Challenges faced by Saudi female paramedics in the Kingdom of Saudi Arabia

Abstract

Emergency Medical Services (EMS) is an important healthcare sector that contributes significantly to improving patient clinical outcomes following prehospital emergency health conditions. In Saudi Arabia, the EMS is well integrated and provided by the Saudi Red Crescent Authority (SRCA), which was established in 1932. Prehospital services have been staffed predominantly by male paramedics and emergency medical technicians (EMTs) since the SRCA’s inception. During the past decade, the EMS system in Saudi Arabia has improved significantly, with one result being the introduction of Saudi female paramedics. However, female paramedics face several challenges in the EMS environment that affect their ability to hold ongoing positions, such as the prehospital and ambulance service infrastructure not yet being developed to accommodate their needs. Today, Saudi female healthcare workers undertake many roles and positions in the healthcare sector within hospitals such as nursing, medicine, radiology and, recently, paramedicine. However, some face visible and/or hidden challenges such as gender bias and work-family balance, which may limit their availability in the Saudi workforce. For example, the EMS system does not have female paramedics working in the prehospital setting and their availability in other health organisations is limited. Studies from other professions have demonstrated that working women face various challenges such as family responsibilities, a socially conservative culture, workplace issues such as violence, and role stereotypes and gender bias. However, many studies of other healthcare professions have demonstrated that women face many of the same challenges within hospitals. Therefore, the primary aim of this thesis was to explore the challenges that Saudi female paramedics face in the workforce in the Kingdom of Saudi Arabia. This thesis has produced important contributions to EMS in Saudi Arabia by being the first to explore the challenges facing female paramedics in the workplace. It has also provided the first scoping review to identify the challenges faced by female healthcare professionals globally. It is the first to use a conceptual framework model combining Gendered Organisation Theory with Glass Ceiling to differentiate between visible and hidden challenges. Furthermore, three different methodologies have been used to explore the aim of this thesis with target cohorts: face-to-face interviews with EMS experts; focus groups with Saudi female paramedics; and a cross-sectional survey with the Saudi public in the Riyadh region of the Kingdom of Saudi Arabia. The findings of this thesis reveal that Saudi female paramedics are affected by many challenges that reduce their availability in the Saudi EMS workforce, based on qualitative studies with EMS leaders, managers and academics, and Saudi female paramedics. The two studies in chapters four and five indicate that Saudi female paramedics face many challenges that affect their availability in the EMS workforce. From those two studies, three themes with multiple threads emerged: family responsibilities; workplace issues; and cultural concerns. In addition, the results from a national study with the Saudi public that involved 3,132 completed questionnaires (Chapter Six) shows 77% of respondents support the need for Saudi female paramedics and 74.8% prefer Saudi female paramedics to treat their female family members. This thesis offers important insights into Saudi female paramedics by exploring the challenges they face in the workplace. This new engagement of Saudi female paramedics is making a mark in the Saudi prehospital sector. To prevent attrition, Saudi female paramedics need to be provided with appropriate work conditions, job opportunities, family and public support, and respect and trust. This thesis offers import