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Empowering Non-Government Organisations to run emergency transport services, Tamil Nadu
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Subject Area="Public / private partnership (including NGOs)." Objective="Access to emergency services."
Details for Reform Option "Empowering Non-Government Organisations to run emergency transport services, Tamil Nadu"

Action: Under a pilot scheme, the Tamil Nadu State Government identified NGOs willing to organise and run transport services for emergency obstetric cases and road traffic accidents. After a vetting procedure, the selected NGO, the Seva Nilayam Society, was given two vehicles free of cost, including communication and life saving equipment, drugs and medicines. They are stationed at one of the Emergency Accident Relief Centres (manned 24-hours by an Auxiliary Nurse Midwife) which are located at 50 km intervals along all National Highways in the state. The centres can be contacted on a toll free number. The NGO is expected to take care of vehicle maintenance, driver and paramedic salaries, fuel charges and insurance. It can charge no more than INR 5 per km – Below Poverty Level (BPL) cases must be transported free. The NGO is expected to offer services free of cost to 10% of cases and all accident emergencies are transported free of cost. The NGO must recruit two drivers and two nurses, train them and ensure they are available to provide 24-hour services working in shifts. Results: The scheme is monitored by a committee headed by the State Deputy Director (Health), the project director and the director of the NGO. The Deputy Director Health Services at the district level also monitors the programme. In Theni district, 30 to 45 emergency cases are transported every month. Out of the total number of cases transported, 30% are obstetric emergencies.

Cost Tamil Nadu Government Health and Family Welfare Department budgeted to spend INR 6.5 lakh on the scheme in the year 2003/4 to provide vehicles and wireless network in Theni district. Two (second-hand) vehicles cost INR 5 to 6 lakh. The NGO incurs a cost of around INR 4-5,000 per vehicle per month.
Place Theni district, Tamil Nadu, since 2002.
Time Frame Three months to invite tenders from NGOs and vet them.

Cost effective: For government because the scheme puts back into use old vehicles which are lying idle because of lack of manpower. Saves lives: NGO provides quality service with timely life-saving first aid services. Public awareness: Raises public awareness of available services.


Not self-sustaining: The NGO incurs a loss each month and must find additional funding.


Suitable NGOs. Government Order. Suitable vehicles.

Who needs to be consulted

NGOs. State Government.



Despite the scheme not being self-sustaining, there is a growing demand for vehicles and more NGOs have expressed their willingness to run a similar service in other districts.

Chances of Replication

Following the success of this pilot scheme, the State government plans to extend it over the whole State under the Tamil Nadu Health Systems Project with funding from the World Bank and NGO support.


The State Government is continuing to encourage more private sector involvement in trauma and emergency care, particularly private hospitals. It has found that 30% of accident deaths occur either during transportation to a hospital or due to lack of emergency care at hospitals. In Haryana, the same problem is being tackled by recruiting ex-servicemen as drivers of ambulances at the block level.The driver is allowed to charge INR 5 per km (private companies charge INR 7 per km) and must maintain the vehicle himself.


Submitted By

Clare Kitchen, Research Consultant, ECTA, New Delhi. September 2004.

Status Active
Reference Files
GO.doc Government Order: GO MS No 166 Dated 29 August 2002: Providing Emergency Transport for Women as a Non-Governmental Organisation.
Scheme Implemented through Seva Nilaym Society.doc Report Scheme Implemented through Seva Nilaym Society in Theni District
PROD74.jpg Staff at Emergency Accident Relief centre, Andipatti
PROD74-1.jpg Ambulance run by NGO
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