A mixed method impact assessment of the use of aerial logistics to improve maternal health and emergencies outcomes in the Ashanti Region of Ghana.

Maternal mortality, a critical global public health issue, is notably higher in low-to-middle-income countries (LMICs). In Ghana, access to healthcare, especially maternal and emergency services, is hindered by infrastructural deficiencies such as poor road networks and unreliable electricity, making the delivery of medical supplies and services difficult. The study used a mixed-method approach to assess the impact of aerial logistics on various maternal health outcomes in the Ashanti Region, focusing on the intervention by Zipline Mpanya distribution center. The study was conducted in the Ashanti Region of Ghana, where clinical outcome data were sourced from the health directorate. Pre-exposure years were 2017-2020, and post-exposure years were 2021-2022. Statistical analysis involved univariate explorations, T-tests, ANOVAs, and Zero-Inflated Poisson regressions, adjusting for factors like poverty. The qualitative study was to describe and analyze changes in providers' and patients' satisfaction, perceived quality across maternal health and health emergencies, and experiences using or being treated with the aerial logistics. The Zero-Inflated Poisson regression analysis indicated significant pre-post increases in antenatal visits and deliveries by 20% and 26% respectively, and a notable 3.41-fold increase in referrals, while emergency visits decreased by 4%. Maternal deaths decreased by 56%, with no substantial changes observed in rates of hysterectomies and neonatal deaths. Nonetheless, marginal means estimations in absolute terms showed overall declines in performance, consistent with the effects of the COVID-19 pandemic. Patients and healthcare providers perceived improvement in access to maternal and emergency medications. In conclusion, this study underscores the groundbreaking role of medical drones in enhancing public health strategies, especially in LMICs, by mitigating the impact of health emergencies on maternal health.