Project Summary
The Programme for Reviving Routine Immunisation in Northern Nigeria (PRRINN) has been operational in the four states of Jigawa, Katsina, Yobe and Zamfara since early 2007 and has recently been expanded to include all Maternal, Neo-Natal and Child Health (MNCH).
An assessment conducted by PRRINN into the supply side of the project and how healthcare reaches the population, indicated transport as a major issue. This is further compounded in rural areas where health workers have to travel immense distances to pick up and deliver vaccines.
In 2007, an assessment of the transport management capacity within Zamfara state was conducted and recommendations for improvement made. Transaid was a key partner in the execution of this assessment. As part of this continuing work, Transaid was requested to train seven primary health care workers to strengthen their transport management capacity and improve healthcare access.
The Problem
There are very few vehicles available to deliver health services within Zamfara State and existing transport resources are extremely limited. As a result, vaccination distribution at grassroots levels is inhibited and the ability for pregnant women to access emergency transfers is severely delayed and in many cases not possible.
With less than 6% of children being fully immunised in the north west and north eastern zones of Nigeria, many children die each year from preventable diseases such as measles and TB. It is estimated that 22% of childhood deaths can be prevented through routine immunisation, but in order to achieve this healthcare needs to be accessible and supplies need to be available in hard to reach areas.
The Process
Following a review of the existing transport management structures, key guidelines have been developed and presented to stakeholders for feedback.
Phase 1, incorporating the training of transport managers has been implemented and a monitoring and supervisory visit to consolidate this learning was carried out in March 2009.
In conjunction with a national Transport Consultant, Transaid delivered theoretical and practical training on the following transport management components.
1. Situation analysis
2. Policy development
3. Operational management
4. Financial management
5. Fleet management
6. Health and safety
7. Human resources
8. Monitoring and assessment of performance
Transaid will continue to monitor the performance of trainees as they implement the transport management system and begin to collect and analyse the transport management data.
Phase 2, which focuses more on data analysis training, is now in progress.
Partners
The PRRINN-MNCH Consortium led by Health Partners International, Save the Children and Grid Consulting, State Ministry of Health Zamfara State, the Ministry of Local Government Zamfara State.
The Results
A transport management system has now been implemented in Zamfara and seven local government primary health care workers have also been trained in the system. This will enable effective monitoring of health service vehicles to take place and will help to improve the efficiency of health transport at the local government level.
Impact
Transaid’s intervention will enable local government and health transport to be more effectively managed, leading to the following outcomes:
• Greater vehicle utilisation (i.e. less vehicles doing more)
• Reduced vehicle maintenance costs
• Reduced maintenance time
• Reduced expenditure on fuel
• Greater vehicle availability
• Faster response to vehicle demand
• Longer vehicle life span
Better managed vehicles will reduce fleet costs and free resources for the procurement of new vehicles resources. With a more highly utilised fleet, more health facilities and outreach sites will be reached, greatly increasing the availability of vaccines in rural areas.
With greater vehicle availability the state will also be able to respond more quickly to emergency requests for transport. This will decrease the time it takes to refer an emergency maternal case from the community to the health centre, thereby reducing the chance of complications leading to maternal mortality.
See also:
• Nigeria, Emergency Transport System for Pregnant Women, PRRINN-MNCH Update, Oct. 2009
• Nigeria, Training of Ambulance Driver Trainers, Yobe State, PRRINN-MNCH Update, August 2009
• Nigeria, Jigawa State, Safe Motherhood Emergency Transport Scheme, 2005-2006
• Nigeria, Increasing access to healthcare for mothers and children, PRRINN - MNCH Update – April 2009
• Nigeria, Programme for Reviving Routine Immunization in Four Northern States, 2007 – 2011
