When ‘enough ambulances’ isn’t enough

The Deputy Director of Public Relations for Ghana's National Ambulance Service (NAS), Simmons Yussif Kewura, recently claimed that "Ghana has enough ambulances" and that "we haven't reached a point where people should worry about not having access to one." However, a closer look at the reality of Ghana's ambulance service reveals significant challenges that threaten patient care and health outcomes.

The National Ambulance Service has grown significantly in recent years, with the number of ambulances increasing from just nine in 2004 to 356 by 2022, and a corresponding rise in the workforce of emergency medical technicians (EMTs) from 64 to 3,473. Despite this expansion, the availability of operational ambulances remains a major concern.

According to a 2024 study in the African Journal of Emergency Medicine, ambulances were only available 77% of the time in 2022, with availability rates ranging from 66.2% to 86.3% across different regions of the country.

Many of these challenges stem from operational issues rather than a lack of ambulances. For example, an NAS Clinical Auditor reported in February 2026 that 127 out of 318 ambulances were out of service, leaving only 191 operational vehicles. The problem is not just the number of vehicles, but also factors such as the age of the vehicles, the need for replacements, and the overall condition of the fleet.

Additionally, the service faces difficulties in ensuring that ambulances are dispatched promptly, equipped with necessary medical equipment, and staffed by well-trained personnel following established clinical protocols.

The consequences of these shortcomings were starkly illustrated by the author's own experience during a critical case in December 2023. A young pregnant woman with HIV, who had missed important medical appointments, arrived at Pentecost Hospital critically ill and required immediate medical intervention. Despite the hospital's efforts, securing an operational ambulance proved to be a significant challenge.

As a result, the patient was transported to Cape Coast Teaching Hospital by the author and her family in a private vehicle, using mobile oxygen to maintain her stability. This journey was fraught with risks, including two road accidents—one en route to Cape Coast and another upon the couple's return to Tarkwa. Remarkably, the patient survived these harrowing circumstances, highlighting the critical need for a reliable ambulance service.

This case underscores the importance of not just having ambulances on paper, but ensuring they are available, operational, and staffed appropriately when patients need them most. The policy question at hand is not simply about the quantity of ambulances, but about their working status, geographic distribution, and the overall readiness of the service to respond to emergencies effectively.

As the Ghanaian Times reports, the World Health Organization emphasizes that an effective ambulance service requires more than just vehicles—it necessitates robust dispatch systems, well-equipped ambulances, trained EMTs, and adherence to clinical protocols.

In light of these findings, Ghana's health policy leaders must move beyond merely procuring more ambulances. Sustainable financing is crucial to keep existing vehicles fuelled, maintain them in good working condition, and ensure that EMTs are adequately equipped and trained to provide timely and effective care. Patients and their families should not be forced to take on the burden of arranging alternative transport during emergencies, nor should healthcare professionals be placed at unnecessary risk in doing so.

The focus must shift toward evidence-based policy solutions that can save lives on a larger scale, rather than treating individual cases on a case-by-case basis.