Webinar slides: Next stop – healthcare: Improving community access to emergency transport using publicly available transport

Transaid and JSI Research & Training Institute, Inc. (JSI) have hosted a webinar on 10th March 2022, to share the impact and key learnings of a collaboration between local transport cooperatives and rural communities to support access to emergency transport as a part of USAID funded ‘Community Capacity for Health Program’ (CCHP).

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 and inadequate access to transport has been identified as one of the three major reasons for delays in access to health services.

This webinar discussed the impact of a collaboration between transport cooperatives and communities to expand community emergency transport networks between rural communities and health centres and hospitals, supporting community members to more easily and affordably access health care. The webinar shared key learnings from the project, highlight how the partnership was successfully integrated and explored the opportunities for scaling the approach.

Speakers included:

  • Dr Yvette Ribaira: Chief of Party, Madagascar Community Capacity for Health Program
  • Dr Izaka Rabeson: Specialist in Community Health Funding and Emergency Transportation
  • Mahery Ramanantoanina: Reguibak BCC and Mobilisation Officer DIANA
  • Kim van der Weijde: Project Manger, Transaid

The USAID Community Capacity for Health Program—known in Madagascar as Mahefa Miaraka was a five-year (2016–2021) community-based integrated health program funded by the United States Agency for International Development (USAID). The Program was a collaborative effort among the Ministry of Public Health (MOPH), USAID, and JSI Research & Training Institute, Inc. (JSI).

Click below to download the webinar slides.

Evidence brief: Scaling up Safe Motherhood Action Groups in Zambia

The Mobilising Access to Maternal Health Services in Zambia programme (MAMaZ) and its successor programme, MORE MAMaZ, supported the scaling up of the national Safe Motherhood Action Groups (SMAG) initiative between 2010 and 2016. Government efforts to roll SMAG activities out to new areas (horizontal scale-up) and to build institutional ownership, thereby placing the initiative on a sustainable footing (vertical scale-up) were supported. These scaling up experiences are highly relevant in a context where current global health policy gives high priority to accelerated implementation of evidence-based initiatives to ensure the survival of every newborn, mother and child.

This brief sets out to capture the changes that have occurred in communities where Safe Motherhood Action Groups (SMAGs) are operational.

Click below to read the full document.

Evidence brief: Key Results from MAMaZ Against Malaria – A Pilot Project Focused on Increasing Rural Communities’ Access to Rectal Artesunate

According to Zambia’s national Health Management Information
System (HMIS), a reported 1,851 Zambians died of malaria in
2016. Many other malaria deaths occur at community level and
go unrecorded. Reported malaria cases increased between 2015-
2016. If Zambia is to achieve the global target of a 40% reduction
in malaria incidence by 2020, a priority focus on areas of highest
mortality, including severe malaria in young children, will be
important.

This evidence brief presents the key results from the MAMaZ Against Malaria (MAM) project, a pilot focused on increasing rural communities’ access to rectal artesunate.

Click below to read the full document.

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.

Click below to read the full technical brief.

Case study: Chitambo District Health Office (DHO) partnering with MAM@Scale in the COVID-19 response

The collaboration between Chitambo District Health Office (DHO) and MAM@Scale has been very effective, not only in the treatment of severe malaria at community level using rectal artesunate, a pre-referral drug, but also developing strong preventative measures against COVID-19 in this transit town.

MAM@Scale uses a strong community engagement approach by establishing and strengthening community systems to uplift health standards at community level. It is an inclusive approach that engages people at all levels, from traditional leadership to members of the community. People who volunteer to work for the community are trained in health education and become the providers of basic health services at community level. Food banks and savings schemes are formed in the communities to fight affordability barriers. This has not only raised demand for health services in the facilities that MAM@Scale is supporting in Chitambo district, but it made it much easier to put up preventative measures against COVID-19.

Click below to read the full case study.

Case Study: Baron educates people on malaria, emergency transport systems and COVID-19 on air

Fwanta is a community in the Kabamba area of Serenje District, Zambia.  In the past, many people in Fwanta who developed medical complications, be it maternal or malarial related, died because people wrongly interpreted the danger signs.

