In many parts of the Busoga region in Eastern Uganda which has an estimated population of 8.3million people, it was common for boda bodas (motorcycles) to be used in transporting patients with medical emergencies requiring specialized care. This included pregnant women with pregnancy – related complications requiring emergency specialized care being transported either from their homes to the entry level health centers or from lower-level health facilities to higher ones. This practice placed mothers and their unborn babies at the risk of being involved in road accidents, which are prevalent with boda bodas.

Korea International Cooperation Agency (KOICA) in partnership with the World Health Organization (WHO) and the Ministry of Health have addressed this challenge. Together, with funding from the Government of the Republic of Korea, they are implementing the Health System Strengthening to Improve Reproductive, Maternal, Newborn, Child and Adolescent Health Services project in five districts of the region. The five districts are Buyende, Bugiri, Kamuli, Iganga, and Mayuge.

The five-year project focuses on strengthening the health system for improved health outcomes in the Busoga region with key interventions including the provision of an ambulance to each district. The ambulances are to facilitate the safe transportation of patients requiring emergency specialized care, including pregnant women.

Improving the referral system was critical in this region because some of the entry health centers are not equipped to handle complications such as excessive bleeding, and high blood pressure before and after delivery. For babies, resuscitation facilities aren’t always readily available. Additionally, the distance between various levels of care can be challenging; sometimes as far as 60km from the nearest Health Centre II or III to the more specialized Health Centre IV or General Hospital. In two of the project districts that currently do not have General Hospitals, boda bodas were the easiest form of transport for emergency conditions despite the risks attached to them.

“The risks were not just about the rough terrain. If one was to use a boda boda, they ought to have had money to pay for the fares. The health centers simply referred the patients and our job ended at that,” explains Dr. Fredrick Isabirye, the Buyende District Health Officer (DHO).

Dr. Geofrey Kasaizaki, the Senior Medical Officer at Nankoma Health Centre IV in Bugiri District recounts the many mothers and their babies lost in transit from the health facility to the hospital where they had been referred before the district received an ambulance.

With the ambulances in place, coordination has been streamlined. The health centers make a call to the facilities where the patients are being referred to allow for prior preparation for their arrival. In most cases, the ambulance has a nurse to provide any care that may be needed along the way. The drivers have also been trained in emergency specialized care so by and large, the risks of losing mothers and babies have been duly mitigated.