Ziqitza - 108 Emergency Response Services
Country of Operation
Target income level
- Lower-middle income (20-40%)
- Middle-income (40-60%)
- Emergency care
SummaryDial 108 Emergency is an emergency transport and response model that is delivered through a public private partnership with state governments and is provided either free or through user-fees as mandated by the contract with the participating State Government.
Key program components
Ziqitza is contracted to operate this service in select states by the government of that state, with service currently being provided in: Rajasthan, Bihar, Punjab, and Trivandrum. However, each region has a slightly different model for these services. For example, the model adopted by Patna City in the state of Bihar differentiates from other models in the country because:
i) Capital expenses are borne by the private provider
ii) A user fee of INR 300 is collected from the patient availing emergency transport.
In partnership with the Punjab State Government, ZHL began operating the 108 model in the state in April 2011. 108 Emergency Response Services started with 90 ambulances. ZHL operates the EMR (Ambulance) service in Patna city and its suburbs in the state of Bihar with 10 ambulances (5 advanced and 5 basic life support ambulances). It has also been contracted to operate 25 ambulances in the Trivandrum district and has taken over the operations of 164 ambulances in Rajasthan from EMRI. The project is being expanded to to 45 locations in each of Bihar's 38 districts, and the number of ambulances will be scaled to 450 in the coming two years.
Incentives & Penalties in the Contract:
Though there are no separate incentives provided in the program, the user fee of INR 300 would incentivize the private provider for better performance. For more number of trips additional amount is received towards variable costs. There are no major penalties provided in the contract.
ZHL also runs the Dial 1298 for Emergency model in Kerala and Maharastra States. In other Indian states, 108 Emergency Response services is run either directly by the government itself or, as in this model with ZHL, it is contracted out to other organizations, such as the Emergency Management and Research Institute (EMRI).
The Principal Secretary of Health designed the 108 emergency model after reviewing other systems, including the rural transport system in West Bengal. A few of the decisions taken that are unique to this model are:
Selection of the private provider was done through a competitive bidding process
A user fee was imposed to avoid misuse of services, as well as to incentivize the private provider for better performance.
Ziqitza Healthcare Limited was selected as the principal contracted provider after a competitive bidding process and an official MoU was signed on 19th Feb 2000. The service was launched a few months later, After about a year, another tender was issued for the expansion and Ziqitza Healthcare was once again selected as the successful bidder and entrusted with 45 additional ambulances.
Over 20,000 patients have been served since 2009 through Ziqitza's Emergency Response Services.