A turning point happened when MAMaZ Against Malaria at Scale (MAM@Scale) began working with this community and the Kabamba Rural Health Centre. They trained Community Health Volunteers (CHVs) on the management of severe malaria at community level through the administering of a Rectal Artesunate Suppository (RAS). MAM@Scale also provided an emergency transport system (ETS), in the form of a bicycle ambulance, to Fwanta.  Baron Mupeta was one of the people selected to be trained as an ETS rider.

Click below to read Baron’s testimonial.

Case Study: Brenda Kundo

Community Health Volunteers (CHVs) are the backbone of the health system in rural Zambia, where they provide invaluable health advice to their communities, which are located prohibitively far from health facilities. Before the pandemic, CHVs were a vital part of our MAM at Scale programme, combatting malaria in their community by educating families on the danger signs of severe malaria and administering RAS (rectal artesunate suppositories), a pre-treatment for children with suspected severe malaria.

CHVs are a trusted voice in their communities, so it was natural that they would form the cornerstone of MAM at Scale’s COVID-19 response. To meet the challenges of the pandemic, the MAM at Scale team has orientated nine Community Facilitators on COVID-19, who have in turn trained 1,379 CHVs, who will help keep their communities safe during the pandemic.

Brenda Kunda is a Community Facilitator with MAM at Scale. A tragic experience in Brenda’s life eventually led to a positive change, not only for her, but for her family and her entire community.

Click below to read Brenda’s story.

The potential role of mobile phone technology in rural motorcycle and three-wheeler taxi services in Africa

Over the last two decades, motorcycle and motorised three-wheeler taxis have become important means of transport in many sub-Saharan African countries, including in rural areas. However, the emerging role of mobile phone technology in improving mobility in rural areas is currently under-explored in the literature.

This paper presents the findings of a small-scale research study that was undertaken into the use of mobile phone technology in the context of motorcycle and three-wheeler taxi use, and its potential to improve rural access. Informed by a literature review, the research focuses on four countries: Kenya, Rwanda, Tanzania and Uganda. Semi-structured interviews and focus group discussions were conducted with riders of motorcycle and motorised three wheeler taxis and the developers of mobile phone-enabled transport technologies.

Mobile technology linked to the utilisation of motorcycle and three-wheeler taxis is increasing, but ‘ride hailing’ applications (apps) are likely to be limited to urban areas for the foreseeable future due to various disincentives to their use in rural areas. The study identifies several promising innovations that combine the use of motorcycles and three-wheelers with mobile technology to increase rural people’s access to essential services and opportunities. These have the potential to be scaled up or expanded to other countries.

To read the full the article, click below.

Guide Des Formateurs Des Transporteurs

Le programme MAHEFA Miaraka (juin 2016- juin 2021) vise à renforcer les capacités du secteur public à planifier, fournir et gérer les services de santé communautaire, tout en redynamisant l’engagement communautaire et l’appropriation de la santé. 

Dans le cadre de la mise en œuvre du Plan de Développement du Secteur de la Santé à Madagascar (PDSS 2015-19), le programme Mahefa Miaraka soutient les moyens de transport d’urgence existants dans ses zones d’intervention, afin d’améliorer l’accessibilité de la communauté aux soins de santé en cas d’urgence sanitaire ou orientation des patients. L’objectif est de donner aux communautés les moyens d’améliorer et d’utiliser efficacement leurs propres plans d’évacuation médicale vers les centres de santé de base (CSB), les hôpitaux de district et les hôpitaux régionaux de référence. 

Ce guide servira d’outil aux formateurs. Il découle de la politique nationale de santé communautaire et a été conçu à partir de l’expérience antérieure du programme et de ses partenaires. 

Pour consulter le manuel en francais ou en malgache, cliquez sur le lien ci-dessous. 

Manuel Des Conducteurs Des Transports Publics

Le programme MAHEFA Miaraka (juin 2016- juin 2021) vise à renforcer les capacités du secteur public à planifier, fournir et gérer les services de santé communautaire, tout en redynamisant l’engagement communautaire et l’appropriation de la santé. 

