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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 cchibiliti@riders.org or visit:

www.riders.org