Increasing access to adequate and acceptable transport

A number of initiatives have been set up to provide alternative transport for women needing emergency obstetric care when health sector resources are limited. In Malawi, Mali, Nigeria and other African countries motorcycle ambulances take women from remote villages to health facilities, transport passengers between health centres and district hospitals, and supply medical equipment and essential drugs.

For example, in the Southern region of Malawi, eRanger project delivered three Motorcycle Ambulances for the safe transportation of pregnant women to clinics or hospitals. The ambulances have transportation times comparable to four wheeled ambulances, but with considerable savings in terms of initial purchase cost and ongoing maintenance.

Working with existing transport networks is another way of improving access to transport. A safe motherhood network in Kebbi, Nigeria, enlisted the support of a local bus drivers union whose members agreed to provide transportation for women with obstetrical emergencies. Drivers received training in how to transport emergency cases and reimbursement for fuel costs from a fund created by community members. A 1995 survey found that 13 percent of women who required transportation for obstetrical care relied on the new system, whereas three years earlier most women had to pay commercial rates for that service (Ransom and Yinger, 2002).

A similar approach is being replicated in Nigeria. Under the DFID funded PATHS programme, in Kano State the community safe motherhood group is collaborating with the National Union of Road Transport Workers. The Emergency Transport Scheme (ETS) drivers engaged in selected communities help in transporting women to hospitals during emergencies.