Fieldwork Report: An Investigation into the Impact on Social Inclusion of High Volume Transport (HVT) Corridors and Potential Solutions to Identifying and Preventing Human Trafficking

This report presents the findings of the research project entitled “An Investigation into the Impact on Social Inclusion of High Volume Transport (HVT) Corridors and Potential Solutions to Identifying and Preventing Human Trafficking”. The research is funded by the UK Foreign, Commonwealth & Development Office (FCDO) through the High Volume Transport (HVT) applied research programme (2017–2023), which is managed by IMC Worldwide Ltd (IMC). The research aims to broaden understanding of the relationship between human trafficking and long-distance transport corridors and cross-border posts in sub-Saharan Africa (SSA), a topic on which little research has been carried out to date. The research, which focuses on Uganda and Tanzania, began in July 2020 and data collection took place over the period January to August 2021.

In September 2021, the project’s Research Strategy Reference Group (RSRG), which comprises key stakeholders from government, civil society and private sectors, was invited to review the preliminary findings of the research and feed into the discussions about implications for policy and practice. Their views are reflected in and integrated throughout this report.

The research findings indicate that there is a case for investing in anti-TIP interventions whenever an HVT road is built or a formal border post established. This should be an automatic consideration as part of the mainstreaming of social inclusion into major infrastructure projects.

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Technical Brief: USAID Community Capacity for Health Programme – A Bicycle Micro-Enterprise Approach to Improving Community Health Worker Mobility and Motivation in Rural Madagascar

In much of rural Madagascar – where over 60 percent of the population lives – a lack of access to affordable and reliable transport hinders uptake of health services. Community Health Volunteers (CHVs) are essential in health service delivery and have key roles in implementing the country’s strategy to achieve universal health coverage. Despite this though, they do not receive a salary from the government and face the same transport barriers affecting rural communities.

Transaid has been an instrumental programme partner in the establishment of “enterprise box” or eBox initiative, as part of Mahefa Miaraka’s broader integrated approach to address transport-related barriers to accessing healthcare. The eBoxes are bicycle sale and repair micro-enterprises managed by registered cooperatives that aim to overcome some of the transportation barriers face by the local population.

The eBox incentivises the ongoing participation of cooperative members through income-generating activities (IGA) and provides strategic support to other integrated transport activities including providing bicycles to selected CHVs to improve their ability to travel, maintaining local bicycle-ambulances, and increasing transportation options for the local community. The profit generated by the cooperatives also provides support to local health insurance schemes (mutuelles de santé and caisse santé) that reimburse participating community members for medical costs incurred at local health centres.

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Technical Brief: USAID Community Capacity for Health Program – Community-Led Transport Solutions Improve Access to Health Care

In Madagascar, the mortality rates for mothers and children under five (CU5) were 335 and 51 per 100,000 in 2019, respectively. Delays in seeking access to quality care are a key contributor to maternal and under-five mortality. Inadequate access to transport has been identified as one of the three major reasons for delays in access to health services, and can worsen the clinical severity of cases, especially when complications exist.

In a context where the availability of transport is often low, the cost of emergency transport is frequently a major barrier. Moreover, difficult terrain and seasonal rainfall often limit access by motorized vehicles to many areas. In areas supported by the USAID Community Capacity for Health program, 44 percent of communities were inaccessible by car or truck for at least four months of the year and 20 percent were inaccessible for almost half the year.

Maximizing the potential for communities to develop and manage their own emergency transport schemes has been shown to be an effective method of increasing access to health care by drawing on available community resources.

Transaid has been instrumental as a key programme partner in the establishment of the community based transport solutions, bringing over a decade of practical experience in operating similar models across sub-Saharan Africa. As always, large focus was given to the sustainability and embedment of such models within the communities they serve.

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Trainer’s manual for delivering communicable disease awareness and preparedness training with a focus on COVID-19 for increasing resilience in Zambia’s health supply chains

Since Zambia recorded its first confirmed COVID-19 case in March 2020, the transport and logistics industry has been under increasing pressure to maintain supply chains of essential goods and medicines across the country. Regional travel restrictions and border testing regimes, introduced to slow the spread of the virus, have disrupted the movement of health commodity cargo, leaving land-locked countries such as Zambia particularly vulnerable to commodity shortages and stock outs. There is growing concern that further disruption to vital supply chains would seriously undermine Zambia’s ability to maintain the distribution of essential medicines across the county whilst in parallel mounting a coordinated response to the COVID-19 pandemic.

In order to protect key workers, Transaid in partnership with the Industrial Training Centre (ITC), and supported by UK industry, have developed a communicable diseases training manual with a focus on COVID-19 awareness and preparedness. The training is suitable for colleagues working at all levels of the health supply chain workforce, and includes additional modules aimed at Fork Lift Truck (FLT) operators and Heavy Goods Vehicles (HGV) drivers.

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Technical Brief: Establishing a Sustainable Model for Professional Driver Training in Uganda

This technical brief presents the details of the PDT-U project, which was implemented in partnership with the Ugandan Government and funded by the German Federal Ministry for Economic Cooperation and Development (BMZ), the UK Department for International Development (DFID) and the Norwegian Agency for Working in cooperation with industry partners.

The project’s aims were to increase the employment opportunities of Ugandan drivers in the transport sector while improving road safety in Uganda, using the EAC standardised curriculum (developed by Transaid in 2015 as a template for training) to build the capacity of heavy goods vehicle (HGV) and passenger service vehicle (PSV) driver training in Uganda.

