2014-2016- “Rural Transport Solutions for Maternal Health; the MORE MAMaZ Emergency Transport Scheme”

The MORE Mobilising Access to Maternal Health Services in Zambia (MORE MAMaZ) programme is an integrated programme that empowers rural communities to address the household and community-level barriers that prevent women and girls from accessing maternal and newborn health services. This programme builds on the successes achieved by a predecessor programme; Mobilising Access to Maternal Health Services in Zambia (MAMaZ), which was implemented between 2010 and 2013.

This technical case study outlines the emergency transport-related activities of the MORE MAMaZ programme. These activities aim to improve access to health services for communities in the five MORE MAMaZ districts.

2014 – “Renforcer les Systèmes de Transport d’Urgence dans Trois Etats du nord du Nigéria dans le cadre…”

Renforcer les Systèmes de Transport d’Urgence dans Trois Etats du nord du Nigéria dans le cadre de l’intervention pour la Santé Maternelle et du nouveau-né (Maternal and Newborn Health – MNH) de l’Initiative Clinton pour l’Accès à la Santé (Clinton Health Access Initiative, Inc. – CHAI) au Nigéria

Cette étude de cas technique résume l’origine, la méthodologie et les conclusions d’un projet de soutien de quatre mois que Transaid a mené pour le programme MNH (Santé Maternelle et du Nouveau-né) de CHAI. Transaid a apporté son expertise au niveau de la conception et de la planification préliminaire à la mise en œuvre de systèmes de transport d’urgence qui renforceraient les systèmes déjà en place.


Transport Management System Training for the Ministry of Health Zanzibar

This report summarises the assistance provided to the MoH in Zanzibar to improve Transport Management Systems in May and June 2014. The support was made possible by UKaid through the Africa Community Access Programme (AFCAP) which is managed by Crown Agents. AFCAP has being leading in the effort to develop a better evidence base for understanding the important role that transport plays in rural health service delivery. It has also been keen to ensure that research gets into practice and supported a successful conference on ambulances and emergency transport for health in Tanzania in March 2014 which shared leading research with a wide range of practitioners. Following the workshop AFCAP was able to support three important follow on activities which responded to issues raised by participants at the workshop and that would all help further AFCAP’s mission of taking evidence and knowledge of what works into practice. This report focuses on the follow on activity which took place in collaboration with the MoH in Zanzibar. Responding to a capacity building request, 12 MoH participants received transport management training in May 2014. In addition a situational analysis was also conducted on both Pemba and Unguja islands and an action plan was collaboratively developed to address key challenges identified. The key recommendations were presented to the MoH Senior Management Team for discussion to seek their support. The recommendations were practical in
nature. Key issues were discussed to seek consensus for adoption as policy guidelines. A detailed action plan was also developed. The overall aim of these activities was to build the capacity of the MoH in transport management and to provide them with the skills, tools and motivation to implement changes that will lead to a safer and more efficient fleet which in turn should lead to improved health outcomes.

Transport Management System Training for the Ghana Health Service

This final report summarises the preparation activities, the content of the training, and the conclusions and recommendations that emerged from a 4 day training workshop held in Accra, Ghana in May 2014. Funded by UKaid through the Africa Community Access Programme, the training workshop was organised by Transaid and the Ghana Health Service (GHS) and brought together GHS Transport Managers representing all of Ghana’s 10 regions as well as participants from wider organisations with a role in transport management. This workshop provided participants with a unique opportunity to share and exchange varied experiences and improve on existing transport management practices. The training was designed according to the stated priorities given by the GHS with a view to building capacity and making maximum use of the full 4 days’ worth of training. The training revealed a growing appetite amongst Transport Managers for training opportunities with participants showing a particular desire to cascade the knowledge that they learnt during the training workshop to their colleagues and respective staff teams. The workshop proposed the implementation of a number of systems to improve the effectiveness of transport management, and linked to this, a number of recommendations have emerged and are noted in this report.

Technical Workshop on Emergency Intermediate Modes of Transport in Madagascar

This report summarises the key preparation activities, desk research, training overview and recommendations from a five day workshop on Emergency Intermediate Modes of Transport (IMT) Design held in June in Antsirabe, Madagascar. This workshop was facilitated by two expert appropriate technology design consultants and the participants included transport technicians, trainers and engineers. The workshop addressed three main topics; quality of production, accurate construction of the bicycle ambulance design and design modifications, including design flaws with the current wheeled stretcher design. It aimed to address the need for ensuring that IMT designs are fit for purpose and that communities and local partners have an input into their design. This report also provides an overview of projects working to develop appropriate technology for IMTs (particularly those used in medical emergencies). A number of key recommendations were highlighted, including the importance of considering culture in addition to functionality, ensuring that you start with simple designs and the value of using locally available materials and testing prototypes before scaling up production. The workshop resulted in the development and production of a new wheeled stretcher design. This report also identifies a number of practical next steps as a result of this workshop as well as two key areas for improvement, namely, the need to have a multidisciplinary team working together and the importance of documenting designs and making them open-sourced.

AFCAP/Transaid Emergency Transport Workshop

This final report summarises the preparation activities, discussions, outcomes and conclusions from a two day emergency transport workshop held in Dar es Salaam in March 2014. This workshop brought together ambulance service practitioners and key emergency transport stakeholders from over ten different countries to discuss and explore how to improve emergency transport for health across sub-Saharan Africa. This was a unique opportunity for emergency transport stakeholders to meet and exchange ideas and approaches, which has resulted in discussions about exciting future collaborative work. The workshop saw a call for more effective dissemination of information about best practice for ambulance services, which has resulted in a webpage being created to share material relating to emergency transport best practice. There was also an overall recognition that there are many different components of an ambulance service and that the best mode of transport and best method of care delivery always depends on the context of the situation and the vehicle must match the specifications of the role that it plays. The workshop saw an enthusiasm for innovative solutions to emergency transport issues and a number of successful examples of the use of Intermediate Modes of Transport and lively discussions on the role of motorcycles and motorcycle ambulances and the role of transport, technology and communication. The workshop also provided a platform for a number of interesting case studies where ambulance services have been set up through successful public-private partnerships. This final report summarises the case studies presented at the workshop, reports on emerging themes, direct outcomes and next steps.

2014 – “Strengthening Emergency Transport Systems in Three States in Northern Nigeria as part of the Clinton Health Access Initiative, Inc. (CHAI) Maternal and Newborn Health (MNH) intervention in Nigeria

This technical case study details the background, methodology and results of two months’ technical support and two month’s training that Transaid provided to CHAI’s Maternal and Newborn Health programme. Transaid provided support in the designing of the emergency transport system and pre-implementation planning for strengthening the emergency transport for Maternal and Newborn Health.

2014- “Transport Management Training in Zanzibar”

This technical case study details the background, methodology and conclusions of  a project that was initiated because of a need identified at the AFCAP/Transaid Emergency Transport Workshop for a session on Transport Management training with the Ministry of Health Zanzibar.