Emergency medical services in Islamabad, Pakistan: a public-private partnership.
OBJECTIVE
The objective of this study was to evaluate the emergency medical services (EMS) based in Islamabad, Pakistan. Rescue-15 is an innovative EMS collaboration project between the police, the private sector and the community.


METHODS
Data from Rescue-15 were used for systems analysis. The institutional set-up, private-public partnership, client satisfaction and sustainability issues were examined. The access and efficiency of EMS were assessed in terms of ambulance response time.


RESULTS
Primarily, systems analysis showed community participation to explain the project's strength. Since its establishment, the project has been meeting its own recurrent expenditures without levying an extra burden on the Government. Sustainability issues such as amendments to legislation have been addressed at departmental and governmental levels. Data analysis showed that rescue time is, on average, 10.4 min (SD=2.6 min). A client survey also demonstrated user satisfaction and increased confidence in the service.


CONCLUSIONS
This EMS programme exemplifies the potential of public-private partnership involving the police and the private sector in project implementation and management in a developing country with scarce resources. This initiative to involve the public and the private sector may provide a model for implementation of such services in other resource-poor developing countries, which may in turn facilitate realistic solutions for better prehospital care in developing countries.
Ali
M
M
Department of Developmental Medical Sciences, Institute of International Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Tokyo 113-0033, Japan. denube5@yahoo.com
Miyoshi
C
C
Ushijima
H
H
D003258:Consumer Behavior; D003299:Cooperative Behavior; D004632:Emergency Medical Services / Q000191:economics / Q000458:organization & administration*; D019538:Health Care Surveys; D006801:Humans; D007373:Interinstitutional Relations; D010154:Pakistan; D017149:Private Sector; D017150:Public Sector