When ‘enough ambulances’ isn’t enough
A recent statement attributed to the Deputy Director of Public Relations of the National Ambulance Service (NAS), Simmons Yussif Kewura, that “Ghana has enough ambulances” and that “we haven’t reached a point where people should worry about not having access to one,” caught my attention, because emergency medical services go beyond having an ambulance fleet on paper.
As a medical doctor and health policy analyst who has studied Ghana’s NAS, I have also experienced its operational challenges firsthand, from delayed dispatches and vehicles awaiting repairs to having to pay for fuel before an ambulance could set off.
In December 2023, while working at Pentecost Hospital, Tarkwa, I managed a young pregnant woman living with HIV who had defaulted on antiretroviral treatment and antenatal care. She arrived critically ill, requiring an emergency Caesarean section and oxygen support, and later developed kidney failure requiring urgent dialysis at Cape Coast Teaching Hospital.
For about a week, we could not secure an operational ambulance. Fearing she would not survive the wait, we took the risk and drove her to Cape Coast ourselves in a private car with her family and a driver, using mobile oxygen to keep her stable. We ran out of oxygen two hours before arrival and were involved in two road accidents, one on the way to Cape Coast and another on the return journey to Tarkwa. She survived, and so did we.
Having ambulances on paper does not guarantee that one will be available when a life depends on it.
A 2024 study in the African Journal of Emergency Medicine shows how much Ghana’s ambulance service has grown. In 2004, NAS had only nine ambulances and 64 emergency medical technicians (EMTs). By 2022, this had increased to 356 ambulances and 3,473 EMTs, with stations in all 261 districts. But having more ambulances does not always mean having one available when a patient needs it. The same study found that ambulances were available about 77 per cent of the time in 2022, ranging from 66.2 to 86.3 per cent across regions, and that roughly eight out of every 10 ambulance trips were to move patients from one health facility to another, like the transfer my patient needed. More recently, Citinewsroom reported in February 2026 that an NAS Clinical Auditor found 127 of 318 ambulances out of service, leaving 191 operational, citing the vehicles’ age and the need for replacement.
The policy question is not how many ambulances Ghana has, but how many are working, where they are, and whether a patient needing an urgent transfer can reach one in time. This mirrors World Health Organization guidance that an effective ambulance service depends on more than vehicles, extending to dispatch, equipment, trained staff and clinical protocols.
Surviving those two accidents led me to step away from clinical practice to study health policy. I came to realise that evidence-based policy can save more lives at scale than treating one patient at a time.
NAS leadership must look beyond procuring more ambulances toward sustainable financing that keeps existing vehicles fuelled, maintained and ready, with EMTs equipped and trained to respond. Patients and their families should not have to bridge that gap, and health professionals should not be put at unnecessary risk in doing so.
Dr Nicholas Addae Mensah is a medical doctor, development economist, and Health Policy Analyst at International Perspectives for Policy & Governance (IPPG), a policy think tank based in Accra, Ghana.
BY DR NICHOLAS ADDAE MENSAH
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