Iranian Primary Healthcare providers` Perspectives on Providing Pre-hospital Emergency Services in Primary Levels of Healthcare System: A Qualitative Study

Background and purpose: Due to the important role of emergencies and accidents as mainspring of mortality and morbidity, providing emergency services must be taken into account at all levels of health system. The aim of this study was to investigate the perspectives of healthcare providers on providing pre-hospital emergency services and its challenges in primary healthcare (PHC) levels in Golestan Province, northern Iran. Materials and Methods: The researchers conducted 31 interviews totally (n=21 community health workers and n=10 family physicians) using semi-structured and in-depth interviews in Golestan Province, north of Iran in the year 2014. All interviews were digitally recorded and transcribed. The collected data was then analyzed through qualitative content analysis. Results: In total, three categories were identified related to emergency services in the primary healthcare system, including 1) Different status of  providing primary preventive and emergency care in primary healthcare levels, 2) Need to develop the emergency services in health houses, and 3) Challenges of providing appropriate emergency services in the primary levels of healthcare system, such as lack of physical and human resources, weakness in monitoring and education system, inadequate skills, motivation in health team, heavy workload, and insufficient cooperation with other related organizations. Conclusion: The primary levels of healthcare system were not properly serviced in emergencies. They were also faced with numerous challenges that necessitate health policy makers to plan for promoting and providing required services at this level of healthcare system.