Transport for pregnant women in Ethiopia

Transport for pregnant women in Ethiopia

Published Apr 2006

Author

Taye Berhanu

Publisher

Focus countries

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Transport for pregnant women in Ethiopia

Africa has the highest maternal mortality ratio, with 830 deaths per 100,000 live births, according to the World Health Organization.

Antenatal services and care after giving birth,assistance from a skilled attendant and access to emergency obstetric serviceswould reduce these figures.

Yet in rural areas where patients often travel longdistances to reach referral health services without appropriate and affordabletransport services, such essential care is difficult to achieve.

The Ethiopian National Forum Group (ENFG) hasresearched how to transport critically ill and high risk patients safely. Inrural Ethiopia, where 85 percent of the population live, patientsfind it difficult to reach clinics or referral hospitals. The research showsthat there are two main problems:

  • The criticalshortage of any means of transport in rural areas forces patients to walk longdistances, resulting in a deterioration of their condition by the time theyreach the health centre.
  • Where traditionalmeans of transport are used, the way patients are positioned for travel cancause complications. Common traditional transport includes: locally made woodenstretchers carried by four people, on the backs of animals or other people, ortransport by horse or donkey cart, truck or any available car.

Such methods are problematic:

  • Keeping patientsin a safe and neutral position is often difficult.
  • The delay ingetting patients medical treatment can lead to additional health complications.
  • Patients withsevere and multiple injuries, such as cervical spine and spinal cord injuries,risk secondary organ damage.

The most vulnerable – those lacking adequate transportand suffering from poor health – are pregnant women and fistula patients. It ismore challenging for medical personnel to perform life-saving activities andmay result in patients dying from a secondary transport-related injury.

Two main policy recommendations arise from theresearch for local planners, decision-makers and government officials:

  • Hardware –Physical access to health services would improve with integrated planning byhealth, transport and other government ministries. Better transporttechnologies, both motorised and non-motorised, such as bicycle ambulances forshort distances, or taxi ambulances for medium and longer distances would helpenormously.
  • Software – In theshort term, training materials to illustrate correct positioning of patientsusing traditional means of transport would help. These could be based onexisting ‘training of trainers’ models used by health-related nongovernmentalorganisations, community-based organisations and local health centres.

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