Reducing the cost of emergency transport

Reducing or eliminating the cost of emergency transport is particularly important for enabling poor families to access timely care. Cost sharing, community saving and pooled insurance schemes are some of the different financing mechanisms that have been used by families and communities to pay for transport, fuel costs and drivers during an emergency. These initiatives make it possible for families to spread the burden of cost thus limiting the impacts of catastrophic expenditures.

In Mpongwe, Masaiti and Lufwanyama, Zambia, committees were set up in villages to collect and keep funds to be used for paying for transport during obstetric emergencies (Alwar et al, 2000). In Muhororo district, Rwanda, a community set up an emergency transport scheme whereby they paid half of the cost of transportation whilst the health committee paid the other half. This scheme has helped poor families that could otherwise not afford to organise emergency transport on time (Pearson and Shoo, 2005).

However, social exclusion can be an issue in the management of emergency funds. Neupane’s 2004 evaluation of Safe Motherhood emergency funds in Nepal, mobilised and managed through local groups, found weak inclusion of Dalits (non-Nepali speaking people who are landless, not eligible for citizenship and citizen-based rights) and the ultra-poor. Many high caste people were not willing to allow Dalits to be members of the community groups, or if members, to be engaged in leaderships roles.