Strengthening Prehospital Emergency Care in Low- and Middle-Income Countries: A Scoping Review

Makmun Wicaksono; Asti Melani Astari; Suryanto Suryanto; Yodha Pranata; Pratista Oktafia

doi:10.70716/mohr.v4i3.769

Authors

Makmun Wicaksono Department of Nursing, Faculty of Health Sciences, Universitas Brawijaya, Malang, Indonesia
Asti Melani Astari Department of Nursing, Faculty of Health Sciences, Universitas Brawijaya, Malang, Indonesia
Suryanto Department of Nursing, Faculty of Health Sciences, Universitas Brawijaya, Malang, Indonesia
Yodha Pranata Master of Critical Care Program, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia
Pratista Oktafia Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

DOI:

https://doi.org/10.70716/mohr.v4i3.769

Keywords:

EMS, prehospital care, health services accessibility, LMICs, ambulance services

Abstract

Prehospital emergency care is a critical component of emergency care systems, particularly for time-sensitive trauma and medical conditions. However, many low- and middle-income countries have experienced persistent structural and operational challenges that have limited timely access to care. This scoping review aimed to identify and map strategies implemented to strengthen prehospital emergency care in low- and middle-income countries. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. A systematic search was conducted in Web of Science, ProQuest, Scopus, and ScienceDirect. Eligible studies were screened, data were extracted, and findings were synthesized using thematic narrative analysis. Twenty-five studies met the inclusion criteria. The evidence showed that strengthening prehospital emergency care required integrated system-level approaches, including community first responder engagement through task shifting, technology-supported coordination and dispatch, context-appropriate transport models, formal emergency medical service development, and standardization with continuous quality improvement. The implementation of these strategies varied according to local resources and system capacity. This review provided a comprehensive synthesis of system-level strengthening strategies across low- and middle-income countries, extending beyond previous reviews that primarily examined individual interventions, and offered an integrated framework to inform future policy, implementation, and research.

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