Reciept of adequate and appropriate treatment

Lack of transportation and transport infrastructure contributes to delays in the delivery of adequate supplies to facilities providing emergency obstetric care (EmOC). A basic package of EmOC consists of capabilities for the administration of antibiotics, oxytonics, anticonvulsants, manual removal of placenta, removal of retained products of placenta, and assisted vaginal delivery (UNFPA, 2003). Comprehensive care also includes caesarean section and blood transfusion.

In Pakistan’s Punjab and North West Frontier Provinces, of the 170 public health facilities that are supposed to provide EmOC services, only 22 could offer basic, and 37 comprehensive EmOC services, meeting the needs of only nine per cent of women seeking care (Ali et al, 2005).

When health centres are unable to provide adequate care, transportation services are needed to transfer women to appropriate facilities. Poor transportation and communication between health centres and district level facilities where ambulances are stationed further delays access to care (Alwar et al, 2000). Most hospitals in the aforementioned Pakistan case study had no functional ambulances to transfer patients to a higher level of care (Ali et al, 2005).

In South Africa, lack of transport to ensure the timely transfer of women between institutions accounted for 13.6 per cent of maternal deaths in 1998. This figure does not include delays in transporting women from their homes to institutions (Hall et al, 2002).