For millions living in rural areas of developing countries, an army of volunteer caregivers provide a vital lifeline to quality healthcare and support.
In rural Malawi, where community health workers serve vulnerable households with home-based care, the transmission of HIV, coupled with access to reproductive health information, is at the forefront of the healthcare challenge.
Many of these hard-to-reach households lack access to running water or transportation and are located up to 15 km from the nearest hospital. Health workers maximize each visit by bringing a wealth of materials: medical therapies, water treatment supplies, even child care and cleaning services.
Reaching clients, expectant mothers and those in need of reproductive care is, at its core, a transport challenge and opportunity for increased bicycle usage.
That’s why, in 2018, with partners Baylor College of Medicine and Save the Children, we piloted our new Wheels for Integrated and Sustainable Health (WISH) program. WISH aims to improve community health service delivery by providing bicycles to health workers administering home-based care.
Using our thriving Bicycles for Educational Empowerment Program (BEEP) as a model, we incorporated program frameworks such as BSCs to ensure the bicycles are well-maintained, serviced and contributing to sustainable impact.
Together with Baylor and Save the Children, more than 500 Buffalo Bicycles were distributed through 43 health facilities in the Malawi districts of Balaka, Mwanza, Neno and Ntchisi. As part of the program, 33 BSCs formed and trained to oversee quality implementation of the program and monitor usage of the bicycles. And 27 field mechanics trained to maintain and repair the bicycles and ensure sustainability.
Data from one facility demonstrated that community health workers were able to see more than double the number of patients per day – five patients compared with two before the bicycles. Another facility reported doubling their average reach from three to six patients per day with the bicycles.
Community health workers would walk up to 18 km to visit some households in their catchment area. The bicycles ensured that they could reach these families on a more regular basis.
With improved access to medication, at one facility, the number of defaulters (patients who failed to take their treatment for HIV & AIDS) dropped from 109 patients to just eight patients over a six-month period.
While WISH has demonstrated many successes, its challenges present an opportunity to learn and improve the program as we take it to scale. In addition to specifying bikes with front brakes to improve safety, we will be working to provide greater support for access to spare parts – key to keeping bicycles on the road.
The next step is to bring WISH to communities that overlap with our education programs – mobilizing a new cohort of health workers with the increased benefits of existing program infrastructure and bicycle awareness.
We know firsthand the importance of keeping programs rolling without interruption.
To date, through our philanthropic and social enterprise programs, World Bicycle Relief has distributed more than 128,383 bicycles in seven countries to support healthcare programs.