An operational assessment of a national free ambulance services programme reveals a drastic reduction in pregnancy-related deaths in rural Ethiopia, suggesting that the innovative model could offer a cost-effective way to improve maternal health outcomes across Sub-Saharan Africa. This argument is presented in an article published today in the Journal of Global Health.
"Despite major international concerns around maternal health and efforts to bring up institutional delivery rates, little attention has been given to the need for logistical solutions that bring African women to delivery centres fast," says Peter Byass, epidemiologist at Umeå University and co-author of the article. "The halving of pregnancy-related deaths that we saw coincided with an increased availability of free ambulance services in Ethiopia suggests that similar services could be a key innovation for improving maternal and infant health throughout Sub-Saharan Africa."
The article describes the health impacts of Ethiopia's national ambulance service programme. The one-year operational assessment was conducted by researchers at Umeå University's Centre for Global Health Research along with the Ethiopian Ministry of Health and the Tigray Regional Health Bureau.
The assessment compared pregnancy-related deaths before and after programme implementation, including the percentage of deliveries using ambulances, across six randomly selected rural districts of northern Ethiopia. During the period, a total of 51 pregnancy-related deaths and 19,179 live births were reported in the districts. The areas where ambulance services were frequently used for women's obstetric needs saw substantially reduced mortality rates. Districts with above average utilisation of ambulance services had a pregnancy-related mortality rate of 149 per 100,000 live births whereas that same rate was 350 in areas with below average utilisation of ambulance services.
The findings are described in an article titled "Can innovative ambulance transport avert pregnancy-related deaths? One-year operational assessment in Ethiopia", published today in the Journal of Global Health.
The Ethiopian government's ambulance service is unique in Sub-Saharan Africa. Providing four-wheel drive ambulances in every rural district in the country, the programme includes a total of 1,250 ambulances offering delivery services 24 hours per day, seven days per week. The national ambulance service programme was launched with a USD 50 million investment. Its sustainability is ensured through collaborative financing agreements with regional governments, who agree to make the services available free of charge.