Prehospital Care System in Low-Resource Setting: Experiences Learned from Newly Established System in Jimma City, Southwest of Ethiopia

Effective emergency care systems could avert a significant portion of the high morbidity and mortality rates attributed to acute illness. Such a system should be structurally integrated, in a continuum style, where care is continuously given in a coordinated sequence. Prehospital care is an important part of the health continuum, but it has been neglected in most African countries for many reasons, mainly due to poor advocacy and a lack of a model to organize the system. A low-resource model was used to establish a formal prehospital care system in Jimma City, the largest city in the south-western part of Ethiopia. A hybrid hospital-based system complemented by volunteer systems was used to establish a local emergency medical service (EMS) system, named Aayyoo Ambulance. The establishment process was financially supported by the government and officially started its operation in October 2020. Initially, emphasis was placed on the foundation of the core elements of the system, and a toll-free phone number (6238) was dedicated to the dispatch center to receive calls and provide a tier-based response. As of the first anniversary, more than 1600 emergency calls were served while a computer-aided dispatch system was implemented. The purpose of this article is to describe the prehospital care system's establishment process, and lessons learned in Jimma City.