Too many people die due to delayed medical assistance every day in Uganda. This is despite government efforts to ramp up emergency pre-hospital care, which includes a more efficient and effective ambulance system. Most people have a story about someone in their family or community who did not receive the medical attention they needed because the ambulance never arrived. In 2016 alone, 336 out of every 100,000 pregnant women died because they were unable to reach a health facility or emergency service in time to safely deliver their babies.
Reasons often have to do with people not being able to afford the service, or the poor state, and low number, of vehicles, or misuse by ambulance drivers—including the unlawful transportation of non-medical goods or people. All these things make ambulances unavailable to the people who need them in the case of an emergency.
A medical worker from a hospital in Bugiri District in Eastern Uganda, drove the point home, recounting the daily reality. “I lost a patient because he was referred to Mulago Hospital in Kampala and had no money to afford fuel for ambulance transport. In the end, he decided to go back home. This isn’t unusual. There are many others who do the same.”
What’s more is that dispatch emergency management communication systems are not yet fully established across the country. People who live in hard-to-reach areas often cannot call an ambulance and receive help. They must instead find their own way to a hospital or a health facility.
Real-time tracking and performance monitoring
In response, the Government of Belgium donated ambulances to medical facilities in the Rwenzori and West Nile regions of Uganda, to ensure that people, and especially pregnant women, receive access to transportation and assistance.
To understand how these ambulances are being used and what other steps could be taken to improve emergency service delivery, Pulse Lab Kampala developed a digital application called Cheetah Tracker.
The tool, implemented with the Ministry of Health and Enabel, Belgium’s Development Agency, uses Global Positioning Systems (GPS) data to provide analytics on transport-related aspects of health service delivery through a user-friendly dashboard and SMS/email alerts.
How it works and primary results
Metrics about how ambulances operate are gathered and analyzed, giving medical staff and health officials real-time tracking information. For example, the application allows officials to know how much fuel was used, the top speed reached, and where (and for how long) an ambulance was parked.
Ms. Maria N. Nkalubo, Principal Operations Officer of Emergency Medical Services at the Ministry of Health, has seen the benefits first-hand and believes this use of big data is one way to provide better emergency services to citizens.
“There are many challenges in providing emergency service care across Uganda,” she said. “Some of the larger gaps include prohibitive operational costs of an ambulance fleet in some districts, while in others ambulances are so old or have logged so many kilometers they have become a hazard and should be taken out of service.”
By using the digital application, local and regional health departments will be able to keep better track of their ambulances. Users receive performance reports in real-time, which improves efficiency and can help emergency staff better manage the limited resources they have.
Most striking is that the GPS software has already made health staff across Uganda more conscious of how emergency vehicles are used. Because it allows someone in Kampala to monitor the location of an ambulance in Rwenzori, it provides better coordination. In addition, “If an ambulance is being misused,” Nkalubo said, “we are able to intervene and take corrective action, which saves lives and improves overall health service delivery.”
Saving lives, one ambulance ride at a time
To date, 27 GPS systems have been installed in ambulances in West Nile and Rwenzori and, once additional funds are secured, Pulse Lab Kampala will scale up the application so local and regional health authorities can outfit all emergency vehicles in both regions with Cheetah Tracker. Once those fleets are running at optimal capacity, other sub-regional facilities are in line to have the application installed in their vehicles.
Various other emergency services—firefighters, first response teams and law enforcement, have also expressed an interest in piloting Cheetah Tracker.