BackgroundNigeria is ranked second highest in the rate of road accidents and other emergencies (Deaths, disabilities) among 193 countries of the world. There is therefore the need for analyzing Emergency Medical Rescue Services (EMRS) in the country to identify options for improvement.MethodThe study was conducted from February, 2016 to March, 2017 in three EMRS organizations (FRSC, NEMA and MAITAMA Hospital) located in Abuja. The structure, resources, process of EMRS activities and outcome (delay times, case fatality as well as victims and service-providers satisfaction with services) were assessed through observation, time measurements and interviews.ResultsFRSC and NEMA offers (Road Traffic Injury) RTI and Disaster services, the ambulances consist of Intensive Care Unit(ICU) buses, Helicopters, Speed boats, motorbikes and other specialized vehicles. Mortality and morbidity recorded for 2016 was 1.1 and 2% respectively. MAITAMA is a specialist centre that offers general medical services. A total number 1227(88.8%) lives were saved during the observational period by three organizations, 60(4.9%) deaths, 132 (9.6%) disabilities, 793 (57.2%) NCDs and 593(42.8%) RTI.ConclusionNon-communicable diseases (NCDs) cause many deaths and morbidities in the developing world compared to infectious diseases. There is need for total revamping and education of EMRS institutions in Nigeria and Low- Middle Income Countries (LMICs). Abuja and its surroundings suffers from delays in rapid emergency services, lack of adequate awareness, functional ambulances, minimal specialists and inadequate consumables lead to the loss of many lives.

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Background: Deaths and disabilities due to the lack of proper Emergency Medical Rescue Services (EMRS) is a global public health concern, also in Dhaka city, Bangladesh.The study aimed at contributing to improve the EMRS in Dhaka city by assessing and identifying major shortcomings with possible solutions. Methods:The study was conducted in July/August 2017, after analyzing medical and relevant records, a one week observational study was conducted in 4 purposively selected hospitals in Dhaka city. The Mode of transport to the emergency centre and delay times were determined by observing and assessing medical records of the incoming patients. Information on the management of incoming emergency calls and trips of the ambulances were also documented. Satisfaction and perceived experience with the services was investigated by in-depth interviews of 56 patients relatives. 23 EMRS providers and managers were interviewed for their perceptions and recommendations.Results: Our document analysis of 2 study hospitals in Dhaka showed that 45.9% of total deaths (N = 13707) in 2014 were due to cardiovascular diseases, road traffic incidents, other accidents, and suicides. During the observation in 4 study hospitals, only 11.3% of the 734 emergency patients used ambulances to get to hospital, while 63% used rickshaws/motor-rickshaws and 25.8% bus/ car. 55.6% of emergency patients got to hospital after 60 minutes/later after start of symptoms (median delay 120 minutes; range: 40-2880 minutes). The median delay of ambulances (call to hospitalization) was 85 minutes (day-time 102 minutes; night 45 minutes). On emergency request only 23.6% of the 127 callers, a hospital ambulance was sent to the patient, while the other cases were not supported due to unavailability, long distance, and high fare issues of ambulance. Ambulances were used in only 10.7% of their available time for transporting patients. Ambulances were poorly equipped (unskilled driver, oxygen and rarely with first aid box). Satisfaction level about current services among patients relatives was low (only 1.8 on a scale of 4; N = 56). Major reasons of their not calling for an ambulance at emergencies were unavailability (67.3%) and unknowing phone number (51.9%). EMRS providers and managers complained about the poor structure of EMRS. Major concerns were: Policy deficit, corruption, no coordination centre with unique phone number, poor ambulance services, and traffic-jams. Conclusion:To reduce the number of deaths and disabilities, Dhaka needs to upgrade and improve its EMRS through a step-by-step process of telephone assisted emergency first responders led pre-clinical care.

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