identifying challenges and policy strategies to improve working conditions for women in pre-hospital emergency operations: a qualitative study

Background: pre-hospital emergency medical services play a vital role in saving patients' lives, and women's participation in this field is increasing; however, qualitative evidence regarding the lived experiences and occupational challenges of female emergency medical technicians (emts) in iran remains limited.objectives: this study aimed to qualitatively explore these challenges, identify participant-proposed solutions, and develop a phased policy framework. methods: this conventional content analysis research involved 32 participants, who were purposively chosen from women in pre-hospital emergency operations across iran between september and december 2024. data collection was carried out through face-to-face, semi-structured, and in-depth interviews lasting between 30 and 60 minutes until data saturation was reached. the gathered data were analyzed following the methodology proposed by graneheim and lundman. additionally, maxqda software version 2010 was utilized for data organization. results: analysis revealed three primary themes characterizing the occupational challenges of female emts: (1) socio-cultural challenges, including fear of public non-acceptance, cultural sensitivities in patient care, lack of family acceptance, and issues with culturally appropriate uniforms; (2) physical-ergonomic challenges, primarily difficulties in moving patients and handling heavy equipment; and (3) organizational-supportive challenges, where job satisfaction was closely tied to the level of managerial support. despite these challenges, participants reported positive public reception and strong collegial relationships. conclusion: effective reform requires leveraging existing public legitimacy to enable institutional change. a phased strategy encompassing awareness initiatives, workplace adaptation, and inclusive infrastructure investment is essential for achieving a more equitable and effective pre-hospital emergency medical system.