A life saving diagnosis

A life saving diagnosis

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Last Update: April 12, 2012

Riders’ Sample Transport model is an innovative motorcycle courier system reducing the time-delay in monitoring and diagnosing HIV/AIDS and TB.

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The Problem

Laboratories are critical to the detection, timely diagnosis and treatment of communicable diseases like HIV and tuberculosis (TB). Yet in rural Africa these services are not easily accessible due to distance, road conditions and a lack of transportation. The result is that potentially hazardous specimens are often carried in improvised containers – at times a plastic bag – in non-specialist vehicles. This poses a serious health risk to those carrying the samples and to others using the same transport. It also means that specimens are not protected during the journey and are often spoiled in transit. The inherent time-delay leads to unacceptable patient waiting times. This not only impacts the health of individuals, but can also put entire communities at risk of infection.

The Solution

Riders for Health (Riders) is a social enterprise dedicated to achieving equitable health care access. Our mission is to strengthen health systems by addressing one of the most neglected aspects of development for the health of Africa – transport and logistics. The Sample Transport (ST) model is a key part of this and was designed, at partner request, to address the bottleneck in primary-level laboratory service access. To do this, Riders recruits and trains specialist motorcycle couriers whose role is to collect diagnostic specimens from health centres and deliver them to the designated laboratory. Post-analysis, the results are returned to the health centre – which allows for expedited follow-up care. All vehicle fleets are managed in-line with Riders’ ‘zero-breakdown’ system and each ST courier is trained in vehicle maintenance and road safety. This process is supported by Riders’ own technicians who deliver outreach maintenance in accordance with an agreed service schedule.

Example

The ST programme aims to reduce the delay in monitoring and diagnosing HIV and TB by bringing reliability to the collection/delivery of samples and the return of results. Initially focused across Lesotho’s 155 health centres, programme development can be outlined as follows: 2007/8: At partner request, Riders allocate 30 motorcycles to the development of the first-ever ST model in Lesotho. Qacha’s Nek district is set-up as a pilot region. Jan/Aug 2009: Riders works in collaboration with the Ministry of Health to roll out the ST model nationwide. -Directly preceding each new district, Riders’ in-country team visit each health centre to develop service routes and prepare for project implementation. -District by district, Riders recruits local couriers with specific knowledge of the terrain. Each courier then completes two-weeks training in road safety and vehicle maintenance. -All couriers receive route-specific instruction and train in professional sample handling. Sept 2009: ST becomes a fully-operational nationwide programme. Regular outreach maintenance ensures the provision of reliable service. Present: All health centres across Lesotho now receive a weekly ST service. This strengthens public health services by ensuring that the country’s 2 million men, women and children have access to laboratory testing. By improving the turnaround time of test results, Riders is helping to reduce the number of patients defaulting on follow-up care/treatment regimes, build public trust in the health system and increase the demand for testing.

Marketplace

It is often not commercially viable for private-sector corporations, such as DHL, to operate sample referral systems that extend beyond a district/provincial level. Primary-level coping mechanisms have evolved to fill the inherent gap, but Riders remains unique in that we offer a bespoke solution to enable ‘last mile’ laboratory service access. Riders does not set-up its systems in parallel and it is our aim to compliment and strengthen existing health infrastructures. As a result, the ST model has been specifically designed to be cost-effective, eliminate waste, build in-country capacity and maximise stakeholder resources. As such it has shown itself to be more appropriate for development (particularly for government ministries) than any other service.

Challenges

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