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The Birth and Growth of the National Ambulance Service in Ghana

Published online by Cambridge University Press:  12 December 2016

Ahmed Zakariah ,
Barclay T. Stewart ,
Edmund Boateng ,
Christiana Achena ,
Gavin Tansley  and
Charles Mock
Ahmed Zakariah
Affiliation:
National Ambulance Service, Ministry of Health, Accra, Ghana
Barclay T. Stewart*
Affiliation:
Department of Surgery, University of Washington, Seattle, Washington USA School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana Department of Interdisciplinary Health Sciences, Stellenbosch University, Cape Town, South Africa
Edmund Boateng
Affiliation:
National Ambulance Service, Ministry of Health, Accra, Ghana
Christiana Achena
Affiliation:
National Ambulance Service, Ministry of Health, Accra, Ghana
Gavin Tansley
Affiliation:
Department of Surgery, Dalhouise University, Nova Scotia, Canada Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
Charles Mock
Affiliation:
Department of Surgery, University of Washington, Seattle, Washington USA Harborview Injury Prevention & Research Center, Seattle, Washington USA Department of Global Health, University of Washington, Seattle, Washington USA
*
Correspondence: Barclay T. Stewart, MD, MscPH University of Washington Department of Surgery 1959 NE Pacific St., Suite BB-487 PO Box 356410 Seattle, Washington 98195-6410 USA E-mail: stewarb@uw.edu
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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

developing countriesEmergency Medical ServicesGhana
Type
Special Reports
Information
Prehospital and Disaster Medicine , Volume 32 , Issue 1 , February 2017 , pp. 83 - 93
Copyright
© World Association for Disaster and Emergency Medicine 2016 

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Footnotes

(Note: Drs. Zakariah and Stewart are co-First Authors.)

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