The current state of emergency medical services in South Africa: A review

Shaun Govender; Olive P. Khaliq; Raveen Naidoo; Jagidesa Moodley

doi:10.17159/sajs.2024/16138

Authors

Shaun Govender KwaZulu-Natal College of Emergency Care, Durban, South Africa https://orcid.org/0000-0003-4261-5532
Olive P. Khaliq Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa https://orcid.org/0000-0002-9742-4525
Raveen Naidoo Directorate: Emergency Medical Services & Disaster Medicine, National Department of Health, Pretoria, South Africa https://orcid.org/0000-0002-6712-7474
Jagidesa Moodley Women’s Health and HIV Research Group, Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa https://orcid.org/0000-0003-1130-9364

DOI:

https://doi.org/10.17159/sajs.2024/16138

Keywords:

emergency medical services, EMS, paramedic, prehospital, emergency care provider, South Africa

Abstract

Emergency medical services (EMS) are a vital component of the health system and provide pre-hospital emergency care and specialised transport for patients requiring access to health facilities, thereby contributing to universal health coverage and improving health outcomes. Evidence regarding the current state of EMS within South Africa to fulfil this role is lacking and was the motivation for this review. Our objective was to describe the current state of EMS in South Africa. A literature search was conducted using keywords, BOOLEAN operating terms, and eligibility criteria on Sabinet, EBSCOhost, Google Scholar, ProQuest, Medline, PubMed, and ScienceDirect databases to find articles related to the components of the EMS system in South Africa. The articles were critically assessed, and six themes emerged: leadership and governance; resources; preparedness (knowledge, attitude, and practices) of the emergency care provider; health and safety; training; and communications. Challenges were found in all themes at a provincial EMS level despite improvements in legislation, leadership, and governance from the National Department of Health. These themes demonstrate that all components in the EMS system are not functioning optimally and may be affecting its contribution to improving universal health coverage and health outcomes. The current state of EMS appears to be constrained and requires greater leadership and governance from the Provincial Departments of Health to improve poorly functioning components of the EMS system.

Significance:

The current state of EMS in South Africa lacks efficiency in its role to provide emergency care and transportation for patients wanting to access health facilities. Poorly functioning components of the EMS system have been identified and provide an opportunity for health authorities to make improvements so that the goal of universal health coverage and improved health outcomes can be realised.