Dans le cadre de la mise en œuvre du Plan de Développement du Secteur de la Santé à Madagascar (PDSS 2015-19), le programme Mahefa Miaraka soutient les moyens de transport d’urgence existants dans ses zones d’intervention, afin d’améliorer l’accessibilité de la communauté aux soins de santé en cas d’urgence sanitaire ou orientation des patients. L’objectif est de donner aux communautés les moyens d’améliorer et d’utiliser efficacement leurs propres plans d’évacuation médicale vers les centres de santé de base (CSB), les hôpitaux de district et les hôpitaux régionaux de référence. 

Ce guide servira d’outil aux chauffeurs et chauffeurs assistants sur les précautions à prendre lors d’une évacuation sanitaire communautaire de patients vers le CSB, les hôpitaux de district et les hôpitaux régionaux de référence. Il découle de la politique nationale de santé communautaire et a été conçu à partir de l’expérience antérieure du programme et de ses partenaires. 

Le Guide clarifie les engagements des chauffeurs et leurs rôles pendant et après le transport d’urgence des patients. Ce guide fournit également des détails sur les mesures à prendre pour leur propre protection et pour la protection du patient transporté ainsi que des autres passagers. La formation aux premiers secours doit rassurer et renforcer la confiance des conducteurs dans la réalisation du transport d’urgence des patients. 

Pour consulter le manuel en francais ou en malgache, cliquez sur le lien ci-dessous. 

Insights on motorcycles and motorised three wheelers: before and during COVID-19 – Transaid webinar slides

On 30th June Transaid hosted a webinar exploring motorcycle and three-wheeler use in five sub-Saharan African countries. Speakers and panellists held a discussion on the research funded by the Department for International Development (DFID) as part of the Research for Community Access Partnership (ReCAP), and shared insights on what’s changed with COVID-19.

Speakers: Ms. Caroline Barber – CEO, Transaid. Ms. Kim van der Weijde – Project Manager, Transaid

Panellists: Dr. Nono Mvuama – University of Kinshasa. Mr. Kevin Mubadi – Chairman, Boda Boda Safety Association of Kenya. Ms. Grace Wahome – Programme Director, International Forum for Rural Transport and Development (IFRTD)

Watch the webinar here.

Click below to download the webinar deck.

Améliorer la compréhension sur l’utilisation sécurisée des motos et motos à trois roues pour le transport rural – Rapport Final: République Démocratique du Congo

Ce rapport final de la RDC présente les conclusions spécifiques à la RDC du projet «Améliorer la compréhension sur l’utilisation sécurisée des motos et motos à trois roues pour le transport rural». Ce projet a été réalisé en RDC entre février 2019 et décembre 2019.

Research for Community Access Partnership (ReCAP) est un programme de recherche, financé par UK Aid, dans le but de promouvoir des transports sûrs et durables pour les communautés rurales d’Afrique et d’Asie. ReCAP comprend le Africa Community Access Partnership (AfCAP) et le Asia Community Access Partnership (AsCAP). Ces partenariats soutiennent le partage des connaissances entre les pays participants afi d’améliorer l’adoption de solutions éprouvées à faible coût pour l’accès rural qui maximisent l’utilisation des ressources locales. Le programme ReCAP est géré par Cardno Emerging Markets (UK) Ltd.

La stratégie et la méthodologie de recherche sont largement basées sur celles utilisées pendant la phase initiale de recherche dans quatre pays du projet, appliquée au Ghana, au Kenya, en Tanzanie et en Ouganda en 2018. Après un premier voyage de cadrage (scoping) en RDC qui a eu lieu en février 2019, la stratégie a été examinée et finalisée en même temps que l’identification des principales parties prenantes et partenaires. Les activités comprenaient un examen du cadre réglementaire et de la formation existante, une enquête sur les avantages et les inconvénients des motos et des taxis à trois roues et des entretiens avec des informateurs clés.

Les résultats de cette étude peuvent être utilisés par le gouvernement de la RDC et d’autres parties prenantes clés pour mieux comprendre les problèmes liés à l’utilisation des motos-taxis dans les zones rurales et pour développer des politiques et des pratiques pour afin de maximiser les avantages et minimiser les inconvénients. Un certain nombre de recommandations sont présentées dans ce rapport. Une activité complémentaire est explorée avec les acteurs locaux sur la base des résultats de cette étude, afin d’influencer positivement les conditions pour les opérateurs et utilisateurs de motos et de trois-roues motorisés.

Pour lire le rapport complet, veuillez cliquer ci-dessous.