{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T18:05:44Z","timestamp":1790013944751,"version":"4.0.1"},"reference-count":22,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,12,1]],"date-time":"2026-12-01T00:00:00Z","timestamp":1796083200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"funder":[{"DOI":"10.13039\/100005301","name":"American College of Surgeons","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005301","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","surgjournal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Surgery"],"published-print":{"date-parts":[[2026,12]]},"DOI":"10.1016\/j.surg.2026.110564","type":"journal-article","created":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T15:14:00Z","timestamp":1788016440000},"page":"110564","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["When ambulances are not enough: An interview-based needs assessment of governance and accountability gaps in prehospital emergency care in Hawassa, Ethiopia"],"prefix":"10.1016","volume":"200","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3141-2815","authenticated-orcid":false,"given":"Fayrouz","family":"Abu-Hamdan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noor","family":"Bhatti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Tesfasilassie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taye","family":"Gari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berhan","family":"Meshesha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belay","family":"Mellese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zemedkun Motera","family":"Wirtu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emnet Tesfaye","family":"Shimber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudha","family":"Jayaraman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed Nabeel","family":"Zafar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Dodgion","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine R.","family":"Iverson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.surg.2026.110564_bib2","author":"Savedoff"},{"key":"10.1016\/j.surg.2026.110564_bib3","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1080\/10903127.2023.2239363","article-title":"Documented use of emergency medical dispatch protocols is associated with improved survival in out of hospital cardiac arrest","volume":"28","author":"Colgan","year":"2024","journal-title":"Prehosp Emerg Care"},{"key":"10.1016\/j.surg.2026.110564_bib4","doi-asserted-by":"crossref","first-page":"1376","DOI":"10.1016\/j.injury.2017.03.050","article-title":"Improving prehospital trauma care in Rwanda through continuous quality improvement: an interrupted time series analysis","volume":"48","author":"Scott","year":"2017","journal-title":"Injury"},{"key":"10.1016\/j.surg.2026.110564_bib5","first-page":"1","article-title":"Ethiopian emergency medical services: bridging up the gaps in prehospital services","volume":"2","author":"Dode","year":"2024","journal-title":"Pan Afr J Emerg Med Crit Care"},{"key":"10.1016\/j.surg.2026.110564_bib6","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.afjem.2012.08.005","article-title":"Emergency medicine development in Ethiopia: challenges, progress and possibilities","volume":"3","author":"Germa","year":"2013","journal-title":"Afr J Emerg Med"},{"key":"10.1016\/j.surg.2026.110564_bib7","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1186\/s12913-024-11292-6","article-title":"Challenges of pre-hospital emergency care at Addis Ababa Fire and Disaster Risk Management Commission, Addis Ababa, Ethiopia: a qualitative study","volume":"24","author":"Seid","year":"2024","journal-title":"BMC Health Serv Res"},{"key":"10.1016\/j.surg.2026.110564_bib8","doi-asserted-by":"crossref","first-page":"104","DOI":"10.5334\/aogh.3324","article-title":"Building trauma and EMS systems capacity in Rwanda: lessons and recommendations","volume":"87","author":"Jayaraman","year":"2021","journal-title":"Ann Glob Health"},{"key":"10.1016\/j.surg.2026.110564_bib9","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1016\/j.afjem.2024.08.003","article-title":"Healthcare professionals perceptions towards the determinants of effective emergency health care services in public health centres of Addis Ababa, Ethiopia","volume":"14","author":"Getahun","year":"2024","journal-title":"Afr J Emerg Med"},{"key":"10.1016\/j.surg.2026.110564_bib10","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgph.0001158","article-title":"Prehospital emergency medical service utilization and associated factors among critically ill COVID-19 patients treated at centers in Addis Ababa, Ethiopia","volume":"3","author":"Olani","year":"2023","journal-title":"PLOS Glob Public