IDEAS home Printed from https://ideas.repec.org/a/plo/pgph00/0001487.html
   My bibliography  Save this article

Community-based transport system in Shinyanga, Tanzania: A local innovation averting delays to access health care for maternal emergencies

Author

Listed:
  • Castory Munishi
  • Gilbert Mateshi
  • Linda B Mlunde
  • Belinda J Njiro
  • Jackline E Ngowi
  • James T Kengia
  • Ntuli A Kapologwe
  • Linda Deng
  • Alice Timbrell
  • Wilson Kitinya
  • Andrea B Pembe
  • Bruno F Sunguya

Abstract

In achieving the sustainable development goal 3.1, Tanzania needs substantial investment to address the three delays which responsible for most of maternal deaths. To this end, the government of Tanzania piloted a community-based emergency transport intervention to address the second delay through m-mama program. This study examined secondary data to determine the cost-effectiveness of this intervention in comparison to the standard ambulance system alone. The m-mama program was implemented in six councils of Shinyanga region. The m-mama program data analyzed included costs of referral services using the Emergency Transportation System (EmTS) compared with the standard ambulance system. Analysis was conducted using Microsoft Excel, whose data was fed into a TreeAge Pro Healthcare 2022 model. The cost and effectiveness data were discounted at 5% to make a fair comparison between the two systems. During m-mama program implementation a total of 989 referrals were completed. Of them, 30.1% used the standard referral system using ambulance, while 69.9% used the EmTS. The Emergency transport system costed USD 170.4 per a completed referral compared to USD 472 per one complete referral using ambulance system alone. The introduction of m-mama emergency transportation system is more cost effective compared to standard ambulance system alone in the context of Shinyanga region. Scaling up of similar intervention to other regions with similar context and burden of maternal mortality may save cost of otherwise normal emergency ambulance system. Through lessons learned while scaling up, the intervention may be improved and tailored to local challenges and further improve its effectiveness.

Suggested Citation

  • Castory Munishi & Gilbert Mateshi & Linda B Mlunde & Belinda J Njiro & Jackline E Ngowi & James T Kengia & Ntuli A Kapologwe & Linda Deng & Alice Timbrell & Wilson Kitinya & Andrea B Pembe & Bruno F S, 2023. "Community-based transport system in Shinyanga, Tanzania: A local innovation averting delays to access health care for maternal emergencies," PLOS Global Public Health, Public Library of Science, vol. 3(8), pages 1-11, August.
  • Handle: RePEc:plo:pgph00:0001487
    DOI: 10.1371/journal.pgph.0001487
    as

    Download full text from publisher

    File URL: https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0001487
    Download Restriction: no

