Emergency Referral Systems D-tree International


Ambulances are often unavailable for maternal & neonatal emergencies

  • No fuel
  • Driver not available
  • Needs maintenance
  • On another call


Use digital technology to organise existing community resources (private cars, taxis) in a supplementary ambulance service.

Similar to "sharing economy" insight


A database of drivers, their phone numbers, and the locations they will serve

A database of routes with prices

A triaging protocol, to determine when a case should be treated as an emergency

Mobile Money integration, to pay driver's automatically once journeys are completed

Call centre where emergency calls can be accepted and cases managed.

The system integrates tightly with a larger system designed to address the "three delays" of obstetric care - the Mobilizing Maternal Health program

Dispatchers service telephone number available 24 hours per day and use app running on tablet to triage calls, organise journeys, and follow-up.

Triaging determines whether call is to be treated as an emergency, and also whether the woman's condition can be handled by a lower-level facility, or whether she needs to go directly to the referral hospital.

A ministry of health ambulance is arranged if one is available, otherwise a community driver is contacted.

Once the despatcher has selected a driver and confirmed availability, driver gets confirmation of client contact information and location automatically by SMS

The dispatcher can review any case information and arrange ad hoc journeys when necessary.

When a client lives on an island, this poses additional challenges and perils. Our driver database also includes boat drivers and the system prompts the dispatcher to arrange a boat to the mainland (and then a taxi from mainland to hospital).

Complexity on the server-side yields simplicity in the system as a whole - our system integrates with a mobile money API and the drivers are paid automatically the amount set for the route undertaken.

This happens as soon as the dispatcher confirms that the journey has been completed.

Video from the Vodafone Foundation, describing the program

D-tree International



Created with images by DFID - UK Department for International Development - "The impact of the violence" • Justin.Raycraft - "Taxi"

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