Summary of council demographics and geography.

In achieving the sustainable development goal 3.1, Tanzania needs substantial investment to address the three delays which responsible for most of maternal deaths. To this end, the government of Tanzania piloted a community-based emergency transport intervention to address the second delay through m-mama program. This study examined secondary data to determine the cost-effectiveness of this intervention in comparison to the standard ambulance system alone. The m-mama program was implemented in six councils of Shinyanga region. The m-mama program data analyzed included costs of referral services using the Emergency Transportation System (EmTS) compared with the standard ambulance system. Analysis was conducted using Microsoft Excel, whose data was fed into a TreeAge Pro Healthcare 2022 model. The cost and effectiveness data were discounted at 5% to make a fair comparison between the two systems. During m-mama program implementation a total of 989 referrals were completed. Of them, 30.1% used the standard referral system using ambulance, while 69.9% used the EmTS. The Emergency transport system costed USD 170.4 per a completed referral compared to USD 472 per one complete referral using ambulance system alone. The introduction of m-mama emergency transportation system is more cost effective compared to standard ambulance system alone in the context of Shinyanga region. Scaling up of similar intervention to other regions with similar context and burden of maternal mortality may save cost of otherwise normal emergency ambulance system. Through lessons learned while scaling up, the intervention may be improved and tailored to local challenges and further improve its effectiveness.

为实现可持续发展目标3.1（Sustainable Development Goal 3.1），坦桑尼亚需投入大量资金，以解决导致绝大多数孕产妇死亡的三大延误环节。为此，坦桑尼亚政府试点了一项基于社区的应急交通干预项目——m-mama项目，旨在解决第二类延误问题。本研究通过分析次级数据，对比该干预方案与标准救护车系统的成本效益。m-mama项目在欣延加地区的六个地方议会实施。本次分析涵盖的m-mama项目数据，包含应急交通系统（Emergency Transportation System，EmTS）与标准救护车系统的转诊服务成本。分析工作借助Microsoft Excel完成，并将相关数据导入TreeAge Pro Healthcare 2022模型进行测算。为确保两套系统的对比公平性，成本与效益数据均按5%的比率进行贴现处理。在m-mama项目实施期间，共计完成989例转诊。其中30.1%的转诊采用标准救护车转诊系统，69.9%的转诊采用EmTS。单例完成转诊的应急交通系统成本为170.4美元，而仅使用标准救护车系统的单例转诊成本则为472美元。在欣延加地区的场景下，引入m-mama应急交通系统相较单纯使用标准救护车系统具备更优的成本效益。将此类干预方案推广至具备相似背景与孕产妇死亡疾病负担的其他地区，可在原本依赖常规应急救护车系统的场景中节约成本。通过推广过程中积累的经验教训，该干预方案可得到优化并适配当地实际挑战，进一步提升其实施成效。