    File URL: https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0001487&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pgph.0001487?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Leon Moskatel & David Slusky, 2019. "Did UberX reduce ambulance volume?," Health Economics, John Wiley & Sons, Ltd., vol. 28(7), pages 817-829, July.
    2. Thaddeus, Sereen & Maine, Deborah, 1994. "Too far to walk: Maternal mortality in context," Social Science & Medicine, Elsevier, vol. 38(8), pages 1091-1110, April.
    3. Chase Hollman & Mike Paulden & Petros Pechlivanoglou & Christopher McCabe, 2017. "A Comparison of Four Software Programs for Implementing Decision Analytic Cost-Effectiveness Models," PharmacoEconomics, Springer, vol. 35(8), pages 817-830, August.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Gayen, Kaberi & Raeside, Robert, 2007. "Social networks, normative influence and health delivery in rural Bangladesh," Social Science & Medicine, Elsevier, vol. 65(5), pages 900-914, September.
    2. Eleftheria Kontou & Noreen McDonald, 2021. "Associating ridesourcing with road safety outcomes: Insights from Austin, Texas," PLOS ONE, Public Library of Science, vol. 16(3), pages 1-18, March.
    3. Lídia Farré, 2013. "The Role of Men in the Economic and Social Development of Women: Implications for Gender Equality," The World Bank Research Observer, World Bank, vol. 28(1), pages 22-51, February.
    4. repec:plo:pone00:0155144 is not listed on IDEAS
    5. Lillian Whiting-Collins & Florina Serbanescu & Ann-Beth Moller & Susanna Binzen & Jean-Pierre Monet & Jenny A Cresswell & Michel Brun & on behalf of the World Health Organization’s MDSR Reporting and , 2024. "Maternal death surveillance and response system reports from 32 low-middle income countries, 2011–2020: What can we learn from the reports?," PLOS Global Public Health, Public Library of Science, vol. 4(3), pages 1-17, March.
    6. Kusuma, Dian & Cohen, Jessica & McConnell, Margaret & Berman, Peter, 2016. "Can cash transfers improve determinants of maternal mortality? Evidence from the household and community programs in Indonesia," Social Science & Medicine, Elsevier, vol. 163(C), pages 10-20.
    7. Sushma Rajbanshi & Mohd Noor Norhayati & Nik Hussain Nik Hazlina, 2021. "Perceptions of Good-Quality Antenatal Care and Birthing Services among Postpartum Women in Nepal," IJERPH, MDPI, vol. 18(13), pages 1-13, June.
    8. Weitzman, Abigail, 2017. "The effects of women's education on maternal health: Evidence from Peru," Social Science & Medicine, Elsevier, vol. 180(C), pages 1-9.
    9. Mosquera, Roberto, 2024. "Stuck in traffic: Measuring congestion externalities with negative supply shocks," Regional Science and Urban Economics, Elsevier, vol. 108(C).
    10. Sara Rivenes Lafontan & Johanne Sundby & Hege L. Ersdal & Muzdalifat Abeid & Hussein L. Kidanto & Columba K. Mbekenga, 2018. "“I Was Relieved to Know That My Baby Was Safe” : Women’s Attitudes and Perceptions on Using a New Electronic Fetal Heart Rate Monitor during Labor in Tanzania," IJERPH, MDPI, vol. 15(2), pages 1-12, February.
    11. Benjamin M Hunter & Sean Harrison & Anayda Portela & Debra Bick, 2017. "The effects of cash transfers and vouchers on the use and quality of maternity care services: A systematic review," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-37, March.
    12. Kasperi Kilpi & Soorej Puthoopparambil & Rejina Gurung & Honey Malla & Omkar Basnet & Ashish KC, 2025. "Association of international remittance with satisfaction and utilization of maternal healthcare services in Nepal: A secondary analysis of two cohort studies," Journal of International Development, John Wiley & Sons, Ltd., vol. 37(1), pages 51-67, January.
    13. Habtamu Tolera & Tegegne Gebre-Egziabher & Helmut Kloos, 2020. "Using Andersen’s behavioral model of health care utilization in a decentralized program to examine the use of antenatal care in rural western Ethiopia," PLOS ONE, Public Library of Science, vol. 15(1), pages 1-18, January.
    14. Courtemanche, Charles & Friedson, Andrew I. & Rees, Daniel I., 2018. "Ambulance Utilization in New York City after the Implementation of the Affordable Care Act," IZA Discussion Papers 11444, Institute of Labor Economics (IZA).
    15. Matsuoka, Sadatoshi & Aiga, Hirotsugu & Rasmey, Lon Chan & Rathavy, Tung & Okitsu, Akiko, 2010. "Perceived barriers to utilization of maternal health services in rural Cambodia," Health Policy, Elsevier, vol. 95(2-3), pages 255-263, May.
    16. Hirose, Atsumi & Borchert, Matthias & Niksear, Homa & Alkozai, Ahmad Shah & Cox, Jonathan & Gardiner, Julian & Osmani, Khadija Ruina & Filippi, Véronique, 2011. "Difficulties leaving home: A cross-sectional study of delays in seeking emergency obstetric care in Herat, Afghanistan," Social Science & Medicine, Elsevier, vol. 73(7), pages 1003-1013.
    17. Kibballi Madhukeshwar Akshaya & Siddharudha Shivalli, 2017. "Birth preparedness and complication readiness among the women beneficiaries of selected rural primary health centers of Dakshina Kannada district, Karnataka, India," PLOS ONE, Public Library of Science, vol. 12(8), pages 1-15, August.
    18. Nicholas Apreh Siaw & Samuel Kwofie, 2016. "Assessment of the Effects of the Free Maternal Health Policy on Maternal Health: A Case Study of New Juaben Municipality, Koforidua, Ghana," International Journal of Business and Social Research, MIR Center for Socio-Economic Research, vol. 6(7), pages 52-62, July.
    19. Nancy A Scott & Taryn Vian & Jeanette L Kaiser & Thandiwe Ngoma & Kaluba Mataka & Elizabeth G Henry & Godfrey Biemba & Mary Nambao & Davidson H Hamer, 2018. "Listening to the community: Using formative research to strengthen maternity waiting homes in Zambia," PLOS ONE, Public Library of Science, vol. 13(3), pages 1-16, March.
    20. Nyaaba, Albert Apotele & Ayamga, Matthew, 2021. "Intricacies of medical drones in healthcare delivery: Implications for Africa," Technology in Society, Elsevier, vol. 66(C).
    21. Tanser, Frank & Gijsbertsen, Brice & Herbst, Kobus, 2006. "Modelling and understanding primary health care accessibility and utilization in rural South Africa: An exploration using a geographical information system," Social Science & Medicine, Elsevier, vol. 63(3), pages 691-705, August.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pgph00:0001487. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: globalpubhealth (email available below). General contact details of provider: https://journals.plos.org/globalpublichealth .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.