Community Voices Bring Ambulance Services Back to Benin’s Plateau Department

When an expectant mother has a medical emergency, a few minutes’ delay can be deadly. But with few public ambulances in parts of Benin, families often spend those precious minutes securing transportation to the hospital.

In the Plateau department, patients have struggled with emergency transportation since 2018, when the last public ambulance broke down. Private health facilities charge up to 25,000 CFA (about $46) for an ambulance, a significant cost for many people. Meanwhile, private drivers are often reluctant to transport patients because of bad roads. As a result, people face the difficult decision of either coming up with a large sum of money or taking public transportation.

Unreliable transportation puts lives at risk. Recent Maternal Death Surveillance and Response audits show that late referral is among the main causes of maternal mortality in Benin. Between January 1 and September 30, 2020, the Plateau department recorded 1,125 obstetric referrals. Of these referrals, 32 maternal deaths were recorded in the Pobè-Adja-Ouèrè-Kétou and Sakété-Ifangni health zones — some of which could have been prevented had an ambulance been available.

This is where the USAID Integrated Health Services Activity stepped in, to bring community leaders together and advocate for ambulance services. First, the activity helped the leaders gather information on locally available and functional vehicles. Through their research and national media reports, the community leaders learned that several ambulances were reserved for selected health zones and that a privately donated ambulance offered to the Beninese government was now available.

Concurrently, the activity provided guidance on negotiating and collaborating with political and administrative authorities. With these new skills, the community leaders made their case to mayors and national politicians on the urgent need for a new ambulance in the Plateau.

Thanks to support from the American people and the local leaders’ persistence, the communities obtained a new ambulance on October 22, 2020. The government of Benin delivered the vehicle through the Regional Disease Surveillance Systems Enhancement (REDISSE) Project, which is funded by the World Bank and implemented by Benin’s National HIV/AIDS, Tuberculosis, and Malaria Council.

Between October 26, when the vehicle was put into service, and December 31, 2020, the ambulance transported 53 people to the Departmental University-Hospital Center of Ouémé and Plateau and the Sakété Health Zone Hospital. Out of these 53 cases, 85 percent were pregnant women, 10 percent were children under five, 5 percent were patients with injuries, and one case was a patient with COVID-19. In addition, the Plateau department is creating guidelines for vehicle maintenance and repair to ensure the ambulance will be used in a sustainable manner.

Rafiou Aya, President of the Pobè-Adja-Ouèrè-Kétou Health Zone Committee, shared his gratitude for all the stakeholders that worked to make this vehicle available. “We want to thank the Government, the Ministry of Health, and other stakeholders at the departmental level that helped us receive this ambulance. Our thanks also go to the staff of the USAID Integrated Health Services Activity in the Plateau for their support. This is true development at play.”