Not long ago, in Yobe State, Fatima, a young mother, experienced severe labour complications late at night. Her husband, Ahmed, fearing the worst, dialled the local emergency number. Within minutes, a state NEMSAS-dispatched ambulance arrived at their doorstep, equipped with a trained paramedic. Fatima was stabilized and transported swiftly to the nearest maternal health care center, where she delivered a healthy baby. Without this intervention, she may have been another tragic statistic. Instead, she is now part of a growing number of Nigerians who have directly benefitted from the National Emergency Medical Service and Ambulance System (NEMSAS).
Fatima’s story is one among thousands. For decades, preventable deaths occurred because there was no coordinated emergency response system. Too often, road accidents, pregnancy complications, strokes, and trauma claimed lives not because treatment was unavailable but because help did not arrive in time. Families watched in anguish as loved ones perished due to lack of access to timely emergency care.
NEMSAS was established to close this critical gap, ensuring every Nigerian, regardless of location or socioeconomic status, has timely access to emergency medical care. While the foundation was laid in previous years, it is under President Bola Ahmed Tinubu’s Renewed Hope Agenda that NEMSAS has been prioritised, expanded, and integrated into Nigeria’s broader health sector reforms. With stronger political commitment, strategic investments, and a whole-of-government approach, NEMSAS is now a pillar of the Nigeria Health Sector Renewal Investment Initiative, strengthening emergency healthcare nationwide.
More than 40 percent of Nigerians live in rural areas with limited access to healthcare, and maternal mortality rates remain among the highest globally. The challenge is not just treatment but timely access to care. The three delays in healthcare highlight that reaching a facility in time is a leading cause of preventable deaths. In the past, pregnant women, accident victims, and critically ill patients had no reliable way to access emergency services. That is changing.
NEMSAS is a national, state-driven, community-anchored emergency medical system ensuring rapid response, timely transportation, and quality emergency care. As the operational arm of the emergency medical treatment gateway under the Basic Health Care Provision Fund (BHCPF), it integrates emergency care within state health systems while maintaining a coordinated national response.
Collaboration is central to NEMSAS’s success. The initiative operates through a structured inter-agency framework, bringing together the National Primary Health Care Development Agency (NPHCDA), the National Health Insurance Authority (NHIA), the Federal Road Safety Corps (FRSC), and the National Emergency Management Agency (NEMA). FRSC responds to medical emergencies and road traffic accidents, NEMA coordinates mass casualty events, NPHCDA integrates emergency services into primary healthcare, and NHIA ensures coverage for enrolled patients. At the tertiary level, hospitals serve as emergency medical hubs for specialised critical cases.
This progress reflects the visionary leadership and strong commitment of the Coordinating Minister for Health and Social Welfare, Muhammad Ali Pate, alongside state governors, local government chairmen, and state commissioners of health, whose collaboration and policy reforms have driven the evolving transformation. Through the Sector-Wide Approach (SWaP), these efforts have ensured a structured framework for integrating emergency medical services into Nigeria’s broader health reforms.
Private sector involvement has been instrumental in expanding ambulance networks, digital emergency response systems, and workforce training. Digital health platforms and emergency tech companies have introduced real-time ambulance tracking, optimising dispatch coordination. Partnerships with commercial transport operators, including the National Union of Road Transport Workers (NURTW), have extended emergency transport services to areas where ambulances are scarce. Security agencies are part of this network to better ensure emergency responders can operate safely in volatile regions.
This collaborative effort is saving lives. In Yobe, tricycle ambulances reach remote areas where standard vehicles cannot operate. In Anambra, private sector emergency response systems have enabled faster ambulance dispatch, improving survival rates. In Rivers, newly procured ambulances under the state emergency medical services system ensure families no longer have to watch loved ones die due to lack of emergency transport.
At the federal level, tertiary hospitals have been onboarded as emergency medical hubs, providing life-saving interventions. From January to December 2024, over 6,000 Nigerians have received emergency medical services through NEMSAS. In Yobe alone, over 1,000 lives have been saved, with a mortality rate as low as 1.5 percent among treated cases. The free 48-hour emergency treatment window has removed financial barriers, demonstrating focused leadership in improving health outcomes.
Recognising the urgency of reducing maternal and newborn mortality, NEMSAS has also prioritised rural emergency services and maternal transport initiatives. This decentralised transport model mobilises tricycles, boats, and commercial operators to serve as emergency responders in hard-to-reach areas. Pregnant women receive transport vouchers to cover emergency transport costs, ensuring financial constraints do not delay care. With support from the World Bank, this initiative has been implemented in 15 high-burden states, reaching underserved communities.
To further equip hospitals for maternal emergencies, the Maternal and Newborn Mortality Reduction Innovation Initiative (MAMII) was launched under the Nigeria Health Sector Renewal Investment Initiative (NHSRII). This game-changing intervention complements NEMSAS and RESMAT by targeting high-burden areas with unacceptably high maternal deaths. The government has removed financial barriers by covering caesarean section costs for poor and vulnerable women in both public and private facilities. MAMII also strengthens emergency obstetric care in hospitals and primary healthcare centres, providing midwives and nurses with specialised training. Community health workers generate demand for skilled birth attendance, educate families on antenatal care, and guide pregnant women toward safe delivery options. By integrating these efforts with NEMSAS, the government is building a fully functional emergency response system that ensures timely, high-quality care.
Despite its successes, NEMSAS faces challenges. Limited public awareness remains a barrier—only 38 percent of Nigerians know about the 112 toll-free emergency number. Inconsistent state ownership has slowed adoption in some regions, requiring further advocacy and commitment. Infrastructure gaps, including poor roads and insufficient ambulances, continue to hinder rapid emergency response. Addressing these requires increased investment in human and material resources.
A renewed hope for health security is unfolding. Picture a Nigeria where emergency medical response is swift and universal, where no woman dies in childbirth due to lack of transport, and where accident victims receive immediate, life-saving intervention. This vision is fast becoming a reality.
NEMSAS is more than an emergency response system; it is a lifeline and a testament to Mr. President’s Renewed Hope Agenda in action. By strengthening health security, emergency response, and universal access to care, we are laying the foundation for a healthier, safer Nigeria.
It is time for all stakeholders—state governments, healthcare providers, development partners, and the public—to rally behind this life-saving initiative. Because in the fight for survival, every second counts. And with NEMSAS, we are making those seconds matter. Saving lives is a shared responsibility.
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