Community-based emergency transport system in Shinyanga, Tanzania: a local innovation to avert maternal and newborns deaths for a low-resource setting

Abstract Introduction In achieving sustainable development goal 3.1, Tanzania needs substantial investment to address the persistent burden of maternal mortality. Efforts are needed to curtail the three delays which underlie most of the deaths. The government of Tanzania implemented a community-based emergency transport intervention to address the second delay through m-mama program to address these delays. This examined the cost-effectiveness of this intervention as compared to the use of a standard ambulance system alone. Materials and Methods Program data provided by the program implementers was used in this secondary data analysis. The data included costs of referral services using the Emergency Transportation System (EmTS) and comparing with the standard ambulance system. Analysis was conducted using Microsoft Excel to generate data that was fed in a TreeAge Pro Healthcare 2022 model. The cost and effectiveness data were discounted at 5% to make fair comparisons of the two systems. Results A total of 989 referrals were made where, 30.1% were completed using the standard referral system using ambulance, and the majority (69.9%) were completed using the EmTS. The Emergency transport system costed USD 170.4 per completed referral compared to USD 472 per referral using ambulance system alone in the six councils of Shinyanga region where the intervention was conducted. Conclusion The introduction of m-mama emergency transportation system has proved to be cost effective compared to the use of standard ambulance system alone in Shinyanga region. Given the high burden of maternal mortality in Tanzania, this community-based program can save implementation costs and may be more sustainable should be scaled up to other regions in Tanzania. Using implementation science methods while scaling up, lessons learned in various regions may further improve the effectiveness of the EmTS.