Characteristics and Distribution of Emergency Medical Services Utilisation for Obstetric Emergencies in the Western Cape
1
Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
2
Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa
3
Center for Integrated Data and Epidemiological Research, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
4
Department of Health and Wellness, Emergency Medical Services, Western Cape Government, Cape Town, South Africa
5
Department of Emergency Medicine, Los Angeles General Medical Center, University of Southern California, California, United States
Popul. Med. 2026;8(Supplement Supplement 1):A2357
ABSTRACT
INTRODUCTION:
Maternal mortality remains a leading cause of preventable fatality globally, particularly in low- and middle-income countries where delays in accessing timely care persist (1). Emergency medical services (EMS) are critical in addressing the second delay - reaching health facilities within the three delays model (2). This study examines prehospital EMS utilisation for obstetric emergencies in the western cape.
METHODS:
A retrospective, cross-sectional analysis was conducted of all primary obstetric emergency calls managed by western cape government health and wellness EMS during 2023. computer-aided dispatch and electronic patient care records data were linked and anonymised before analysis. Dispatch priority was recorded in the dataset as Priority 1 (life-threatening) or Priority 2 (non-life-threatening). Two multivariable logistic regression models identified predictors of priority assignment and timely response, defined by provincial targets (≤15 minutes for urban and ≤60 minutes for rural calls).
RESULTS:
Among 16752 calls, the median maternal age was 26 years (IQR: 21–31), and most calls occurred in urban areas (86.0%), classified as Priority 2 (80.2%), and labour-related, with a median EMS response time of 41 minutes (IQR: 22–76). Priority 1 assignment was significantly associated with increasing maternal age (adjusted odds ratio [AOR]: 1.03; 95% confidence interval [CI]: 1.02–1.03) and prehospital birth (AOR: 1.74; 95% CI: 1.36–2.23). Rural location (AOR: 13.28; 95% CI: 12.01–14.69) and Priority 1 classification were the strongest predictors of a timely response.
CONCLUSIONS:
EMS utilisation for obstetric calls in the western cape is predominantly labour-related. Although rural emergencies were more likely to meet response targets, different dispatch thresholds and operational constraints, including safety concerns, can further impede EMS access in urban areas (3). This requires further exploration. Strengthening EMS planning is essential to reducing maternal risk and achieving universal health coverage.
Maternal mortality remains a leading cause of preventable fatality globally, particularly in low- and middle-income countries where delays in accessing timely care persist (1). Emergency medical services (EMS) are critical in addressing the second delay - reaching health facilities within the three delays model (2). This study examines prehospital EMS utilisation for obstetric emergencies in the western cape.
METHODS:
A retrospective, cross-sectional analysis was conducted of all primary obstetric emergency calls managed by western cape government health and wellness EMS during 2023. computer-aided dispatch and electronic patient care records data were linked and anonymised before analysis. Dispatch priority was recorded in the dataset as Priority 1 (life-threatening) or Priority 2 (non-life-threatening). Two multivariable logistic regression models identified predictors of priority assignment and timely response, defined by provincial targets (≤15 minutes for urban and ≤60 minutes for rural calls).
RESULTS:
Among 16752 calls, the median maternal age was 26 years (IQR: 21–31), and most calls occurred in urban areas (86.0%), classified as Priority 2 (80.2%), and labour-related, with a median EMS response time of 41 minutes (IQR: 22–76). Priority 1 assignment was significantly associated with increasing maternal age (adjusted odds ratio [AOR]: 1.03; 95% confidence interval [CI]: 1.02–1.03) and prehospital birth (AOR: 1.74; 95% CI: 1.36–2.23). Rural location (AOR: 13.28; 95% CI: 12.01–14.69) and Priority 1 classification were the strongest predictors of a timely response.
CONCLUSIONS:
EMS utilisation for obstetric calls in the western cape is predominantly labour-related. Although rural emergencies were more likely to meet response targets, different dispatch thresholds and operational constraints, including safety concerns, can further impede EMS access in urban areas (3). This requires further exploration. Strengthening EMS planning is essential to reducing maternal risk and achieving universal health coverage.
| eISSN: | 2654-1459 |
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