Better Coverage with the Same Resources? A Look at Ambulance Systems in Kenya and India – the Challenge of Efficient Emergency Care

The image shows the front view of an ambulance parked under a covered area. The vehicle is white, with the word “AMBULANCE” written in bold red letters across the hood and a green medical cross symbol above it.

How can emergency services be improved when resources are scarce? Ambulance systems in countries such as Kenya and India show that it doesn’t necessarily take more vehicles to achieve better care but smarter coordination.

In many low- and middle-income countries, emergency transport systems are highly fragmented. Numerous small providers operate independently, often without central dispatch or shared standards. Platforms such as Flare in Nairobi and Red.Health in Hyderabad aim to connect these providers digitally. However, since they typically do not own their vehicles, their ability to direct ambulances – especially to underserved areas – is limited.

Many providers also accept requests outside these platforms, making ambulance availability and location difficult to predict – a classic logistics challenge.

Coordination Over Expansion

Leveraging qualitative and quantitative data by Red.Health, we compared different models – from independent providers to pure-coordination platforms and a combination of both. While the latter improves coverage the most, we find that substantial gains can already be realized by pure coordination of existing providers.

Using data from our partner Flare, we examined which dimension of commitment, spatial or temporal, is most valuable. Our results show that spatial commitment is typically preferred, and particularly powerful when the central platform can choose the location for those ambulances to fill otherwise existing coverage gaps.

A Local Problem with a Clear Insight

Our research focuses on specific conditions in countries where centrally coordinated emergency systems are still missing. In regions such as Europe or the United States, where such systems are well established, these findings cannot be applied directly.

That makes them all the more valuable. They highlight how logistical principles can help build functioning emergency transport systems under challenging conditions. These local examples show that operations research is not only about improving efficiency – it can also make a tangible difference in saving lives.

Read the full study in two papers:
https://doi.org/10.1177/10591478231224973

https://papers.ssrn.com/sol3/papers.cfm?abstract_id=5238107

Authors: Pieter L. van den Berg, Andre Calmon, Andreas Gernert, Stef Lemmens, Maria Rabinovich, Gonzalo Romero

Prof. Dr. Andreas Gernert

Prof. Dr. Andreas Gernert is Assistant Professor for Sustainable Operations at KLU. Prof. Dr. Gernert's current research examines policies, business models, and strategies pertaining to the three dimensions of sustainability - environmental, social, and economic. To facilitate the students' learning experience, Prof. Dr. Gernert utilizes interactive and student-centered teaching methods such as case study discussions and educational games.