EMSs in the KSA currently employ only male paramedics. However, female patients could experience delays in prehospital care because of the conservative culture, which heightens the need for trained female paramedics. Recently, a few universities have begun to offer structured EMS training to female students. For example, King Saud bin Abdulaziz University for Health Science has introduced an EMS bachelor’s degree program for women, which is among the first structured curricula in this field at a public university. This EMS program aims to provide well-trained female paramedics to serve the region.
Despite these new programs, public knowledge and perception of female paramedics had not been explored previously in Saudi Arabia. Therefore, given its focus on public perception of female paramedics, our study is unique. Our findings indicated that most participants realized the importance of employing female paramedics in the KSA. Further, public concern regarding the preservation of women’s privacy and the cultural and religious beliefs common in the KSA were reflected in levels of agreement, in that 20 to 30% of participants had refused EMS contact in the past because no female paramedics were available.
Regarding sex preferences, female participants expressed strong agreement with accepting care from female paramedics, particularly in critical situations in which the presence of a male paramedic would be inconvenient. The existing literature also describes the refusal of hospital and other care because of sex preferences [6, 7]. Male participants indicated strong disagreement with the provision of care to their wives, mothers, and sisters by male paramedics, and they strongly agreed that male paramedics should be accompanied by female paramedics to overcome these sex limitations when treating female patients.
In the KSA, public awareness of this issue has increased following several media reports wherein female patients experienced serious complications because of cultural limitations that delayed the entry of male paramedics into women-only areas [11]. Most respondents reported that female paramedics could easily gain access to women-only areas and approach female patients in public places. In addition, most participants agreed that female paramedics were capable of handling very sick patients, regardless of sex or age. The perceived skills and patient management abilities of female paramedics in a prehospital setting were examined in a previous study, which showed a lower rate of prehospital care refusal among patients treated by female paramedics, relative to those treated by their male counterparts [6].
Moreover, most participants supported the pursuit of a paramedic career by women, considering cultural limitations. Our questionnaire included a suggestion box, in which participants could suggest limitations such as restricting the roles of female paramedic to women-only areas such as schools, colleges, and women’s health centers. Other participants highlighted the professional dress code and suggested that it should be modest, in accordance with the Islamic religion and traditions of the KSA. Further, participants listed some factors that could affect women’s ability, such as physical fitness, emotional liability, and the ability to work within an uncontrolled crowd. These suggestions indicated that the public is aware of the occupational hazards, particularly those faced by female paramedics, in accordance with previous studies that identified sex as a risk factor for post-traumatic stress disorder and occupational violence [12, 13].
A local review of the evolution of EMSs in the KSA showed that, despite advances in recent years, considerable opportunities remain for further improvement, particularly through increased public awareness and enhanced paramedic education [14]. Our study is unique in that we used a survey to assess public knowledge of and agreement with the existence of female paramedics, as this issue contributes to public concerns regarding sex preferences. Despite the paucity of existing literature, we examined public perception of female paramedics. The Saudi government aims to increase the number of women in the national workforce, which could involve staffing EMSs with female paramedics following increased demand and educational advancements [15]. However, the generalizability of our findings was limited by the sample size and study setting. Therefore, we recommend a national-level assessment of public perception of female paramedics.