For millions living in rural areas of developing countries, an army of volunteer caregivers provide a vital lifeline to quality healthcare and support.
Providing a last-mile transportation solution for healthcare is a key focus for World Bicycle Relief. We work with government and NGO partners to design sustainable programs that incorporate Bicycle Supervisory Committees (BSCs), bicycle field mechanic training and much-needed access to quality spare parts.
To date, through our philanthropic and social enterprise programs – and with your incredible support – World Bicycle Relief has distributed more than 128,383 bicycles in seven countries to support healthcare programs.
“Before the bicycle, I found it difficult to come for stock to Mwanza Hospital. Now I can come one way in 15 minutes to get condoms.”
The Struggle to Thrive
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.
“We carry friends who are walking in the same direction.”
Supporting Community Care
By improving access to health services, bicycles increase the amount of time community health workers spend with clients – resulting in a greater understanding of patient needs and better adherence to treatment plans. Benefits also extend to the health worker by providing an incentive to continue unpaid work, producing greater continuity of care and healthier communities.
Taking on this challenge, we used expertise in building sustainable and cost-effective bicycle programs for education and applied it to healthcare. Our new Wheels for Integrated and Sustainable Health (WISH) program 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’ve incorporated program frameworks such as BSCs to ensure the bicycles are well-maintained, serviced and contributing to sustainable impact.
We know firsthand the importance of keeping programs rolling without interruption.
“If you finish your work, and you prioritize work, we can use the bicycle for other things. I appreciate. If need be, I can take the child to school.”
Piloting WISH in Malawi
In 2018, with partners Baylor College of Medicine and Save the Children, we piloted our WISH program.
Over 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.
“I’ve been encouraged. Before in a week, I could go to four villages. I couldn’t even get the work done because I was so tired. Now I am able to go on. The bicycle has helped energize me for my work.”
From Challenges to Benefits
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.
Will you help us continue to support and innovate our programs in developing countries?