Facilitators and barriers influencing the provision of prehospital care following road traffic crashes in Rwanda: a descriptive qualitative study

Background Prehospital care is essential for improving outcomes among road traffic injury victims. In low- and middle-income countries such as Rwanda, prehospital healthcare providers often face contextual barriers that may hinder timely and effective care, while certain facilitators may support service delivery. This study aimed to explore the facilitators and barriers influencing prehospital care delivery post road traffic accidents in Rwanda. Methods A descriptive qualitative study was conducted among 20 purposively selected prehospital healthcare providers from Service d’Aide Médicale d’Urgence, the Rwanda Red Cross, and Ruhengeri Level II Teaching Hospital, representing urban and rural settings in Rwanda. Data were collected through face-to-face in-depth interviews conducted between December 2025 and January 2026 using a semi-structured interview guide. Data were analyzed inductively using thematic analysis supported with ATLAS.ti version 24. Results Two overarching themes emerged: facilitators and barriers influencing the provision of prehospital care following road traffic accidents. Facilitators included provider experience and motivation, in-service training, digital communication and triage tools, police collaboration, adequate medical supplies, supportive leadership, and community assistance. Barriers included traffic congestion, staffing shortages, limited training opportunities, inadequate equipment, ambulance scarcity, insufficient hospital bed capacity, communication challenges, limited public awareness of emergency access, and weak coordination between ambulance services and hospitals. Conclusion Prehospital care provider motivation, training, leadership, communication systems, and collaboration with police and communities facilitate prehospital care delivery in Rwanda. However, workforce shortages, limited public awareness, inadequate resources, weak coordination, insufficient clinical protocols, and limited receiving facility capacity continue to hinder timely and quality care. Strengthening these areas may improve prehospital emergency care.