Improving access to emergency obstetric care through local transport resources

Lack of transport keeps many women with pregnancy complications in Nigeria from obtaining timely access to skilled medical care. To address this issue, the PATHS2 Project supports emergency transport to the nearest qualified health facility using volunteer taxi drivers in the community from the National Union of Road Transport Workers. Communities with high cases of maternal mortality were selected for the intervention and sensitized. Community taxi drivers interested in volunteering were trained on danger signs in pregnancy and delivery, how to handle pregnant women, vehicle maintenance and data collection. Taxis were evaluated for road-worthiness. The drivers' cellular phone numbers were displayed throughout the community. Drivers were unpaid but were given priority for picking up passengers in the community as a reward. Drivers logged data on the number of women transported, their complication, and the distance to the health facility. Between June and August 2012, about 50 volunteer drivers transported about 350 pregnant women in urgent need of medical care over a total distance of 4,208km. The women transported had: Antepartum Hemorrhage-17%, Abdominal Pain-9%, Labour-16%, delivered at Home without SBA-16%, Eclampsia-5%, Severe Weakness/Dizziness-9%, Fever-9%. The average distance travelled to a facility was 12 Km, a significant distance during an obstetric emergency. The PATHS2 model is a sustainable and scalable model for other communities in LMIC with poor access to health facilities offering Basic or Comprehensive Emergency Obstetric Care