2012-2015 “An Emergency Transport Scheme in Rural/Peri-Urban Uganda that Utilises Informal Transport Services

This technical case study outlines Transaid’s involvement in a 4 year programme called MSD for Ugandan Mothers (MUM). The MUM programme works with franchised, private health facilities, local businesses, and communities to expand women’s access to affordable, quality maternal healthcare. Transaid worked as part of the MUM programme to improve the understanding around the transport related constraints to women accessing maternal healthcare and to design and implement an intervention to improve access.

Improving Community Logistics: Using Hovercraft to Improve Distribution of Health Commodities in Madagascar

Improving Community Logistics: Results from the Use of Hovercraft to Improve the Distribution of Health Commodities in Boeny Region, Madagascar.

This report outlines a Community Logistics Improvement Project that piloted a solution for the year-round distribution of essential medicines to communities deemed inaccessible for some or all of the year. The two main objectives of this project were to improve the availability of health commodities at the community level and reduce stock-outs. Between December 2012 and June 2013, the Community Logistics Improvement Project used a combination of hovercraft and four wheel drive vehicles (4x4s) to supply health commodities to a Point d’Approvisionnement (PA) or supply point in each of the seven communes of Mitsinjo District, Boeny Region. A PA is a supply point, established by MAHEFA’s partner organisation Population Services International (PSI), which allows CHWs to travel to a central point to collect health commodities for use in the community. Four communes were supplied by 4×4, while the most hard-to-reach areas which are inaccessible by road were supplied by hovercraft. Hovercrafts are ideal for very specific geographical conditions as they can travel across land and water, they can be especially useful on rivers prone to significant changes in depth due to seasonal changes.

Linking Rural Communities with Health Services

Linking Rural Communities with Health Services: Assessing the Effectiveness of the Ambulance Services in Meeting the Needs of Rural Communities in West Africa.

It is increasingly accepted in our understanding of maternal healthcare in Africa that poor physical access is reducing the effectiveness of measures to reduce maternal mortality. This project developed an evaluation framework that combined transport measures with health condition assessment methods of the Vital Signs approach and the Glasgow Coma Score to assess differences in patient condition when being referred from local health centres to higher-level referral facilities. Surveys were undertaken of 704 women from 40 communities across Katsina State, Northern Nigeria. It was found that whilst the majority took 1-2 hours between being referred and arriving at the referral facility many took up to 7 hours. Whilst using the Glasgow Coma Score, the study found no statistical relationship between health condition and how a patient arrived at the referral facility or how long it took to arrive. However, using the Vital Signs approach, statistical associations were found between a number of vital signs and how women arrived at the referral facility and how long it took to be referred. As a result, improvements to how women travel to a referral facility and the time referral takes can have positive impacts on the severity of patients managed by referral facilities. Efforts by a range of countries across West Africa to establish widespread ambulance provision may be effective in contributing to reducing maternal mortality. This study shows they may have a positive impact on the skills, resources and equipment emergency obstetric care facilities needed to reduce maternal mortality.