Prior to the COVID-19 pandemic, Guinea-Bissau's health system lacked an ambulance network for patient transportation and emergency assistance. Many of the ambulances that had been allocated to the various health regions had fallen into disrepair, rendering them unusable. Even those that were still in good working condition were expensive to maintain, with costs that far exceeded the national minimum wage. This meant that the most urgent cases were unable to seek health care quickly and efficiently. To improve access to health care for the estimated two million people in Guinea-Bissau, the government partnered with the World Health Organization (WHO) to establish the Integrated Network of Ambulances, Rede Integrada de Ambulâncias (RIA). This led to ambulances being fully equipped and staffed with highly trained and qualified medical personnel, with, on average, 15 interhospital transfers and 5 prehospital transfers completed every day. Services are now available to all two million citizens of Guinea-Bissau around the clock and can be accessed by calling the free emergency line 112. With the introduction of the RIA, individuals in affected regions have been able to access health care with greater ease.

How did Guinea-Bissau, with the support of the WHO Secretariat, achieve this?

During the COVID-19 pandemic, it became evident that Guinea-Bissau’s emergency care system needed to be strengthened to provide adequate treatment for severe cases. To identify specific areas for improvement, WHO Guinea-Bissau provided technical support to the Ministry of Health (MoH) to conduct a WHO Emergency Care Systems Assessment (ECSA). ECSA is a ministry-led process that brings together key stakeholders to assess different components of the emergency care system including injury care, using ECSA as a template to cover all elements of the system.

 To ensure that everybody in Guinea-Bissau had access to emergency services, WHO enabled sharing of best practices from South Africa where a successful emergency network had already been established. To publicize the RIA service and activities, WHO provided technical and financial support to develop, produce and distribute 5000 posters to health centres, markets, places of worship and other public places. To raise awareness about the availability of these services, the nongovernmental organization (NGO) VIDA [1] established a call-centre to monitor COVID-19 cases.

 Furthermore, WHO Guinea-Bissau mobilized funds from the Islamic Development Bank (IsBD), the European Union and the World Bank to purchase 15 ambulances, each outfitted with monitors, respirators, oxygen cylinders, thermometers, sphygmomanometers, stethoscopes, nasogastric tubes, stretchers and cervical collars. These ambulances were then distributed throughout all the health regions, and mobile phones were provided to facilitate communication between health facilities and patients.