Emergency medical services or EMS can reduce mortality and morbidity. In Kenya EMS is mainly provided by private ambulance agencies. There is insufficient information on EMS in Kenya. This study aimed to explore factors that influence provision of EMS in Nairobi as viewed and experienced by ambulance agency managers. A qualitative study design using grounded theory was selected. Nine in-depth interviews were conducted and data was analyzed using constant comparison. Four factors emerged: Subjective EMS standards, availability and distribution of resources, EMS awareness, and existing road infrastructure. The factor common to all was: ‘the role of the government in EMS implementation
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