daniel chigunwe
Rumbidzayi Zinyuke in KANYEMBA, Mbire District
THE Government is making strides towards achieving equitable access to healthcare, through the implementation of the integrated specimen transport (IST) system in hard to reach areas.
Villagers in Kanyemba and Masoka previously faced significant challenges in accessing timely medical care with the lack of transport for samples to laboratories causing delays in the diagnosis of diseases and leading to poorer health outcomes. This was compounded by the dangers of travelling through wildlife-prone areas.
However, the implementation of the IST programme has transformed healthcare delivery as lab results are now delivered to patients much faster, allowing for earlier intervention and improved health outcomes.
Working with support from the Global Fund, through UNDP, the Biomedical Research and Training Institute has supported the Ministry of Health and Child Care to address the specimen and result transport gap, designing, implementing, and sustaining a well-coordinated specimen transportation system.
Speaking during a tour to assess the impact of the project in Mbire district, nurse-in-charge at Chapoto rural health centre Mr Meck Karikoga said prior to the IST system implementation, there were delays in the transport of medical samples thus delaying crucial diagnosis for diseases like malaria, HIV, and TB leading to complications and increased risk of transmission.
“We had no set system for collection and transport of samples. We also have network challenges in this area so sometimes we would not be able to call the referral district hospital whenever we had samples that needed collection, so it meant samples would not be transported on time and this affected the integrity of the sample.
“When we collected our viral load samples, we would send them to the lab using different stakeholders and this made follow up for results difficult and we never had an answer for the clients who wanted their results. As a result, many patients decided to transfer to facilities in Zambia where their results came back faster,” he said.
Chitsungo serves a population of about 4 830 people and among these, 198 people are HIV-positive on antiretroviral treatment.
The health centre is less than 10km from Mozambique and about 4km from Zambia but it is about 150km from the referral hospital at Chitsungo. Samples have to be ferried more than 435km to the provincial referral lab.
To ensure efficiency, the IST program uses a network of motorbikes to collect samples from rural clinics and transport them swiftly to laboratories. Owing to the bad terrain, the risk of human-wildlife conflict and long distances travelled to reach labs from the clinics such as Chapoto, Mbire district uses the IST vehicle to service these rural health centres.
Mr Karikoga said since the IST programme was initiated, healthcare delivery has significantly improved.
“We have seen changes because we know samples are collected on a particular day, so we mobilise our clients and collect samples for early infant diagnosis, viral load testing, sputum for TB testing and many other diseases. We have also now advised the community about the availability of this service and this has resulted in an improvement in the health seeking behaviours and those who had transferred to Zambia have now come back to us,” he said.
Mr Karikoga said when the programme started, the baseline for viral load testing was at 45 percent and this went up in October 2022 to 79,8 percent and is now above 95 percent reflecting that more people were using the services at the health centre.
Mashonaland Central provincial IST coordinator and truck driver Mr Blessed Mudumo said the use of the vehicle had reduced the turnaround time for results.
“For Chapoto and Masoka clinics, these are the furthest clinics which are deep down in the game area. We collect samples bi-weekly so after every two weeks on Mondays, the vehicle will pass through Masoka then it comes to Chapoto and collect the samples. It then drives back to Chitsungo Mission Hospital, that’s where we sleep, then proceed the following morning and service the other hubs along the way, which are Guruve, Mvurwi, Concession, back to Bindura,” said Mr Mudumo.
He said during the rainy season the roads were difficult to manoeuvre on while the hot weather also affected sample transport. To address this, the IST truck was equipped with fridges to ensure that samples arrived in good condition.
“To make sure we keep with the sample integrity, our temperatures are monitored from the point of collection to the testing lab to make sure that the sample represents a patient when it gets to the testing lab. That is one of our key areas which we always strengthen to make sure each sample we carry gives a true representation of the patient when they get to the testing lab,” he added.
Mbire District nursing officer Mindy Chipokosa, said although the whole district used to be serviced by motorbikes, the threat of human wildlife conflict made it difficult to ensure the safety of the riders and maintain the integrity of the samples.
“Because of this, we had a low viral load sample collection, low specimen collection so the staff couldn’t manage the patients well. After the introduction of the transportation by using the vehicle, we reported a positive impact on HIV management.
“This transport using the vehicle is so easy and very convenient for the management of clients in the district. We now have fewer defaulters because we can mobilise our clients for the specimen collection,” she said.
The strengthening of the country’s IST system, significant improvements have been made in delivering timely and effective treatment, ultimately improving patient outcomes and overall public health.
Online Reporter