Ghana, Ministry of Health Transport Policy, 1993-1999

Project Summary

A seminal project undertaken by Save the Children UK, with major input from Transaid, as part of the health system reform programme in Ghana. It was the first project to apply basic transport management procedures, as utilised in the UK in the private sector, to a Ministry of Health operation in Africa. Following its completion, Transaid was launched as an independent organisation.  This work laid the foundation for Transaid’s Transport Management System and informed subsequent work with other health ministries in Africa. 

The Problem

An efficient and available vehicle fleet is crucial to delivery of primary health services, including immunisation, in rural areas of Africa where population density is low.  In Ghana, it is estimated that approximately 40% of all immunisations are given by mobile health workers but the Ghanaian Ministry of Health, in common with all African ministries at the time, had no transport policy and many vehicles were either broken down, not fit for purpose or used to maintain a skeleton supply system. The Ministry recognised that a lack of transport was acting as a major constraint to the delivery of health care.  Donors had spent large capital sums on the provision of vehicles but there had not been a significant improvement in health care statistics, and they were starting to refuse to provide funding for further vehicles.

The Process

A basic transport management system was implemented, backed up by a programme of transport skills building.  It involved all personnel with a responsibility for transport including managers, health workers, drivers, riders, mechanics and administrators.  Please see the Transaid Transport Management System Summary for more details on the methodology of the system.   The main focus of the project was on building management capacity rather than developing technical expertise. 

  • The Partnersto the

The Ministry of Health in Ghana, Save The Children, the Department for International Development, Riders for Health.

The Result

Transport is now recognised as a vital health tool for the delivery of health services.  Ghana became the first Ministry of Health in Africa to operate a national Transport Policy, defining guidelines on the acquisition, operation, disposal, replacement, maintenance and information management of transport.  A large number of staff, from senior management to outreach health worker, were trained in transport management skills, including the knowledge to specificy appropriate vehicles for the conditions.  Drivers & riders were trained in vehicle operation and basic maintenance and all types of personnel involved reported increased confidence, communication and problem solving skills and knowledge of their role.

The Impact

The Ministry saw a dramatic increase in vehicle efficiency, with 70% more kilometres travelled, using 13% less vehicles, at less cost.  It has been estimated that an additional 90,000 children can be vaccinated a year as a result of the transport efficiency gains made.  The ability to demonstrate that an effective transport management system was in place helped to secure a $2m grant for vehicles from the World Bank.