entered into Epi data version 4.4, and exported to SPSS software for analysis. Binary and multivariable logistic regression analyses were performed, with a P-value of 0.05 considered statistically significant. Results: The study found that 43% (82) of pre-hospital healthcare providers in Addis Ababa, Ethiopia, had good practice in prehospital emergency care. The identified factors that increased the odds of good practice in pre-hospital emergency care were: being able to provide advanced life support (AOR = 88.99; 95% CI: 27.143–291.603); adequate monitoring and defibrillators (AOR = 5.829; 95% CI: 1.430–23.765); having work experience of 4–5 years (AOR = 5.86; 95% CI: 1.424–24.109); and having the opportunity to continue education (AOR = 31.953; 95% 6.479–157.591). Conclusions and Recommendations: The study found high levels of poor practice among pre-hospital healthcare providers in Addis Ababa, Ethiopia. Factors contributing to good practice include being trained in advanced Life Support, adequate monitoring, defibrillators, work experience, and having the opportunity to continue education. Therefore, policymakers and health planners should establish teaching and training centres based on Ministry of Health and Education guidelines. Plain Language Summary: Medical emergencies, such as cardiac arrests, benefit more from quick field interventions and stabilization before transport, while rapid transportation to definitive healthcare with fewer field interventions by trained paramedic professionals improves trauma outcomes. A facility-based cross-sectional study was conducted from October 2021 to February 2022, with 191 prehospital healthcare providers working in prehospital healthcare facilities in Addis Ababa. Participant observational study data were collected using a checklist, followed by a self-administered questionnaire administered by trained data collectors at each prehospital health facility. The identified factors increased the odds of good practice of pre-hospital emergency care, including advanced life support, adequate monitoring and defibrillator, and 4–5 years of work experience and opportunities to continue education. More than half of the prehospital healthcare providers had poor prehospital care practices. Factors that increase the likelihood of good practice include competently performing ALS, adequate monitoring and defibrillation, work experience, and opportunities for continuing education. Policymakers and health planners should establish prehospital healthcare teaching and training centers based on prehospital healthcare guidelines.