Awareness of the Rivers State Emergency Medical Services and Ambulance System (REMSAS) among traders in Mile 1 Market, Diobu, Port Harcourt, Nigeria

Background: Emergency medical services (EMS) reduce deaths and disability from sudden illness and injury, but their benefit depends on whether the public knows that the service exists, how to reach it, and when to call. Market traders work in crowded, high-risk environments, yet little is known about their awareness of the Rivers State Emergency Medical Services and Ambulance System (REMSAS).
Objective: To assess the level of awareness of REMSAS among traders in Mile 1 Market, Diobu, Port Harcourt; to describe trader’s perception of factors affecting awareness; and to describe trader’s views on way of improving awareness of REMSAS.
Methods: A descriptive cross-sectional survey was conducted in 2025. A sample of 200 traders aged 20 years and above was determined with Taro Yamane’s formula from a population of 400 and selected by systematic random sampling. Only traders who were willing to participate were included. Data were collected with a researcher-developed, face and content validated questionnaire and analyzed with frequencies and percentages.
Results: The results revealed that out of 200 questionnaires distributed, 180 were retrieved (response rate = 90.0%). Most traders (72.2%) agreed they had heard of REMSAS and 77.8% agreed that it should be called in an emergency, but only 50.0% stated they knew its emergency telephone numbers and 36.1% mentioned they had never used it or knew someone who had. The perceived level of awareness of REMSAS was moderately high with a mean of 0.674. The traders also stated that perceived factors affecting the awareness of REMSAS were not enough radio jingles (76.7%), lack of trust in government facilities (71.1%), and language and communication barriers (67.8%). The traders stated more radio jingles (83.3%), free REMSAS service (80.6%), and door-to-door campaigns (76.7%) are ways of improving awareness of REMSAS.
Conclusion: Most traders in Mile 1 Market are aware of the existence of REMSAS but not how to utilize their services. The traders suggested more radio jingles with emphasis on free service delivery and door-to-door campaigns as ways of improving awareness and of REMSAS which will further improve its utilization.

Rivers state emergency medical services and ambulance system, awareness, market traders

1. Akinreni, T., Filani, T., Asuni, O., & Owodunni, F. (2023). Awareness and utilization of emergency response service to road traffic crashes in Nigeria: a cross-sectional study. Journal of Public Health and Emergency, 7. [Google Scholar] [Crossref]

2. Alanazy, A. R. M., Wark, S., Fraser, J., & Nagle, A. (2019). Factors impacting patient outcomes associated with use of emergency medical services operating in urban versus rural areas: a systematic review. International journal of environmental research and public health, 16(10), 1728. [Google Scholar] [Crossref]

3. Babbie, E. R. (2020). The practice of social research. Cengage Au. [Google Scholar] [Crossref]

4. Cummins, R. O., Ornato, J. P., Thies, W. H., & Pepe, P. E. (1991). Improving survival from sudden cardiac arrest: the" chain of survival" concept. A statement for health professionals from the Advanced Cardiac Life Support Subcommittee and the Emergency Cardiac Care Committee, American Heart Association. Circulation, 83(5), 1832-1847. [Google Scholar] [Crossref]

5. Delaney, P. G., De Vos, S., Eisner, Z. J., Friesen, J., Hingi, M., Mirza, U. J., ... & Thullah, A. H. (2025). Challenges, opportunities, and priorities for tier-1 emergency medical services (EMS) development in low-and middle-income countries: A modified Delphi-based consensus study among the global prehospital consortium. Injury, 56(1), 111522. [Google Scholar] [Crossref]

6. Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.). (2015). Health behavior: Theory, research, and practice. John Wiley & Sons. [Google Scholar] [Crossref]

7. Gunderson, M. (2021). Principles of EMS system design. Emergency medical services: clinical practice and systems oversight, 2, 16-31. [Google Scholar] [Crossref]

8. Kironji, A. G., Hodkinson, P., De Ramirez, S. S., Anest, T., Wallis, L., Razzak, J., ... & Hansoti, B. (2018). Identifying barriers for out of hospital emergency care in low and low-middle income countries: a systematic review. BMC health services research, 18(1), 291. [Google Scholar] [Crossref]

