Impact of inter-facility transport on maternal mortality in the Free State Province

Marthinus Gerhardus Schoon


Aim. In December 2011, having identified inter-facility transport as a problem in the maternity service, the Free State Department of Health procured and issued 48 vehicles including 18 dedicated to maternity care. Subsequently, a sustained reduction in mortality was observed. We probed the role of inter-facility transport in effecting this reduction in mortality.

Methods. A before-after analysis was performed of data from 2 separate databases, including the district health information system and the emergency medical and rescue services call-centre database. Data were compared for a 12-month prior- and 10-month post-intervention period using descriptive and correlation statistics.

Results. The maternal mortality decreased from 279/100 000 live births during 2011 to 152/100 000 live births during 2012. The mean dispatch interval decreased from 32.01 to 22.47 minutes. The number of vehicles dispatched within 1 hour increased from 84.2% to 90.7% (p<0.0001). Monthly mean dispatch interval curves closely mirrored the maternal mortality curve.

Conclusion. Effective and prompt inter-facility transport of patients with pregnancy complications to an appropriate facility resulted in a reduction of maternal mortality. Health authorities should prioritise funding for inter-facility vehicles for maternity services to ensure prompt access of pregnant women to centres with skills available to manage obstetric emergencies. 

Author's affiliations

Marthinus Gerhardus Schoon, Free State Department of Health; Faculty of Health Sciences, Free State University, South Africa

Full Text



transport; inter-facility; maternal mortality; maternal health

Cite this article

South African Medical Journal 2013;103(8):534-537. DOI:10.7196/SAMJ.6828

Article History

Date submitted: 2013-02-22
Date published: 2013-06-05

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