Reducing the Burden of the Three Delays on Maternal Health ...
Sample Transport: Reducing delays to accessing laboratory-based testing in
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Sample Transport: Reducing delays to accessing laboratory-based testing in
Chadiza district, Eastern Province, Zambia
C. Chibiliti, D. O’Farrell, J. Brown, A. Jenkinson, K. NicholsRiders for Health
What is Riders for Health?
Riders is a not-for-profit social enterprise that manages transport operating in African health systems.♦ Focused on providing reliable,
scalable, cost-efficient and appropriate transport solutions
♦ Emphasis on rural access and experts in difficult terrain
♦ Partner with DHOs in Eastern and Southern Provinces, Zambia
♦ Manage transport for any partnerinvolved in health care delivery
Background
November 2009: Riders partnered with Chadiza District Health Office (DHO) in Eastern Province, Zambia, on a Sample Transport (ST) programme.♦ Riders trained and employed five ST
couriers mobilised on motorcycles to transport samples/results between primary health facilities and district labs on a weekly basis
♦ Riders manages the motorcycles under a preventive maintenance system
♦ Samples included blood for CD4, chem/haematology testing; sputum for TB diagnosis; and dried blood spot (DBS) for early infant diagnosis (EID), etc.
Research objective and methods
♦ To review ST effectiveness by examining testing volumes and turnaround times (TATs) of sample collection to return of result across health facilities in Chadiza district
♦ Conducted analysis using baseline and follow-up structured interviews with staff at 15 health centres and weekly ST courier log sheets
Results
♦ Avg. TAT decreased: 11 to 8 days before/after ST.♦ Each ST courier transported 442.8 samples/month
in 2010, 355.6 in 2011, and 423.6 in Jan-May 2012♦ Sample volumes at Chadiza district lab increased
by several times after ST.
Q3, 2008 Q3, 2009 Q3, 2010 Q3, 20110
2,000
4,000
6,000
8,000
10,000
Series 1Before ST
After ST
Conclusions♦ Decreased TAT and increased sample volumes potentially due to
ST meant that additional women and children in Chadiza accessed lab-based testing, possibly contributing to early initiation of and/or adherence to treatment.
♦ Couriers also transport sample-collection consumables, DBS kits♦ Challenge: laboratory and health centre capacity to manage high
testing volumes. ♦ Preventive maintenance and fleet
management critical to ST reliability and trust of stakeholders.
♦ October 2011: ST began in Nyimba; Riders hopes to expand ST to all EPand the rest of Zambia but requires funding and support from partners.
Thank you
♦ To our MoH partners, especially the Chadiza DHO and Eastern PHO, who have strongly supported this programme and enabled its success
♦ To CIDRZ and other partners♦ To our team in Chipata for their dedication
For more information, please contact Ms. Constance Chibiliti at [email protected] or visit:
www.riders.org