Seeking and reaching emergency care: A cross sectional household survey across two Liberian counties

The overwhelming burden of morbidity and mortality from injury and medical conditions requiring acute care are borne by low- and middle-income countries lacking accessible, quality care systems. Current evidence suggests the lack of prehospital care systems likely contributes to this disproportionate burden. As an initial step in a longitudinal, collaborative effort to strengthen the chain of survival for emergency conditions in Liberia, baseline attitudes and behaviors in accessing and utilizing emergency care were characterized. A multistage, proportional, cluster sampling frame was employed to conduct a cross-sectional, community-based survey of 800 households across rural Lofa County and the greater capital (Monrovia) metropolitan area. The primary outcome was facility-based utilization of emergency care within the 12 months prior to survey administration.

Methods
A community-based, cross-sectional survey was conducted in collaboration with the Emergency Medical Response-EMS/Respiratory Division of the Ministry of Health, Monrovia, Liberia, the University of Colorado, and Restore Hope, Liberia. Collected data was de-identified and cleaned prior to initial analysis in Excel. Further data analysis was performed via Stata (Version 14.2, College Station, TX).