The mothers with their babies and health officers
In Ghana’s Northern region, the joy of childbirth often turns into sorrow. Women, having carried their pregnancies for nine months, face unbearable loss on delivery day.
The region in 2023 recorded 100 institutional maternal death compared to 69 in 2022. This brought the region’s institutional maternal mortality ratio to 136.7 per 100,000 live births in 2023 compared to 94.5 per 100,000 live births for the year 2022, with the national target being 125 per 100,000 live births says Dr. Abdulai Abukari, Northern Regional Director of Health.
According to him, Neonatal mortality rate also witnessed a slight increase from 4.6 per 1,000 in 2022 to 4.7 per 1000 in 2023.
“This is a serious case considering the numbers we have recorded overtime. The slight increase in neonatal mortality was largely due to service delivery challenges of occasional absence of medical doctors in some of the major referral centres in the region leading to suboptimal functioning of those hospitals,” he stated.
The National Ambulance Service and Catholic Relief Service owing to this persistence challenges and it accompanied complication pregnant mothers face in rural communities initiated the modified motor-tricycle ambulance in the Northern Region and parts of rural Ghana with the aid of birth assistants.
The tricycle ambulance, which is locally manufactured is equipped with essential features such as a removable stretcher, seats for family members and medical personnel, and basic life support options.
This has led to the introduction of mobile clinics and community health programs targeting underserved populations, offering crucial maternal care in remote areas, aim at decreasing maternal mortality in the region.
Health Referral Network
Due to the inaccessibility of roads, traditional ambulances often cannot reach these areas. As a solution, tricycle ambulances, which are equipped with attendants trained are used to assist pregnant women during transit.
In addition to the tricycle ambulances, Emergency Dispatch Center (EDC) has been established. This center acts as a vital communication hub, connecting healthcare providers with Modified Motorcycle Ambulances (MMAs). When a medical emergency arises, the dispatch center is notified about the situation, allowing for a swift response.
Upon receiving a call, the MMA team is dispatched to the location of the patient. Once they arrive at the CHIPs facility, there is a dedicated telephone line linking the facility to the dispatch center.
If the healthcare staff at the CHIPs determine that they cannot manage the patient’s condition, they can immediately contact the dispatch center for further assistance.
In such cases, the dispatch center coordinates the deployment of a traditional vehicular ambulance to meet the MMA at an accessible location. This seamless transfer ensures that patients receive the necessary care and are transported to hospitals without unnecessary delays.
Community Story Focus
Northern Regional Advance Emergency Medical Technologist (AEMT), National Ambulance Service Jerryjees Mohammed recalled that some months ago the service received a call from the Damankun community in Gushegu urgently reported that a woman required transportation to the hospital after delivering her first twin. Tragically, she was experiencing severe weakness due to profuse bleeding.
In response, the National Ambulance team upon arrival, swiftly transported her, and, in a miraculous turn of events, she delivered twin babies right inside the ambulance.
However, shortly after the birth, the woman became unresponsive. The EMTs sprang into action, employing their training and expertise to revive her. With dedicated care and the necessary treatments, they worked tirelessly to stabilize her condition, ensuring she received the medical attention she urgently needed.
In an interview with Daily Guide, Jerryjees Mohammed shared that recognizing the influential role of Traditional Birth Attendants (TBAs) in the community, they engage them as vital partners in promoting safe childbirth practices in the Gushegu municipality.
AEMT Jerryjees Mohammed further indicated that the service does work closely with local healthcare facilities to create a seamless referral system for mothers who need specialized care.
They organise regular meetings with healthcare providers to help establish protocols for communication and support, ensuring that all parties are aligned in their efforts to enhance maternal health services.
He also revealed that considering their operations in rural communities who are bound by traditional beliefs and customs, the service makes a conscious effort to incorporate local cultural practices related to childbirth and maternal care into it programs.
Touching on challenges, AEMT Jerryjees Mohammed highlighted that one of the significant challenges they face has to do with staffing. He added that during the rainy season the roads become almost immotorable, with sections becoming invisible or completely flooded. This greatly affects the tricycle programme’s ability to operate efficiently and provide timely service to those in need.
CEO of National Ambulance Service, Prof. Ahmed Nuhu Zakariah said the introduction of motorized cycles as served as a vital solution to bridge the gap between rural areas and the emergency services provided by the National Ambulance Service.
“We recognize numerous hard-to-reach areas that traditional ambulance vehicles cannot access. However, motorcycles can navigate these challenging terrains, allowing us to transport patients quickly. We have observed the success of this initiative, particularly in the northern regions where it began as a pilot programme,” he stated.
Prof. Nuhu Zakariah, added that the establishment of the Emergency Medical Dispatch Center to facilitate communication between local communities and the ambulance service, as well as with nearby health facilities was initially implemented in Nkwanta in the Oti Region and Gusegu in the Northern Region.
The service, he said will expand this model to other rural communities adding that, “It’s important to acknowledge that this is a collective responsibility. We work closely with local communities to provide personnel while complementing their efforts”.
He indicated that the goal of the Ambulance Service is to gradually build a robust team capable of serving rural areas effectively.
“Expanding the Emergency Dispatch Center to all communities will significantly enhance our services. By doing so, we will not solely rely on the national emergency dispatch system; instead, we will empower local dispatch systems that understand their communities intimately. This localized approach will help overcome language barriers and improve communication, ensuring that we address the unique challenges faced by each community,” he added.
By Prince Fiifi Yorke