Enablers and barriers of community initiated health emergency transport systems in the Upper West Region of Ghana

ABSTRACT

In the Global South, community emergency transport systems (CETS) are typically in response to inadequate National Ambulance Services and a poor transport network, particularly in rural areas. In Ghana, CETS have emerged some communities under the auspices of the Community-based Health Planning Services program.  We explored the enablers and barriers to the success of CETS in the Upper West Region. The results show that among others, effective leadership, acceptance of risk-pooling and community cohesion enabled success. Key barriers included community level conflicts and lack of resources. In poor resource context, CETS could be up-scaled to supplement an existing ambulance system.

KEYWORDS:

• Deprived communities
• emergency health transportation
• community health workers
• barriers
• health inequalities

Acknowledgements

The authors would like to thank the Upper West Regional CHPS management and the district CHPS planning team for their support throughout the study. We would also like to thank all the study participants for taking time to take part in the study. We are also grateful to the reviewers for their helpful and constructive comments.

Disclosure statement

The authors declare that they have no competing interest.

Availability of data and materials

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Additional information

Funding

The authors have no funding to report.

Notes on contributors

Umar Haruna

Umar Haruna, PhD - is a lecturer of medical sociology at the Department of Social, Political and Historical Studies, at the University for Development Studies. His research interests in access and utilization of health care.

Hannah Woods

Hannah Woods, MSc – is a research scientist at the Centre for Urban Health Solutions, St. Michael’s Hospital, Toronto. Her research interest is equitable access to essential medicines for Non-communicable diseases.

Moses Kansanga

Moses Kansanga, PhD - is at the Department of Geography and International Affairs, George Washington University. His research interests is on environment and health, smallholder agriculture, political ecology, and food security.

Irenius Konkor

Irenius Konkor is a PhD student in Geography at the University of Toronto. His research focus is on immigrant health and non-communicable diseases.

Jenna Dixon

Jenna Dixon, PhD – is a Project Manager in the School of Public Health and Health Systems at the University of Waterloo. Her research interest is on infectious disease epidemiology and public health.

Isaac Luginaah

Isaac Luginaah, PhD - is a professor at the Department of Geography, University of Western Ontario and Member of the College of the Royal Society of Canada. His research focuses on the geographies of environment and health, sustainable agriculture, and food security