Use of Emergency Medical Services in Liberia: A Retrospective Review of a Novel EMS System

The concept of prehospital care in Africa is still evolving, with only one-third of African countries having an established Emergency Medical Services (EMS) system. In 2019, the Ministry of Health of the Republic of Liberia created its first division of EMS. This study aims to characterize use of EMS in Liberia over a period of 22 months after its inception in order to guide system improvement and resource allocation. This is a retrospective review of the monthly EMS dispatch report summaries within Liberia from July 2020 to April 2022. A descriptive analysis was conducted to examine call characteristics, chief complaints, geographic call distribution, and patient destinations. During the study period, 4,494 EMS calls were recorded, with 89.3% resulting in transport. The majority of patients were female (59.9%, n = 2694) and aged 16–35 years (52.1%, n = 2343). Most calls originated from the Commonwealth and Central Monrovia health districts, both located in the most populous county, Montserrado. JFK Hospital, located in the capital city of Monrovia, received the highest volume of patients (42.6%, n = 1708). Obstetric complaints, particularly labor, were the most common (23.8%, n = 955), followed by infectious disease (17.4%, n = 700) and road traffic accidents (7.6%, n = 306). This study presents the first review of data from Liberia’s national EMS system. The high prevalence of obstetric, infectious disease, and road traffic accident calls reflects the high burden of time-sensitive conditions faced by low- and middle-income countries (LMICs) and underscores the need to support access to emergency care, in which prehospital care is a key component. The findings further support the importance of targeted EMS training, protocol development, and resource allocation for high-frequency complaints, along with the strategic placement of ambulances to enhance response times and improve patient outcomes. EMS Utilization in the Republic of Liberia: A Retrospective Review of a Novel EMS System