Motorcycle ambulances for referral of obstetric emergencies in rural Malawi: do they reduce delay and what do they cost?

Int J Gynaecol Obstet. 2008 Aug;102(2):191-7. doi: 10.1016/j.ijgo.2008.04.001. Epub 2008 Jun 16.


Objectives: To assess whether motorcycle ambulances placed at rural health centers are a more effective method of reducing referral delay for obstetric emergencies than a car ambulance at the district hospital, and to compare investment and operating costs with those of a 4 wheel drive car ambulance at the district hospital.

Methods: Motorcycle ambulances were placed at 3 remote rural health centers in Malawi. Data were collected over a 1-year period, from October 2001 to September 2002, using logbooks, cashbooks, referral forms, and maternity registers.

Results: Depending on the site, median referral delay was reduced by 2-4.5 hours (35%-76%). Purchase price of a motorcycle ambulance was 19 times cheaper than for a car ambulance. Annual operating costs were US dollars 508, which was almost 24 times cheaper than for a car ambulance.

Conclusions: In resource-poor countries motorcycle ambulances at rural health centers are a useful means of referral for emergency obstetric care and a relatively cheap option for the health sector.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Ambulances / economics*
  • Costs and Cost Analysis
  • Emergency Medical Services / economics*
  • Female
  • Hospitals, District
  • Humans
  • Malawi
  • Motorcycles / economics*
  • Pregnancy
  • Pregnancy Complications / economics
  • Pregnancy Complications / therapy*
  • Referral and Consultation / economics*
  • Rural Health Services / economics*
  • Time Factors