Transaid is part of a large USAID funded project focusing on improving access to child and maternal healthcare in the northern and western regions of Madagascar. Transaid’s role in the project is focusing on emergency transport for pregnant women and children under five, improving the drug supply chain and health worker mobility and access to remote communities.
In December 2011, Transaid completed the first transport needs assessment in the region of Menabe, in western Madagascar. A number of community health workers were interviewed to gain an insight into the transport barriers they face when trying to access rural communities. Discussions were also held with members of rural communities including women, men, village heads and local authorities to address emergency transport issues. Research was carried out on the distribution and availability of health supplies and general transport availability.
Key challenges identified include: distance of communities from health facilities, road conditions and the effects of the rainy season which make many villages inaccessible by 4 X4 vehicles. Even in the dry season, some villages can only be accessed by ox cart, and in the rainy season only by canoe - if at all. This makes reaching health facilities in an emergency and the distribution of medical supplies almost impossible. Some communities are located as far away as 200km from the district capital, where the main hospital exists.
The tools used and developed from the study will be refined and utilised to conduct similar assessments in four other regions and the results will enable Transaid to suggest and implement the most appropriate transport solutions.
In addition to conducting this review, Transaid has set up a bi-lingual (French and English) transport and logistics monitoring and evaluation working group, bringing together researchers, consultants, academics and those responsible for project implementation.
Due to the cross-cutting nature of transport, indicators that relate to the impact of transport on health are often difficult to measure. This group will help ensure that key outcomes related specifically to transport and logistics interventions are effectively evaluated so the importance of transport in health initiatives can be seen more clearly. It is hoped that this data can then be used to set the bar for future development initiatives to ensure transport is properly integrated.
Transaid has also given support to study focused on the forecasting of medical supplies and what commodities are needed where over the life of the project (including items such as malaria testing kits, contraceptives, drugs etc). Understanding the quantities required, where they will come from and who they will be distributed to, is essential in advance of planning any distribution needs.
Click here to view a case study demonstrating the transport challenges facing people living in rural communities.
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