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The Blantyre District Health Office (DHO) has provided 18 motorcycles to health centres under its jurisdiction for the direct delivery of routine immunization vaccines and other interventions – known as the EquityDRIVE programme, which aims to scale up last-mile supply chain delivery solutions in Malawi.
The 18 motorcycles were handed over at the Blantyre DHO premises at Ginnery Corner on Monday, July 1, and will be used by the organisation to provide mobility during the delivery of immunisation services through the assistance of volunteers.
The Director of Health and Social Services at the Ministry of Health, Dr Gift Kawalazira, said the motorcycles were provided with the support of UNICEF, adding that this was the first project of its kind, drawing lessons from the challenges faced by the country during different disease outbreaks.
“We can now reach as many people as possible in hard-to-reach areas to combat different outbreaks and carry out routine immunization services,” he said.
Councillor Moussa Chikwawa, who chairs the Blantyre District Council’s environment committee, said volunteers had been properly trained on how to handle vaccine packaging.
He added that as a committee, they will ensure proper coordination between them, health centres and volunteers for smooth delivery of the vaccine.
“We will ensure that the volunteers reach their intended destinations and that the motorcycles are used for their intended purpose,” he said.
The project’s description explains that it builds on extensive experience in delivering vaccines directly from healthcare facilities to outreach session sites, with or without refrigerators.
It is reported that this will ensure high supply chain efficiency, increase the supply of vaccines at vaccination sites, reduce the time spent by medical staff in delivering vaccines, reduce out-of-pocket expenses for medical staff, and help increase coverage and reduce zero-dose and underserved populations.
Its aim is to reduce morbidity and mortality from vaccine-preventable diseases such as tuberculosis, measles, polio, diphtheria, pertussis, rotavirus-induced diarrhoea, pneumococcal, tetanus, Haemophilus influenzae type b, and hepatitis B virus infections.
The goal is to vaccinate all children under 24 months of age, all girls between 9 and 14 years of age, and pregnant women and all other women between 15 and 49 years of age against HPV.
The delivery of vaccines to outreach clinics relies solely on health service assistants, who also undertake other services such as community assessments and other village-level services.
Most aides found it difficult to provide other community services because they needed to quickly pick up the vaccine, attend outreach events, and return to the health center to store the vaccine in the refrigerator—thus missing out on the opportunity to invest quality time in RI meetings.
Cold chain equipment for transporting vaccines includes vaccine carriers or refrigerated boxes; conditioning ice packs; sealed bags or simple plastic bags and freezer labels.
According to the Malawi Ministry of Health, Malawi established the Expanded Programme on Immunization in 1979 and its services are part of the primary health care plan for promotional and preventive health care.
Immunization services are provided along with other parts of the primary health care package, which includes growth monitoring; nutritional screening and vitamin A supplementation; family planning; health education; safe drinking water and early treatment of illnesses – including malaria and other diseases in children under five.
At the same time, volunteers received training on maintaining the cold chain, including: If the motorcycle has a malfunction such as a flat tire, they should notify the responsible medical institution and the HSA at the outreach clinic.
They are also advised to remove the vaccine transporter from the motorcycle transporter and place it in a cool place away from direct sunlight – and never open the vaccine transporter to avoid exposing the vaccine to high temperatures.
In terms of motorcycle management, they check tire pressure to make sure it is adequate before riding, and ensure the bike is well lubricated and has the correct chain tension.
They also have to wash their bikes regularly; keep an eye out for squealing brakes; always keep their batteries charged and carry a tool kit with them.
The DRIVE Equity Initiative aims to reduce stock-outs in health facilities due to transportation challenges and is also a social enterprise initiative as it supports the livelihoods of community members.
Volunteers will benefit financially through the income from the motorcycle business and are asked to remit enough money so that Ho Chi Minh City can purchase a new motorcycle to replace the current one in 2-3 years.
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