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1 Increasing health system efficiency: Use of motorcycles for patient outreach in Kisumu, Nyanza Province D. O’Farrell 1, K. Nichols 1, K. Harrison 1,

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Presentation on theme: "1 Increasing health system efficiency: Use of motorcycles for patient outreach in Kisumu, Nyanza Province D. O’Farrell 1, K. Nichols 1, K. Harrison 1,"— Presentation transcript:

1 1 Increasing health system efficiency: Use of motorcycles for patient outreach in Kisumu, Nyanza Province D. O’Farrell 1, K. Nichols 1, K. Harrison 1, M. Lutukai 1, J. Lewis-Kulzer 2,3, G. Agengo 2, P. Oyaro 2, I. Sakura 1 1 Riders for Health, 2 FACES/KEMRI, 3 UCSF

2 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 ministries of health (MoHs) and other health partners in 7 countries

3 Background/program description ♦Expertise: −FACES: comprehensive HIV prevention, care, & treatment program −Riders: motorcycle management through preventive maintenance and rider training to increase reliability −FACES & Riders partnership: in Oct. 2009, 9 outreach workers trained to use 6 motorcycles for defaulter tracing at 5 FACES supported health facilities in Kisumu District, in addition to usual tracing means

4 HIV care and treatment challenges ♦Challenging for outreach health workers to traverse difficult terrain and long distances to trace HIV- infected patients who default on care ♦Outreach workers used public transport, walked, and had infrequent access to motorcycles ♦Motorcycles were not preventively maintained and were not reliable

5 Study Objective This study examined whether mobilising outreach workers using accessible motorcycles maintained preventively and routinely affected patient tracing and return rates.

6 Methods ♦Evaluation: retrospective study at five health facilities ♦Data collection: existing aggregated program data on monthly patient defaulter tracing rates were abstracted and compared at: −Baseline: Jan – Sep 2009 −Follow-up 1: Jan – Sep 2010 −Follow-up 2: Jan – Sep 2011 ♦Analysis: Student’s t-test

7 Objective and methods ♦Objective: Study examined whether mobilising outreach workers using accessible motorcycles maintained preventively/routinely affected patient tracing and return rates. ♦Methods: −Retrospective study conducted at 5 health facilities in Kisumu District −Aggregated programme data on monthly patient defaulter tracing rates to the facility were utilized. −Baseline data (Jan.-Sept. 2009) were compared to data from the same time period in 2010 and 2011 following implementation using paired Student’s t-tests. Joy Judy FACES outreach health worker

8 Results across ♦10,334 patients defaulted between ♦63.9% (n=6,603) were traced, among which 55.6% (n=3,669) returned.

9 Result #1: Tracing rates The average monthly percentage of defaulters who were traced increased significantly ( ). * Indicates significant change from previous period (p=.0001) ** Indicates slightly insignificant change from previous period (p=.055)

10 Result #2: Return rates The average monthly percentage of traced defaulters who returned increased significantly ( ). * Indicates significant change from previous period (p=.0216) ** Indicates significant change from previous period (p=.0393)

11 Conclusions ♦Substantial increases in tracing and return rates were found after managed motorcycles were introduced. ♦Increases could be potentially attributed to: −Facility staff numbers −Use of phone tracing and other tracing means −Motorcycle functionality ♦Providing outreach workers with managed motorcycles may be a viable approach to increase tracing and other outreach services in Kenya.

12 Further research/partnerships ♦Potential research to examine comparison facilities and GPS mapping results to improve understanding of motorcycle impact ♦Additional analysis of other Riders partnerships, where outreach health workers are mobilised on motorcycles to deliver health education, host support groups, monitor water and sanitation programmes, etc. ♦Open to further partnerships to manage transport used in health care delivery, such as a motorcycle courier system to transport samples between clinics and labs

13 Thank you ♦To our partners at FACES, KEMRI and UCSF, who have strongly supported this programme and enabled its success. See ♦To our teams here in Kenya for their dedication For more information, please contact or visit:


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