Project Summary
Transaid is working in the four northern states of Jigawa, Katsina, Yobe and Zamfara to improve maternal, newborn and child health to reduce maternal and child mortality.
A vehicle inventory conducted in mid-2009 found that there were just 59 functioning ambulances in Katsina for a population of approximately 6.5 million - indicating just one ambulance for every 110,000 people. With so few vehicles available, the correct and safe utilisation of existing ambulances is key not only for the delivery of effective health services but also for any subsequent vehicle donations.
Transaid was requested to train several ambulance drivers as ‘Master’ trainers to build capacity and ensure a sustainable programme of ongoing ambulance driver training and assessment within the Ministry of Health. Following their initial training these Master trainers carried out ‘step down’ training to train other ambulance drivers in key driving skills.
Katsina has acquired 35 new ambulances so this training is essential to ensuring the effective use of the new vehicles. Although the ambulance drivers have received different types of training relating to their position there has been no formal ambulance driver training since the State was formed in 1987.
The Problem
The World Health Organisation reports that the maternal mortality rate in Nigeria is over 1000 deaths per 100,000 live births as opposed to only 8 deaths per 100,000 live births in the UK. One of the key reasons for this is the lack of access to affordable and available healthcare and the lack of skilled birth attendants.
Huge capital investment is needed to purchase ambulances for use within the health sector, but once vehicles arrive, there is often no clear system in place for driver training or routine maintenance checks to extend the availability and lifespan of the ambulance to do the job required. As more vehicles are donated, unsafe and untrained drivers are increasingly at risk of becoming road crash victims themselves.
Transaid is working with the Ministry of Health in Nigeria to tackle the problems surrounding transport and access to health to improve availability and efficiency so funds can be saved and invested back into improving the service or spent elsewhere.
The Process
An 11 day training course for Master trainers was conducted to six drivers, covering both theoretical and practical aspects. This was followed by a five day ‘step-down’ training course of 29 ambulance drivers by the newly trained Master trainers.
The training covered:
• Planned Preventative Maintenance
• Safe Driving Theory
• Basic Driving Techniques
• Hazard Awareness
• Basic First Aid
• Nigerian Highway Code
Components of the Highway Code and First Aid were covered by the Katsina Federal Road Safety Commission (FRSC) and the Nigerian Red Cross. Training was also carried out with the assistance of Ibrahim Yusuf who was trained by Transaid as a Master trainer in Yobe in 2009.
Partners
The PRRINN-MNCH Consortium led by Health Partners International, Save the Children and Grid Consulting.
Local partners including: the State Ministry of Health in Katsina, Katsina Primary Health Care development Agency (KPHCDA), Federal Road Safety Commission (FRSC), Nigerian Red Cross.
Results
Six ambulance drivers completed the training to be Master Trainers and 29 ambulance drivers received training in basic and advanced driving techniques, including first aid and the highway code. The driver training manual was also updated to reflect the local environment in Katsina. The Master trainers will now provide the capacity to conduct training for any new ambulance drivers within the State.
The Impact
As a result of this training, ambulance drivers now have a greater awareness of how to operate their vehicles more safely and efficiently and how to carry out basic maintenance checks. This will increase the availability of fully operational ambulances and will also help improve the efficiency of health service delivery, giving more people access to emergency transfers.
The following operational improvements will be achieved:
• Reduced expenditure on fuel and maintenance
• Increased ambulance lifespan
• Reduced number of health and safety incidents and potential road crashes when operating the vehicles
A well utilised fleet means more health workers and supplies will reach more facilities and could increase access to healthcare in remote and rural areas. Better vehicle availability will result in faster response times, greatly reducing the time it takes to transfer emergency pregnancy cases as well as other patients in need of emergency care.
Lower operating costs due to better fuel utilisation and vehicle maintenance will enable Ministry of Health resources in Katsina to be spent elsewhere. For example, on training more midwives or equipping health facilities with more medical supplies to increase their ability to deal with future emergencies.
See also:
• Nigeria, Emergency Transport Scheme for pregnant women, PRRINN-MNCH Update, Oct,2009
• Nigeria, Training of ambulance driver trainers, Yobe State, PRRINN-MNCH Update, August 2009
• Nigeria, Training of Transport and Health Officers, Zamfara State, PRRINN Update - May, 2009
• Nigeria, Jigawa State, Safe Motherhood Emergency Transport Scheme, 2005-2006
• Nigeria, Increasing access to healthcare for mothers and children, PRRINN-MNCH Update – April 2009
• Nigeria, The Programme for Reviving Routine Immunisation in Four Northern States, 2007 - 2011
