Riders for Health International works to improve the capacity and efficiency of health care delivery platforms in Africa. Riders strengthens transport systems by providing a structure, introducing new thinking and fostering attitude change, to support the work of those whose remit is to reach the rural poor in sub-Saharan Africa with health care and vital services.
Riders work to find transport solutions which add value to your work. We can help an organisation, government entity to design/implement a customised transport solution at a sustainable cost. Built on over 30 years’ experience of managing vehicles in Africa, we offer an end-to-end service to our partners, enabling the delivery of health care goals efficiently and effectively.
Rural Africa is a hostile environment for vehicle management. There may be no or few representative dealerships within a manufacturer’s franchise system and they may have few informal facilities. There is also a lack of supply-chain for genuine replacement parts.
Breakdowns will inevitably occur if users do not conform to the manufacturers’ standards for preventive maintenance care. In developed countries the easiest way for the user to do this is to take the vehicle to the official franchised dealer/agent, or to an after-sales parts supplier/fitter. In rural Africa this is not generally possible. So, another technique is needed
- To train users in safe, careful, vehicle-respecting driving/riding techniques
- To train users in daily maintenance checks/adjustment (PLANS, FFLOWERS)
- To ensure that professional technicians regularly see the vehicles and service them where they are (outreach maintenance)
- To ensure a predictable supply of correct and genuine replacement parts.
- To offer organisations working in health care, delivery optional planning and budgeting advice for optimal operation of vehicle management and maintenance.
Building on Riders expertise in vehicles and fleet management we also design, set up and implement tailored ‘last-mile’ logistics systems, which are designed to address partners’ needs. Fleet maintenance and management is at the backbone of all transport services. These systems include:
We offer a range of services to help keep your fleet running efficiently all based on preventive maintenance. For a relatively new fleet, we can utilise our preventive maintenance system, which means regular, scheduled servicing including all replacement parts fitted at Riders’ maintenance units, or through our outreach maintenance service. For an older fleet, which is expensive to refurbish or has unknown servicing history, we offer servicing at regular intervals and standard repairs, since we cannot predict parts replacement. Options include vehicle insurance, fuel/fuel management and driver employment
Riders has mobilised outreach health workers on motorcycles, enabling them to increase coverage and provide more people with information on family planning, screening, breast feeding, immunisations, healthy living and prevention tools/strategies. Our systems also allow health workers to regularly provide follow-up care/counselling, vaccinations and conduct disease surveillance. This system is our flagship and we mobilise outreach health workers across all of our seven country programmes, four of which are in direct partnership with the respective MoH. Riders also manages vehicles used to transport health workers to scheduled rural outreach clinics
a) Sample Transport Management (ST):
Riders is one of the pioneers in sample transport systems on motorcycles in Africa. Riders also designing a WHO certified (UN3373) back pack. Riders’ motorcycle courier system is used to transport patient samples and results between primary health facilities and district laboratories to enable disease diagnosis and monitoring, and to support timely treatment initiation. This courier service can also carry reports and statistics, as well as distribute health supplies. We run these systems in four African countries (Lesotho, Liberia, Nigeria and Malawi)
Key elements of sample transport system
Periodic maintenance of motorcycles for specimen transport system following pre-planned preventive maintenance modules
Our sample transport vehicles operate in very harsh terrains and maintenance is one of the pillars of our Sample Transport system. We maintain our fleet of motorcycles and 4-wheeled vehicles used for sample transport on preventive maintenance basis. Sample transport couriers are taught how to carry out daily basic checks on their motorcycles which helps them to carry out minor adjustments and pick up and report faults before they develop into failures or result in breakdowns. Our motorcycle technicians visit the couriers on routine schedules for comprehensive technical follow ups on the motorcycles and replace parts before they fail and cause breakdowns. Outcome
Reduces occurrence of breakdowns and hence less downtime and more motorcycle capacity which makes scheduling and quick response possible
eliminates accidents caused by motorcycle mechanical failures
Training for couriers in riding and handling of specimens (Road Safety, Bio safety and Bio Security)
Infection Prevention Control training- Bio-Safety and Bio Security
Personal and environmental protection is key when transporting laboratory samples. Our couriers undergo Infection Prevention and Control (IPC) training designed to teach them on what to do and what not to do during pickup and delivery of samples in order prevent themselves from being infected, infecting others and contaminating the environment. For example, none of our couriers in Liberia who have transported highly infectious zoonotic samples for Ebola, Lassa fever, yellow fever, etc have been reported to be infected, which is a testimony to the good quality of the IPC training given to them.
We are sensitive to the Global trending bio-security concerns. Our sample transport designs take this into consideration in terms of our equipment, routing, supervision, reporting and accountability. For 3 years in Liberia (2015 to 2017), our couriers moved over 50,000 samples and we have managed to account for all samples transported
Rider/driver training (Road safety)
Our couriers undergo a through and rigorous training in defensive motorcycle rider training before they start picking samples. The training enables the couriers to handle the tough off-road terrains as well as the urban traffic conditions. Every year our couriers are given a refresher training in order to make sure that they continue to adhere to what they were taught.
Each courier is equipped with the proper riding gear in order to enhance their safety when riding the motorcycles. Our ISO certified PPE for our couriers protects them from the adverse weather conditions and personal infection.
