Commercial drivers provide nearly half of emergency transport in Nigeria – Report

This transport network reflects the realities of Nigeria’s health system, where limited ambulance fleets and infrastructure gaps make community participation essential.

A report by the Federal Ministry of Health and Social Welfare has revealed that commercial drivers affiliated with the National Union of Road Transport Workers (NURTW) provide nearly half of the emergency transportation services supporting healthcare delivery in Nigeria.

The findings included in the State of Health of the Nation Report 2025 show that NURTW drivers provide 47 per cent of emergency transport services, making them the largest contributors to patient transport during medical emergencies.

Tricycle operators follow with 31 per cent, while ambulance support services and community volunteers each contribute 11 per cent.

The data indicate Nigeria’s growing reliance on community-based transportation networks to support access to emergency healthcare, particularly in areas where formal ambulance services remain limited.

Emergency transport within Nigeria’s referral system

The report also highlights the role of the National Emergency Medical Service and Ambulance System(NEMSAS), a federal initiative to strengthen emergency response and referral services nationwide.

In the year under review, a total of 15,517 emergency transports were conducted, the majority driven by maternal needs.

“Transportation due to labour accounts for 12,787 cases (83 per cent), while obstetric emergencies represent 1,994 cases (13 per cent), and neonatal emergencies account for 736 transports,” the report said.

Under this system, community-based transport providers complement the limited formal ambulance services by helping move patients from primary healthcare centres to higher-level hospitals capable of providing specialised care.

A breakdown of the emergency transportation by referral destinations reveals that 89 per cent were referred to Basic Emergency Obstetric and Newborn Care (BEmONC) facilities and 11 per cent to Comprehensive Emergency Obstetric and Newborn Care (CEmONC) facilities.

State versus federal hospitals

By the third quarter of 2025, 5,086 emergencies were responded to by the State Emergency Medical Services and Ambulance System (SEMSAS) and Federal Tertiary Hospitals (FTH).

However, all obstetric emergencies were managed via the SEMSAS operational pathway, whereas the majority of road traffic accidents, under-five emergencies, gunshot wounds, and snakebite injuries were managed by tertiary health facilities.

Of the 819 neonatal emergencies handled by both the SEMSAS and FTH, the former reported 43 deaths.

“This highlights an urgent need to strengthen newborn emergency response capacity across all SEMSAS teams,” the report says.

The report noted that engagement with private ambulance operators and medical practitioners has enhanced service integration into NEMSAS and contributed to the availability of 523 ambulances nationwide, including 150 deployed through support from the Federal Road Safety Corps (FRSC).

Despite this progress, the current number of ambulances is far below the estimated national target of 3,143.

Maternal and emergency healthcare

Nigeria has a shortage of emergency medical services, with only 0.4 ambulances per 100,000 people, far below the World Health Organisation’s recommendation of 1 per 10,000 people.

The lack of timely access to healthcare due to this scarcity affects millions, creating a critical gap in emergency services.

This is especially concerning since more than 80 per cent of maternal deaths are potentially preventable.

As of last year, PREMIUM TIMES reported that Nigeria contributes the largest number of maternal deaths globally linked to postpartum haemorrhage, a severe bleeding complication that occurs after childbirth and remains one of the leading causes of maternal mortality.

Similarly, a PREMIUM TIMES report last year highlighted that Nigeria remains among the countries with the highest maternal mortality rates globally, with weak health financing, shortages of skilled health workers and limited access to emergency obstetric care continuing to drive preventable deaths.

In addition, an investigation by PREMIUM TIMES in underserved Lagos communities such as Makoko and Bariga found that gaps in primary healthcare infrastructure and delayed emergency referrals continue to put pregnant women at risk.

The investigation documented cases where women had to travel long distances or rely on boats to reach health facilities during labour, highlighting how poor access to healthcare services contributes to maternal and neonatal deaths in vulnerable communities.

‘SAVEMAMA’

To address these gaps in maternal and newborn emergency response, the report noted that Rural Emergency Services for Maternal and Newborn Transport (RESMAT) structures have been established in 166 priority Local Government Areas (LGA), with 107 LGAs actively transporting emergencies.

The initiative, through SAVEMAMA, plans to offer a digital platform for safely transporting pregnant women and neonates to health facilities.

“SaveMama is a USSD-enabled Dispatch and Voucher Payment Platform that connects pregnant women, community drivers, and health facilities instantly via a single short code: 3581,” the report noted.

“The 3581 short code provides immediate access to pregnant women and mothers in need, connecting them directly with trained drivers and healthcare facilities to ensure timely support.”