Assessment of Prehospital Emergency Care Resources in Urban and Rural Rwanda Using the WHO Health System Framework: A Cross-Sectional Study.

BACKGROUND: Prehospital emergency care is essential for reducing preventable deaths and disabilities from road traffic accidents. Evidence regarding the availability and distribution of prehospital emergency care resources in Rwanda remains limited. OBJECTIVE: This study assessed prehospital emergency care resources across three prehospital systems in Rwanda. METHODS: A descriptive cross-sectional study assessed prehospital emergency care resources using a locally adapted WHO prehospital emergency assessment tool. Key informants from one rural and two urban systems were purposively selected. Data were analyzed descriptively using WHO prehospital emergency system building blocks. RESULTS: Prehospital emergency care resources varied across systems. The urban public system employs 99 providers, mostly nurses, and operates 510 ambulances supported by a 24/7 toll-free dispatch system (912). The urban private system has 21 permanent staff members, including 18 prehospital care providers primarily emergency care assistants, and three administrative personnel, supported by 150 volunteers. It operates 12 ambulances and a 24/7 toll-free line (2100). The rural public system has 11 nurses and six ambulances relying on the urban public dispatch system for emergency activation. CONCLUSION: Rwanda's prehospital system is expanding; however, rural and private systems continue to face resource limitations. These gaps should be addressed to ensure equitable and effective prehospital care.