Project summary
The objective of this UK Department for International Development funded project was to develop and implement transport management systems in eight of the nine Provincial Departments of Health in South Africa. It provided staff with new tools, skills and knowledge and a strong set of ideals to address health delivery problems and the information based system has demonstrated considerable savings and improved service delivery, often with a much reduced fleet size.
The problem
When work began in 1995 South Africa was moving away from hospital based, curative health care towards clinic and community-based, preventative care which placed a much greater demand on the Ministry of Health's transport operations. Problems with transport were cited as one of the major barriers to success.
The process
Transaid put in place a Transport Management Systems in eight of the nine provincial departments of health in South Africa. It built the skills of senior management, transport officers and drivers and used champions within the provinces to manage implementation and motivate colleagues.
The partners
Ministry of Health - South Africa, UK Department for International Development
The result
The Transport Management systems have been established in 8 provinces and enhanced monitoring and performance indicators have given departments the ability to monitor and control the cost of health transport. The project has improved the confidence and abilities of transport officers within provincial health departments and the information based system has demonstrated considerable savings and improved service delivery, often with a much reduced fleet size. In North West province, for example, the fleet size was reduced from 2,300 to 1,000 vehicles, delivering the same level of service and a major cost saving to the department. The final independent evaluation concluded: “The greatest benefit from Transaid has been the general removal of transport as the major constraint in health delivery”. In a separate, but related project, a new national vocational qualification in Public Sector Road Transport Management was developed and this is now officially recognised within the South African National Qualification Framework. 90 trainers, assessors and moderators have reached qualification level and 2000 transport officers have been trained.
The impact
The head of corporate services in Limpompo Province reported that infant mortality had fallen from 72 to 37 per thousand over the last decade and said that improved transport management had made an important contribution to this achievement. Improved availability of transport with no increase in cost has enabled health workers in South Africa to be increasingly confident in their ability to deal with national health priorities and meet government targets for immunisation and TB surveillance. Often it is assumed that when transport is an issue, more vehicles are needed. This project proves that the solution is not necessarily more vehicles, but more effective management of existing vehicles.
