Perspectives on the current state of Nigeria’s emergency care system among participants of an emergency medicine symposium: a qualitative appraisal

Usoro, Agnes; Aiwonodagbon, Benjamin; Strong, Jonathan; Kivlehan, Sean M; Akodu, Babatunde; Olufadeji, Ayobami

doi:10.1136/bmjopen-2020-043869

Cited by 8 publications

(21 citation statements)

References 20 publications

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“…The role of EMS is spread across numerous public and private organizations resulting in lack of resources integration and protocols standardization implying that EMS as a whole is fragmented and are underfunded or inconsistently funded which further reduces the capacity as well as quality of EMS. 4 Similar characteristics of EMS are also evident in countries like Nepal, 5,6 Nigeria, 7 Vietnam, 8 and South Asian 9 and African 10 nations. Sheu and Pan 11 have shown that a centralized emergency supply network in response to a large scale disaster is efficient than a de-centralized system in terms of cost as well as response time.…”

Section: Introductionmentioning

confidence: 79%

A Sustainable Model for Emergency Medical Services in Developing Countries: A Novel Approach Using Partial Outsourcing and Machine Learning

Rathore¹,

PK²,

Parida³

2022

RMHP

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Introduction: Unlike Western countries, many low-and middle-income countries (LMIC), like India, have a de-centralized emergency medical services (EMS) involving both semi-government and non-government organizations. It is alarming that due to the absence of a common ecosystem, the utilization of resources is inefficient, which leads to shortage of available vehicles and larger response time. Fragmentation of emergency supply chain resources motivates us to propose a new vehicle routing and scheduling model equipped with novel features to ensure minimal response time using existing resources. Materials and Methods:The data set of medical and fire-related emergencies from January 2018 to May 2018 of Uttarakhand State in India was provided by GVK Emergency Management and Research Institute (GVK EMRI) also known as 108 EMSs was used in the study. The proposed model integrates all the available EMS vehicles including partial outsourcing to non-ambulatory vehicles like police vans, taxis, etc., using a novel two-echelon heuristic approach. In the first stage, an offline learning model is developed to yield the deployment strategy for EMS vehicles. Seven well researched machine learning (ML) algorithms were analyzed for parameter prediction namely random forest (RF), convolutional neural network (CNN), k-nearest neighbor (KNN), classification and regression tree (CART), support vector machine (SVM), logistic regression (LR), and linear discriminant analysis (LDA). In the second stage, a real-time routing model is proposed for EMS vehicle routing at the time of emergency, considering partial outsourcing. Results and Discussion:The results indicate that the RF classifier outperforms the LR, LDA, SVM, CNN, CART and NB classifier in terms of both accuracy as well as F-1 score. The proposed vehicle routing and scheduling model for automated decision-making shows an improvement of 42.1%, 54%, 27.9% and 62% in vehicle assignment time, vehicle travel time from base to scene, travel time from scene to hospital, and total response time, respectively, in urban areas.

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Section: Introductionmentioning

confidence: 79%

A Sustainable Model for Emergency Medical Services in Developing Countries: A Novel Approach Using Partial Outsourcing and Machine Learning

Rathore¹,

PK²,

Parida³

2022

RMHP

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“…Some of these practices, such as the provision of care from untrained family members and bystanders who do not recognize an emergency, may delay care. Others, such as applying direct fire and flame to the feet of a convulsing child to rid them of the evil spirits that caused the seizure, are harmful [18] . Other challenges inhibit the provision of care by bystanders.…”

Section: Discussionmentioning

confidence: 99%

Out of hospital emergency care in Nigeria: A narrative review

Oyedokun

Islam

Eke

et al. 2023

African Journal of Emergency Medicine

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“…The provision of EMS in Nigeria is still nascent after different failed attempts by national and state governments at establishing a comprehensive emergency system in the country. This has resulted in inadequate and often delayed medical care for individuals with medical emergencies [ 16 – 18 ]. Challenges of EMS include a lack of infrastructure, limited resources, and inadequate training [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Strengthening care for emergencies: what is the level of awareness and utilization of Emergency Medical Services (EMS) in FCT, Nigeria?

Nto,

Oluwatola,

Samuel

et al. 2024

BMC Emerg Med

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Background As part of the Federal Government of Nigeria’s desire to increase medical coverage among the citizenry, the National Emergency Medical Service and Ambulance Scheme (NEMSAS) was set up and piloted in the FCT in 2022. To gauge the progress so far, this study sought to assess the level and determinants of public awareness and utilization of Emergency Medical Services (EMS) among residents of the Federal Capital Territory, Abuja. Methods A cross-sectional study was conducted in June 2023 among 1177 respondents residing in FCT Abuja at the time of the survey. Data was collected by trained research assistants using an interviewer-administered questionnaire and purposive sampling was adopted. The level of awareness and the socio-demographic determinants of the level of awareness in the FCT were assessed. Logistic regression was used to find predictors of EMS awareness and utilization. Results 57.8% of respondents are aware of EMS, while 42.2% are not. 62.7% are uncertain about the source of information for EMS with only a minority relying on word of mouth (17.7%), traditional media (11.1%), or social media (8.5%). 91.4% have not accessed or utilized EMS via the toll-free emergency line, while only 8.6% reported doing so. There are median EMS awareness and utilization differences across gender, age, location, and employment status of the respondents. Additionally, the multivariate logistic regression showed that age, location, and employment status are significant predictors of EMS awareness and utilization. Males have lower odds of awareness and utilization of EMS compared to females. Furthermore, there was a significant relationship between EMS access and utilization (Chi-square = 80.748, p < 0.001). However, awareness did not necessarily translate to utilization. Conclusion The relationship between EMS awareness and utilization and the unmasked predictors in this paper should be factored into the design of interventions to increase access and utilization of EMS in Nigeria.

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Perspectives on the current state of Nigeria’s emergency care system among participants of an emergency medicine symposium: a qualitative appraisal

Cited by 8 publications

References 20 publications

A Sustainable Model for Emergency Medical Services in Developing Countries: A Novel Approach Using Partial Outsourcing and Machine Learning

A Sustainable Model for Emergency Medical Services in Developing Countries: A Novel Approach Using Partial Outsourcing and Machine Learning

Out of hospital emergency care in Nigeria: A narrative review

Strengthening care for emergencies: what is the level of awareness and utilization of Emergency Medical Services (EMS) in FCT, Nigeria?

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