Improving emergency response with a network of trained community-based first responders in Nigeria  

It is estimated that 54% of deaths occurring in lower middle-income countries are due to conditions that can be addressed by pre-hospital and emergency medical care (Debas et al., 2015). In Nigeria, out of the 2.4 million annual deaths, at least 1.2 million of those fatalities could potentially have been prevented by an efficient emergency medical service system.

Appropriate emergency care is therefore essential. In February 2022, the Federal Ministry of Health in Nigeria launched the National Emergency Medical Service and Ambulance System (NEMSAS), a pilot project to enable state levels to implement emergency medical support nationwide. However, state governments face a lack of trained emergency responders and coordination difficulties.

The Nigerian social enterprise Emergency Response Africa (ERA) has prototyped and tested at a small scale a technology-based solution that enables trained responders to assist the victim in minutes and deliver emergency care. Victims and by-standers can request help via a toll-free phone call or a mobile application developed by ERA. The system then analyses the case and dispatches the most appropriate responders based on their location, training, access to vehicle, and equipment. Patients who need advanced care will be handed over to existing state-run ambulances and hospitals for further care.

While this first pilot focused primarily on prototyping and testing the set of mobile and web applications that connects emergency victims, first responders, ambulances and hospitals, the objective of the current pilot is to bring data-informed answers on the effectiveness of training members of the community as first responders and its results on patient outcomes.

FID’s Stage 1 funding will allow Emergency Response Africa, in partnership with the Edo state government, to pilot the recruitment and training of 170 volunteer community-based first responders in support of existing state-run ambulances and hospitals. This pilot project will collect preliminary data on the effectiveness of care provided by first responders as well as within state services. In addition, these volunteer first responders will be tasked with encouraging patients to enroll in public health insurance.

The objective of this pilot is to gather data on a set of indicators that will assess the quality of emergency care provided by community-based first responders, including:

• Number of volunteers recruited and trained as community-based first responders
• Capacity of community-based first responders to deliver emergency first aid
• Use of emergency transportation services and hospitals managed by local governments
• Public usage of the emergency helpline
• Time to dispatch and response time of the community-based first responders
• Government’s ability to detect and respond to public health crises
• Number of enrollments in health insurance scheme

It is estimated that 7,300 reported emergency incidents should be addressed during this twelve-month pilot phase. Over the next 5 years, the project team aims to directly reach over 100,000 individuals in Benin City, Edo State.