Health"},{"key":"10.1016\/j.surg.2026.110564_bib11","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/s12873-019-0242-5","article-title":"Trends and barriers of emergency medical service use in Addis Ababa; Ethiopia","volume":"19","author":"Sultan","year":"2019","journal-title":"BMC Emerg Med"},{"key":"10.1016\/j.surg.2026.110564_bib12","doi-asserted-by":"crossref","DOI":"10.1016\/j.heliyon.2024.e31906","article-title":"Utilization of emergency medical service and its associated factors among patients visited public hospitals at Hawassa City, Sidama Region, Ethiopia, 2023","volume":"10","author":"Mekonen","year":"2024","journal-title":"Heliyon"},{"key":"10.1016\/j.surg.2026.110564_bib14","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qual Res Psychol"},{"key":"10.1016\/j.surg.2026.110564_bib15","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups","volume":"19","author":"Tong","year":"2007","journal-title":"Int J Qual Health Care"},{"key":"10.1016\/j.surg.2026.110564_bib16","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1017\/S1049023X23006088","article-title":"Prehospital emergency care in Low- and middle-income countries: a systematic review","volume":"38","author":"Bhattarai","year":"2023","journal-title":"Prehosp Disaster Med"},{"key":"10.1016\/j.surg.2026.110564_bib17","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1136\/injuryprev-2021-044487","article-title":"Barriers and opportunities of establishing an integrated prehospital emergency response system in North West Ethiopia: a qualitative study","volume":"28","author":"Denu","year":"2022","journal-title":"Inj Prev"},{"key":"10.1016\/j.surg.2026.110564_bib18","doi-asserted-by":"crossref","DOI":"10.1016\/j.glmedi.2026.100241","article-title":"Gaps and priorities in prehospital emergency services in Addis Ababa, Ethiopia: a mixed-methods assessment","volume":"9","author":"Bhatti","year":"2026","journal-title":"J Med Surg Public Health"},{"key":"10.1016\/j.surg.2026.110564_bib19","series-title":"Prehospital emergency care: operational guidance for ambulance systems","year":"2025"},{"key":"10.1016\/j.surg.2026.110564_bib20","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1186\/s12913-018-3091-0","article-title":"Identifying barriers for out of hospital emergency care in low and low-middle income countries: a systematic review","volume":"18","author":"Kironji","year":"2018","journal-title":"BMC Health Serv Res"},{"key":"10.1016\/j.surg.2026.110564_bib21","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2015-009208","article-title":"Perceptions of emergency care in Kenyan communities lacking access to formalised emergency medical systems: a qualitative study","volume":"5","author":"Broccoli","year":"2015","journal-title":"BMJ Open"},{"key":"10.1016\/j.surg.2026.110564_bib22","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1136\/emermed-2015-205054","article-title":"Community-based perceptions of emergency care in Zambian communities lacking formalised emergency medicine systems","volume":"33","author":"Broccoli","year":"2016","journal-title":"Emerg Med J"},{"key":"10.1016\/j.surg.2026.110564_bib23","doi-asserted-by":"crossref","first-page":"S65","DOI":"10.1016\/j.afjem.2020.04.010","article-title":"Emergency care systems in Africa: a focus on quality","volume":"10","author":"Kannan","year":"2020","journal-title":"Afr J Emerg Med"},{"key":"10.1016\/j.surg.2026.110564_bib24","doi-asserted-by":"crossref","DOI":"10.9745\/GHSP-D-22-00332","article-title":"Strengthening Kampala's urban referral system for maternal and newborn care through establishment of an emergency call and dispatch center","volume":"11","author":"Ononge","year":"2023","journal-title":"Glob Health Sci Pract"}],"container-title":["Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0039606026004897?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0039606026004897?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T17:04:58Z","timestamp":1790010298000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0039606026004897"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,12]]},"references-count":22,"alternative-id":["S0039606026004897"],"URL":"https:\/\/doi.org\/10.1016\/j.surg.2026.110564","relation":{},"ISSN":["0039-6060"],"issn-type":[{"value":"0039-6060","type":"print"}],"subject":[],"published":{"date-parts":[[2026,12]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"When ambulances are not enough: An interview-based needs assessment of governance and accountability gaps in prehospital emergency care in Hawassa, Ethiopia","name":"articletitle","label":"Article Title"},{"value":"Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.surg.2026.110564","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"110564"}}