Availability of emergency drugs and essential resuscitation equipment and associated barriers in Addis Ababa Health Centers, Ethiopia: a mixed-methods study

Abstract

Introduction: Essential medications, supplies, and equipment are crucial for emergency care; however, significant resource shortages in low- and middle-income countries, including Ethiopia, hinder the delivery of safe services. Although research on emergency capacity analysis has been conducted at the hospital level, data from lower levels, such as health centers, are lacking, despite numerous studies recommending the development of emergency services at the primary healthcare level to reduce the burden on hospital emergency departments. Therefore, this study primarily aims to assess the availability of emergency equipment and drugs and barriers to availability in health centers in Addis Ababa, Ethiopia. Methods: An explanatory sequential mixed method design study was conducted in Addis Ababa, in September 2025. Quantitative data were collected from the six health centers selected through convenience and random sampling. Non-probability purposive sampling was used to select key informants for the qualitative interviews, and thematic content analysis was conducted to develop items that emerged from the transcribed information. Results: The survey revealed a significant gap in availability of emergency equipment and drugs. While oxygen delivery devices and infection control materials were widely available, critical equipment and essential medications like crash carts, defibrillators, digoxin, and sodium bicarbonate were largely absent. Qualitative analysis identified the barriers to be ineffective management, disjointed logistics and health system, shortage of human resource and patients' financial constraint. Discussion: The readiness of health centers to provide emergency care in Addis Ababa is inadequate, largely due to resource shortages and systemic barriers. Urgent interventions are needed to improve emergency preparedness at the primary care level, including provision of crash carts, investment in staff training, and revision of procurement and policy frameworks.