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Maternal Health and Transport; Practical Solutions for a Practical Problem

Maternal Health and Transport; Practical Solutions for a Practical Problem. Gary Forster, May 2010. Presentation to the IFRTD ’Bridging the gap: addressing mobility needs as a means to achieve the health-related MDG’s’ side event at UN-CSD-18, New-York, 3 rd May, 2010 .

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Maternal Health and Transport; Practical Solutions for a Practical Problem

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  1. Maternal Health and Transport;Practical Solutions for a Practical Problem Gary Forster, May 2010 Presentation to the IFRTD ’Bridging the gap: addressing mobility needs as a means to achieve the health-related MDG’s’ side event at UN-CSD-18, New-York, 3rd May, 2010

  2. Brainchild of HRH The Princess Royal Founded by Save the Children and the Chartered Institute of Logistics and Transport Roots from the mid- 1980’s famine crisis in Sub-Saharan Africa Independent charity since1998 Annual turnover ½ million GBP Transaid History

  3. To improve access to basic services through the development of appropriate transport solutions To increase economic opportunities through increasing the capacity of the transport and logistics sector to operate effectively, efficiently and safely Our goals Photo Courtesy of Hafsat M. Baba, Program Officer Demand Creation, PRRINN-MNCH, Katsina Office, Nigeria

  4. “Around the world, in much of development work, transport is the ultimate enabler. By serving other sectors of a nation’s economy, it puts development goals within reach. We know, for instance, that an estimated 75 percent of maternal deaths could be prevented through timely access to childbirth-related care, facilitated by transport.” A Statement from the World Bank: (Source; Katherine Sierra, Vice President, Sustainable Development, “Safe, Clean, and Affordable…, Transport for Development”, The World Bank Group’s Transport Business Strategy for 2008-2012)

  5. Maternal Complications and Time to Death

  6. What are the causes of the 2nd Delay? • cost of travel, • unavailability of vehicles, • condition of vehicles, • lack of fuel, • lack of road infrastructure, • geography, • distance • communications: • Radio • Mobile Phone • Motorcycle

  7. The Transport Solutions

  8. Government Interventions

  9. Ghana Ministry of Health Fleet Management Project • 70% more kilometres traveled in 12% less vehicles within the same budget • 20% less fuel used • Ante-natal care increased by 100% • Attended births increased by 400% • Child immunisation increased by 100% • Donors prepared to support vehicle replacement plan as they could see clear benefits

  10. Private Sector Involvement

  11. Northern Nigeria Emergency Transport System – Jigawa State

  12. PRRINN-MNCH 3 States

  13. Community Managed Systems

  14. Zambia Bicycle Ambulance Project • 40 bicycle ambulances were produced and distributed to Zambia’s Eastern Province for Comparative Testing • Ambulance usage and management follows TMS principles • In previous studies up to 30% of ambulance use has been attributed to pregnancy cases

  15. “If there was no bicycle ambulance I was not going to sit here today and talk to you, I would have been wasted, thank you so very much”. “It’s a facility which has come to save lives and I'm happy that I used it”. “Thank you very much, I would have died at home if it was not for the bicycle ambulance”.

  16. Intermediate Modes of Transport; What does the research say? • A bicycle ambulance project in Uganda found that one typical use was the transport of pregnant women, which accounted for 52% of all medical indications for transport. iii • “the community affirmed that before it developed problems, the motorcycle ambulance contributed immensely in providing access to pregnant women on emergency obstetric care; more than any other means of transport they ever used in carrying pregnant women and sick persons to health centres”. iv iii Heyen-Perschon, J., Summary on the FABIO/BSPW - Bicycle Ambulance Project (Uganda), ITDP Europe iv. Balogun, I, A., (2008), Draft Report of the Assessment of Motorcycle Ambulance Trailers in Jigawa State, Transaid, July 2008 i.

  17. Motorcycle ambulances for referral of obstetric emergencies in rural Malawi: Do they reduce delay and what do they cost? • Motorcycle ambulances reduce the delay in referring women with obstetric complications from remote rural health centers to the district hospital, particularly under circumstances where health centers have no access to other transport or means of communication to call for an ambulance. Jan J. Hofman, Chris Dzimadzi, Kingsley Lungu, Esther Y. Ratsma, Julia Hussein

  18. A Final Thought; “With a few exceptions, such as some small-scale community initiatives, most schemes fail to address transport and time barriers” Borghi, J., Ensor, T., Somanathan, C., Lissner, C., Mills, A., (2006), Mobilising financial resources for maternal health, Lancet 2006; 368: 1457–65, Published Online, September 28, 2006 DOI:10.1016/S0140- 6736(06)69383-5

  19. Thank You

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