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

Jan J Hofman, Chris Dzimadzi, Kingsley Lungu, Esther Y Ratsma, Julia Hussein

Research output: Contribution to journalArticle

49 Citations (Scopus)


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.
Original languageEnglish
Pages (from-to)191-197
Number of pages7
JournalInternational Journal of Gynecology & Obstetrics
Issue number2
Early online date16 Jun 2008
Publication statusPublished - Aug 2008



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

Cite this