Blantyre District Health Office (DHO) has provided 18 motorcycles to health centres under its jurisdiction for direct delivery of routine immunisation vaccines and other interventions -- dubbed the DRIVE Initiative for Equity, that aims at scaling up the last mile supply chain delivery solutions in Malawi.
The handover of the 18 motorcycles was made on Monday, July 1, at Blantyre DHO premises at Ginnery Corner, which through volunteers is to assist in mobility during the provision of immunisation services.
The DHO's director of health and social services, Dr. Gift Kawalazira said the motorcycles were made available with support from UNICEF, saying this the first of its kind project having taken lessons from challenges the country has faced with different disease outbreaks.
"We can now reach out to as many people as possible in hard-to-reach areas to combat different outbreaks as well as carry out routine immunisation services," he said.
On his part, Councillor Mussa Chikwakwa, chairperson of Environmental Committee of Blantyre District Council, said the volunteers have been properly trained on how to handle the vaccine packages.
He added that as a committee, they would make sure there is proper coordination between them, the health centres and the volunteers for smooth delivery of the vaccines.
"We are going to make sure that the volunteers reach out to the intended destination and that the motorcycles are used for the intended purposes," he said.
A presentation of the project explains that this has been built on extensive experience with implementing direct delivery from health facility to outreach session site and the scope is direct vaccine delivery with a refrigerator or without a refrigerator.
This, according to the presentation, will ensure high supply chain efficiency, increased vaccine availability at session sites, reduction in time spent on vaccine delivery by health workers, reduction in out-of-pocket expenses for health workers and contribute to higher coverage and reduction of zero dose and underserved populations.
It is aimed at reducing morbidity and mortality rates from vaccine preventable diseases such as tuberculosis (TB), measles, poliomyelitis, diphtheria, pertussis (whooping cough), diarrhea caused by rotavirus, pneumococcal, tetanus, hemophilus influenza B and hepatitis B virus infections.
The objective is to immunise all children less than 24 months of age; all girls between 9 to 14 years against human papilloma virus and expectant mothers and all other females between 15-49 years old.
Delivery of vaccines to outreach clinics relied only on health service assistants, who were burdened with other services such as community assessments, and delivery of other village level services.
Most of the assistants found it difficult to deliver other community services as they needed to quickly pick up vaccines, going to outreach session and return to the health center to store the vaccine in refrigerators -- hence missing opportunities to invest quality time at RI session.
The Cold Chain equipment to transport vaccines includes vaccine carriers or cold boxes; conditioned ice packs; zip lock bags or improvised plastic bags and freeze tags.
According to the DHO, the Expanded Program on Immunization was established in Malawi in 1979, whose services are part of the essential health care package for promotive and preventive health.
Immunization services are provided alongside other components of the essential health care package, which include growth monitoring; nutrition screening & vitamin A supplementation; family planning; health education; water safety and early treatment of ailments --including malaria in under-5s and others.
Meanwhile, the volunteer bikers have been trained the do's and don'ts in maintaining the Cold Chain, which include that if the motorcycle develops a fault such as a flat tyre, they should inform the health facility in-charge and the HSA at the outreach clinic.
They are also advised to remove the vaccine carrier from the motorcycle carrier and put it under a shade away from direct sunlight -- and never to open the vaccine carrier to avoid exposure of the vaccines to heat.
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On motorcycle management, they are to check their tyre pressure and ensure that the pressure is adequate before riding off and to make sure the bike is well lubricated as well as to maintain the correct chain tension.
They are also to wash their bike regularly; listen for squealing brakes; to keep the battery topped up at all times and to always pack a toolkit on board.
The DRIVE Initiative for Equity -- while it is to reduce stock out at the health facility due to transport challenges -- is also a social enterprise initiative as it supports community members' livelihoods.
The volunteers shall benefit economically through earnings from the motorcycle business and they shall be required to remit sufficient money such that at the end of 2-3 years, the HCMC aims to purchase a new motorcycle to replace the current one.
