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. 2017 Feb;32(1):83-93.
doi: 10.1017/S1049023X16001151. Epub 2016 Dec 12.

The Birth and Growth of the National Ambulance Service in Ghana

Ahmed Zakariah  1 , Barclay T Stewart  2 , Edmund Boateng  1 , Christiana Achena  1 , Gavin Tansley  3 , Charles Mock  2
Affiliations

The Birth and Growth of the National Ambulance Service in Ghana

Ahmed Zakariah et al. Prehosp Disaster Med. 2017 Feb.

Abstract

Introduction This study aimed to document the growth and challenges encountered in the decade since inception of the National Ambulance Service (NAS) in Ghana, West Africa. By doing so, potentially instructive examples for other low- and middle-income countries (LMICs) planning a formal prehospital care system or attempting to identify ways to improve existing emergency services could be identified.

Methods: Data routinely collected by the Ghana NAS from 2004-2014 were described, including: patient demographics, reason for the call, response location, target destination, and ti1mes of service. Additionally, the organizational structure and challenges encountered during the development and maturation of the NAS were reported.

Results: In 2004, the NAS piloted operations with 69 newly trained emergency medical technicians (EMTs), nine ambulances, and seven stations. The NAS expanded service delivery with 199 ambulances at 128 stations operated by 1,651 EMTs and 47 administrative and maintenance staff in 2014. In 2004, nine percent of the country was covered by NAS services; in 2014, 81% of Ghana was covered. Health care transfers and roadside responses comprised the majority of services (43%-80% and 10%-57% by year, respectively). Increased mean response time, stable case holding time, and shorter vehicle engaged time reflect greater response ranges due to increased service uptake and improved efficiency of ambulance usage. Specific internal and external challenges with regard to NAS operations also were described.

Conclusion: The steady growth of the NAS is evidence of the need for Emergency Medical Services and the effects of sound planning and timely responses to changes in program indicators. The way forward includes further capacity building to increase the number of scene responses, strengthening ties with local health facilities to ensure timely emergency medical care and appropriateness of transfers, assuring a more stable funding stream, and improving public awareness of NAS services. Zakariah A , Stewart BT , Boateng E , Achena C , Tansley G , Mock C . The birth and growth of the National Ambulance Service in Ghana. Prehosp Disaster Med. 2017;32(1):83-93.

Keywords: EMT emergency medical technician; LMICs low- and middle-income countries; NAS National Ambulance Service; PHTLS Prehospital Trauma Life Support; Emergency Medical Services; Ghana; developing countries.

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Conflict of interest statement

Conflicts of interest: none

Figures

Figure 1
Figure 1
Ghana National Ambulance Service Organogram. Abbreviations: EMT, emergency medical technician; HR, human resources; M&E, monitoring and evaluation; Ops, operations.
Figure 2
Figure 2
Map of the Expansion of Service Range by the National Ambulance Service in Ghana from 2004 through 2014.
Figure 3
Figure 3
Number and Location of Responses by the National Ambulance Service in Ghana from 2004 through 2014. Note: Health facility refers to inter-hospital transfer for referral or diagnostic evaluation.
See this image and copyright information in PMC

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