Establish robust local referral hospital linkages and facility transfer arrangements

• Ambulance transfers:
  Ambulance and emergency transfer protocols will be enhanced to ensure patient transfer to a site where volunteers will have best possible Canadian doctor emergency and or intensive care. Cost minimization analyses will be performed to compare different strategies to enhance ambulance service provision on clinical trial days. Comparative strategies will include;
  1. Outright purchase of ambulance, maintenance services, driver + ambulance training
  2. Rental services on clinical trial days from reputable ambulance/evacuation services in Uganda .
  3. Innovative private public arrangements.