NEW DELHI, India — The maternal mortality ratio (MMR) of Chhattisgarh has reduced to 137 per 100,000 live births in 2018-20 as compared to the last MMR which was 160. This is a huge improvement. The government schemes and the support of nonprofit organizations made this possible.
NGO Saathi Samaj Seva Sanstha, with the support of UNICEF, has taken one such initiative which provides free emergency rides for the pregnant tribal women of the Narayanpur district of Chhattisgarh to the nearest health care center through their innovative Motorbike Ambulance.
Need for the Motorbike Ambulance
Narayanpur is a region of rugged tracts with dense forests, hills, rivers and streams with the presence of Maoist activities too. This makes it difficult for pregnant women to reach the nearest town for health checkups or for deliveries without a proper ambulance. Prior to the initiative, women would give birth at home with the help of other women or take a makeshift open carriage, posing a serious threat to the lives of both the mother and the child.
In 2014 UNICEF partnered with Saathi and began the motorbike ambulance project. The state government’s health department also supported the project and started providing free ambulance services to reach health centers in the nearest town.
Working on the Motorbike Ambulance
Each motorbike ambulance is a modified four-stroke motorcycle with a side attachment of a very compact 200cm X 143cm. “To keep the bike light and easy to handle we only have a small oxygen cylinder and first aid or a responder kit in it.” Bhupesh Tiwari, chairman of Saathi, told The Borgen Project in an interview.
In this ambulance, the patient can comfortably lie down on the side carriage and an attendee/family member can also accompany the patient with the driver. After the checkup, the motorbike ambulance takes them back to their homes.
“Most pregnant women say that it has not only brought ease in their commute to hospitals for free but they can also take their children with them and not worry about them at home,” says Tiwari.
Tiwari explains that the drivers of the ambulances are from the same locality and know the tribal language and area and understand the geography well. The drivers are then trained in first aid responder training to be able to provide assistance in the time of emergency. Saathi pays the salary of the drivers via the project.
Every motorbike ambulance has a separate helpline number which is distributed to various people in the service area like self-help groups, Anganwadi (rural child care center) workers, health workers, youths and pregnant women. The number is also written in many public places.
Funding of the Project
UNICEF provided financial and technical support to implement the project to achieve its objectives. It also supported the running cost of the motorbike ambulance in the area. “We propose the intervention to various funding agencies (who work in Health Domain) for funding. At present all the motorbike ambulances are run on DMF funds allocated to each district,” says Tiwari.
Results and Challenges
The active presence of motorbike ambulances in the lives of the community has directly resulted in reduced incidences of maternal, infant and child mortality. The ambulance not only helps pregnant women to reach the hospital for delivery but also takes them for their regular health check-ups, which helps monitor pregnancy complications, UNICEF reports.
“We were able to closely study the impact of motorbike ambulances in the Narayanpur district. In Narayanpur till now 27% of institutions’ deliveries are happening because of Motorbike ambulances,” Tiwari states. “This has also helped the community to change their behavior towards public health services. As it makes services reachable and known, people start to debunk misconceptions about medicine and the health system, resulting in more trust in the system.”
There are challenges too. “Our major concern is running the Motorbike Ambulance smoothly without any breakage in the service delivery,” explains Tiwari. In hard-to-reach areas, sometimes there is no proper network connectivity which results in a delay in the service during an emergency.
Despite the challenges, motorbike ambulances have proved to be a boon for the villagers. At present, there are 17 motorbike ambulances running in the Narayanpur, Bijapur, Balrampur and Kawardha districts of Chhattisgarh. There are four motorbike ambulances running in Narayanpur at the moment. Overall, these Motorbike Ambulances cater to 368 villages with approximately 100,000 people.
– Aanchal Mishra