Motorcycle ambulances for referral of obstetric emergencies in rural Malawi: Do they reduce delay and what do they cost?
Received 4 January 2008; received in revised form 17 March 2008; accepted 6 April 2008. published online 12 May 2008.
Abstract
Objectives
To assess whether motorcycle ambulances placed at rural health centers are a more effective method of reducing referral delay for obstetric emergencies than a car ambulance at the district hospital, and to compare investment and operating costs with those of a 4 wheel drive car ambulance at the district hospital.
Methods
Motorcycle ambulances were placed at 3 remote rural health centers in Malawi. Data were collected over a 1-year period, from October 2001 to September 2002, using logbooks, cashbooks, referral forms, and maternity registers.
Results
Depending on the site, median referral delay was reduced by 2–4.5 hours (35%–76%). Purchase price of a motorcycle ambulance was 19 times cheaper than for a car ambulance. Annual operating costs were US $508, which was almost 24 times cheaper than for a car ambulance.
Conclusions
In resource-poor countries motorcycle ambulances at rural health centers are a useful means of referral for emergency obstetric care and a relatively cheap option for the health sector.
ABSTRACT