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Operations & systems
Governance gaps cripple Ethiopian prehospital care
When ambulances are not enough: An interview-based needs assessment of governance and accountability gaps in prehospital emergency care in Hawassa, Ethiopia
Surgery · Added 24 September 2026
Qualitative needs assessment using the WHO prehospital assessment tool across 15 interviews with EMS and health bureau leaders in Hawassa, Ethiopia identified six recurring barriers — infrastructure, medicines/equipment, communication, community perceptions, workforce and, cutting across all of them, unclear governance and accountability — leaving services functioning as interfacility transport rather than true prehospital care.
- Study type
- Qualitative
- Design
- Qualitative interview-based needs assessment using WHO prehospital assessment tool
- Participants
- 15 interviews with EMS leaders, administrators and health bureau coordinators in Hawassa, Ethiopia
- Main finding
- Six recurring barriers identified: infrastructure, medicines/equipment shortages, communication gaps, community perceptions, workforce limitations and structural weaknesses, with unclear governance and accountability as a central cross-cutting barrier; services often function as interfacility transport rather than prehospital care.
- Caveat
- Small, single-city qualitative study in a low-income setting — limited generalisability to Australia
- Bottom line
- Context only
Why it matters in Australia (Low relevance). valuable LMIC systems insight but nothing applicable to ACTAS operations or an established governance structure
Learning goal
Understand how governance and accountability structures shape whether prehospital systems deliver care rather than transport.
More
- Topic: Operations & systems
- Daily scan: 24 September 2026
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