This includes a logistics system to distribute pharmaceuticals and supplies down to the primary facility level, usually from the district/state/regional levels of the health system. At these levels, there is usually a lack of a formalised and reliable system and facilities are often responsible for collecting their supplies, or else the higher level is in charge of using their limited and not-always-functioning vehicle(s).

Riders-managed ambulances can efficiently refer patients from health centres to hospitals when a higher level of care is needed, critical in obstetric emergencies. Ambulance referrals is underpinned by strong preventive maintenance systems to ensure that there is a viable ambulance ready to be dispatched. Strong communication system so that ambulances can be available when needed, data management through mobile technology for decision making on patient care. Strong emergency referral systems are essential to being able to provide patients with emergency care