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Technical Brief: Empowering road freight transport operators to respond to the COVID-19 pandemic

Since 2016, Transaid’s Professional Driver Training – Uganda project (PDTU) has been working to improve the capacity of heavy goods vehicle (HGV) and passenger service vehicle (PSV) drivers in Uganda. The COVID-19 pandemic, first recorded in Uganda in March 2020, has added a number of new challenges for professional truck drivers at a time when the need to maintain vital supplies of foods, medicines and other essential assistance is increasingly falling to road transporters.

Despite the risk of exposure, truck drivers have continued to work through unpredictable and deteriorating working conditions, whilst facing increased scrutiny and stigma particularly at the beginning of the pandemics when many of the new cases of COVID-19 being reported in Uganda were from long distance drivers being tested at the borders.

Between August and November 2020, Transaid and Safe Way Right Way partnered with transporter unions in Uganda to produce truck driver-specific COVID-19 information and key road safety messaging in collaboration with the Ministry of Health. This information was distributed together with a package of essential personal protective equipment (PPE) by specially trained Field Officers to 3,994 cross border truck drivers from 9 different countries as part of wider sensitisation campaign.

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Manual: eBox Management Guidelines

The USAID Community Capacity for Health program is an integrated community health program funded by USAID for five years (June 2016- June 2021). The program, Mahefa Miaraka, is implemented by JSI Research & Training Institute, Inc., in partnership with FHI 360, Transaid, and Action Socio-Organization Secours (ASOS), and in close collaboration with the Ministry of Public Health.

The eBox initiative follows a social enterprise approach and generates income as a bicycle workshop which sells and repairs second-hand bicycles. The eBoxes were introduced to respond to gaps in the bicycle sales and repairs market, and focus on building local skills amongst community members to ensure a long lasting impact.

This ‘Complete Simplified Manual’ has been developed to provide guidance to all those associated with managing and operating the eBox. It provides information on the roles and responsibilities of those associated with the eBox including the Board of Directors and eBox staff. An abridged version of this manual is also available, which focuses on essential tasks for eBox staff members.

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Literature Review: An Investigation into the Impact on Social Inclusion of High Volume Transport Corridors and Potential Solutions to Identifying and Preventing Human Trafficking

This report presents a literature review and annotated bibliography undertaken as part of the research project: An Investigation into the Impact on Social Inclusion of High Volume Traffic (HVT) Corridors, and Potential Solutions to Identifying and Preventing Human Trafficking. The literature review followed the core principles of a systematic literature review process. The review found that very little is known about the relationship between Trafficking in Persons (TIP) and HVT corridors, other major trade routes and border crossings along these routes. It also found that the role of transport sector operators within the human trafficking process is not well understood. This validates the choice of research topic and confirms the need to strengthen the evidence base on these issues.

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MAMaZ Against Malaria at Scale: Midline Survey Report

The MAM@Scale project is a scale up of the pilot project which was carried out in Serenje district between July 2017 and July 2018. The main objective of conducting the midline review was to gauge progress to date of the MAM@Scale activities. The results in this report reflect progress part way through implementation of the project (the current phase of the project ends on 30 November 2020). The review was carried out in selected project areas to review progress in achievements and assess the possible change that can be attributed to the project, particularly with regards to management of cases of severe malaria. The review was conducted in June and July 2020.

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Professional Driver Training – Uganda project: Leveraging the private sector’s support in reducing road traffic fatalities and saving lives in Uganda

Based on data gathered in 2016, the World Health Organisation’s Global Status Report on Road Safety (2018) reported an estimated 1.35 million deaths on our roads, with a significant number of people also suffering injury and/or disability. As we move into the UN’s second Decade of Action against Road Safety (2021-2030), these figures continue to present a significant burden for public health services in low income countries where the majority of fatalities and injuries occur.

In Uganda, the WHO (2018) estimated that over 12,000 lives are lost as a result of road traffic incidents annually and, taking into account the intra- and inter-regional carriage of goods and people (road transport accounts for over 95% of cargo freight and passenger movement in Uganda), the transport industry has a key role to play in reducing casualty rates in countries like Uganda.

The effective management of road safety offers efficiencies to the transport sector, which is already a key driver of economic growth through facilitating domestic and international trade as well as contributing to national integration and providing access to essential services such as education, employment and healthcare. Therefore there is every incentive for private and public sector transporters to invest in addressing this global health crisis.

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Results of a community-driven intervention in rural Zambia to reduce child mortality – Evidence Brief

As the global development agenda converges around the Sustainable Development Goals (SDGs) and aims for Universal Health Coverage (UHC), there is much emphasis on the need for an inclusive development approach. To achieve this, communities need to be at the centre of interventions and must have the knowledge and resources to drive their own development agenda according to their local needs. However, in rural Zambia, as in many other sub-Saharan African contexts, communities continue to face multiple barriers in accessing basic services. Underlying factors include geographical, financial and social constraints.

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Importance of gender empowerment to reducing malaria mortality in Zambia – Evidence Brief

Gender equality and women’s empowerment are key to achieving universal health coverage. They are also important in their own right as a means to achieve sustainable development. Building on a successful gender mainstreaming approach used in three earlier projects, MAM@Scale integrated a focus on gender into the design of a severe malaria intervention in Zambia. Community health volunteers (CHVs) were trained to administer quality assured 100 mg rectal artesunate to children with severe malaria danger signs at community level and to refer patients to the health facility for further treatment. The project’s gender strategy aimed to address the wide range of social norms and gender stereotypes that prevented rural households from responding promptly to severe malaria and other child health emergencies.

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