9. Kruk, M. E., Gage, A. D., Arsenault, C., Jordan, K., Leslie, H. H., Roder-DeWan, S., ... & Pate, M. (2018). High-quality health systems in the Sustainable Development Goals era: time for a revolution. The Lancet global health, 6(11), e1196-e1252. [Google Scholar] [Crossref]

10. Merchant, R. M., Topjian, A. A., Panchal, A. R., Cheng, A., Aziz, K., Berg, K. M., ... & Adult Basic and Advanced Life Support, Pediatric Basic and Advanced Life Support, Neonatal Life Support, Resuscitation Education Science, and Systems of Care Writing Groups. (2020). Part 1: executive summary: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation, 142(16_Suppl_2), S337-S357. [Google Scholar] [Crossref]

11. Modi, P. D., Solanki, R., Nagdev, T. S., Yadav, P. D., Bharucha, N. K., Desai, A., ... & Langade, D. G. (2018). Public awareness of the emergency medical services in Maharashtra, India: A questionnaire-based survey. Cureus, 10(9). [Google Scholar] [Crossref]

12. Mould-Millman, N. K., Dixon, J. M., Sefa, N., Yancey, A., Hollong, B. G., Hagahmed, M., ... & Wallis, L. A. (2017). The state of emergency medical services (EMS) systems in Africa. Prehospital and disaster medicine, 32(3), 273-283. [Google Scholar] [Crossref]

13. Nto, S. E., Oluwatola, T., Samuel, O., Okagbue, H., Atobatele, S., Ibanga, A., ... & Sadiq, S. (2024). Strengthening care for emergencies: what is the level of awareness and utilization of Emergency Medical Services (EMS) in FCT, Nigeria?. BMC Emergency Medicine, 24(1), 73. [Google Scholar] [Crossref]

14. Obermeyer, Z., Abujaber, S., Makar, M., Stoll, S., Kayden, S. R., Wallis, L. A., & Reynolds, T. A. (2015). Emergency care in 59 low-and middle-income countries: a systematic review. Bulletin of the World Health Organization, 93, 577-586. [Google Scholar] [Crossref]

15. Olaomi, O. O., Okoye, G. O., & Balarabe-Musa, B. (2024). Current trends in emergency medicine in Nigeria. Nigerian Journal of Clinical Practice, 27(12), 1345-1350. [Google Scholar] [Crossref]

16. Oreh, A., Owodunni, F., Adewunmi, O. A., Opelia-Ezeh, I., Onasanya, O., Ojum, S., ... & Green, K. (2026). Rural-urban disparities in Emergency Medical Services: a qualitative study of barriers and opportunities in Rivers State, Nigeria. African Journal of Emergency Medicine, 16(1), 100946. [Google Scholar] [Crossref]

17. Perera, N., Birnie, T., Whiteside, A., Ball, S., & Finn, J. (2023). “If you miss that first step in the chain of survival, there is no second step”–Emergency ambulance call-takers’ experiences in managing out-of-hospital cardiac arrest calls. PloS one, 18(3), e0279521. [Google Scholar] [Crossref]

18. Saberian, P., Shafiee, A., Hasani-Sharamin, P., Rafiemanesh, H., & Baratloo, A. (2023). The general public awareness of emergency conditions and the services provided by emergency medical services. Bulletin of Emergency & Trauma, 11(3), 154. [Google Scholar] [Crossref]

19. Sawe, H. R., Mfinanga, J. A., Kisakeni, S., Shao, P., Nkondora, P., White, L., ... & Noste, E. (2019). Development and Implementation of Short Courses to Support the Establishment of a Prehospital System in Sub‐Saharan Africa: Lessons Learned from Tanzania. Emergency medicine international, 2019(1), 3160562. [Google Scholar] [Crossref]

20. Stefanov, M. (2023). Current state and improvement prospects of warehouse workers health and safety practices in Bulgarian manufacturing and trading organizations. Acta Logistica (AL), 10(3), 403. [Google Scholar] [Crossref]

21. Xirasagar, S., Tsai, M. H., Heidari, K., Hardin, J. W., Wu, Y., Wronski, R., ... & Sen, S. (2019). Why acute ischemic stroke patients in the United States use or do not use emergency medical services transport? Findings of an inpatient survey. BMC Health Services Research, 19(1), 929. [Google Scholar] [Crossref]

22. Yamane, T. (1967). Statistics: An introductory analysis (2nd ed.). Harper & Row. [Google Scholar] [Crossref]

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