Routing and Scheduling
One of the critical stages in developing an effective sample transport system is the design of the routes and scheduling. The primary objective is to achieve a target saturation level in the most economical way and routing efficiency is also critical for the samples turn-around time. RFH uses Cluster routing, Relay system and ‘Hub and spoke’ method for routing of samples to the laboratory.
Management of the specimen transport system
Use of dedicated couriers
Riders utilises dedicated couriers, this is also coupled with high standards in managing of a large number of staffs. Riders can also build capacity to cadres from the MoH dedicated to carrying samples. Dedicated couriers ensure
- standards for collection and transportation can be monitored and followed
- the system is reliable
- quick turnaround times which helps in specimen viability for temperature
- sensitive specimen for results to be reliable
- Sample Cold Chain
It is critical to maintain samples transported to the laboratory under acceptable temperature range for laboratory viability. In Liberia, Riders setup and maintains a dedicated Sample Cold Chain system across the sample transport network for overnight storage of transit samples. On routine basis, our trained Cold chain technician visits all the samples cold chain units for maintenance. This has greatly minimised samples rejection due to poor storage from the point of collection through the relay centres to the laboratory.
Monitoring and Evaluation- Includes the mobile data management and GPS
On a daily basis our M&E team receives and manage sample transport data from all couriers’ activities. We use a specialised mobile data collection software to track real time samples pick up and drop off. We also make use of telematics, using the GPS, to track and monitor our fleet of motorcycles as they pick and drop specimens in their routes.
- includes vehicle uptime, vehicle utilization and other logistics data
- health centre interviews, financial data
- courier activity/sample volumes through mobile data collection software
Riders-managed ambulances can efficiently refer patients from health centres to hospitals when a higher level of care is needed, critical in obstetric emergencies. Ambulance referrals is underpinned by strong preventive maintenance systems to ensure that there is a viable ambulance ready to be dispatched. Strong communication system so that ambulances can be available when needed, data management through mobile technology for decision making on patient care. Strong emergency referral systems are essential to being able to provide patients with emergency care
Riders has expertise in managing vehicles and logistics in rural and remote areas to ensure that medicines and health supplies are distributed quickly and reliably in the ‘last mile’. This distribution can also include motorcycles to take the distribution right down to community level.
This includes a logistics system to distribute pharmaceuticals and supplies down to the primary facility level, usually from the district/state/regional levels of the health system. At these levels, there is usually a lack of a formalised and reliable system and facilities are often responsible for collecting their supplies, or else the higher level is in charge of using their limited and not-always-functioning vehicle(s). This is a major offering in Nigeria, where we distribute anti-retroviral (ARVs) and HIV-related commodities in the South-South and also for rapid diagnostic tests (RDTs) and Artemisinin-based Combination Therapy (ACTs)
Riders can offer consultancy services for the design/planning and setup of transport-related projects or programmes, based on our service offerings, in countries where we currently work, as well as in areas where we do not have any infrastructure. These service offerings are all components of our ongoing services and logistics systems.
Fleet and Logistics planning and budgeting
We can support partners with budgeting for transport, using tailored costing tools, to plan expenditure over projects or vehicle life-times. Transport is an expensive component in any logistical system, but running different scenarios allows us to design plans that deliver maximum value at given budgets. We can also help suggest appropriate vehicles and plan routes to maximise efficiencies. Our costing tools help partners think about future replacement of the fleet and can offer options to pay for replacement of vehicles over time. In certain circumstances, we are able to offer vehicle leasing.
Riders’ technical team has expertise in fleet assessment (desk-based and physical) which determines the condition of vehicles. This helps with refurbishments and fleet disposal recommendations. We can recommend the composition of the fleet to align with use, terrain and climatic factors.
Procurement of vehicles, protective clothing and equipment
Our centralised procurement department has spent many years establishing strong, trusted supplier relationships to ensure competitive prices, often below local rates, for new four-wheeled vehicles and motorcycles. We can also facilitate dispatch of genuine, approved parts. For motorcycle riders, we can procure the best protective clothing to ensure the safety of the riders– helmet, jacket and trousers, kidney belt, riding boots and gloves.
We have also designed specialised equipment for transporting patient specimens, a backpack for holding blood samples or other bio hazardous materials. We can procure these specialised backpacks, as well as top-boxes, for the back of a motorcycle to increase carrying capacity.
Driver and Rider training
Drivers and riders control expensive and potentially dangerous equipment, so training is critical to minimise accidents. Riders offer training courses in vehicle control skills and defensive driving/riding techniques, which enhance road safety awareness, increases knowledge and enhances driver/rider motivation. We also provide training in daily maintenance checks, which help minimise accidents by empowering the driver/rider with knowledge on keeping their vehicle road worthy and can also keep vehicles running for longer. In addition, our International Academy of Vehicle Management (IAVM) in Zimbabwe, Kenya and The Gambia include basic fleet management training – offered onsite or on an outreach basis in other countries.
Review and update of vehicle management policies
Utilising over 30 years’ experience in running fleets in Africa we also have expertise in reviewing and updating fleet management policies so that they can be modelled in the effective maintenance system as done by Riders for Health. W e have in 2016 reviewed the vehicle management policy for the MoH of Liberia and in 2018 on behalf of Abt Inc. we reviewed and updated the vehicle management policy for the Zambia Ministry of Health
Results for you
Managing 1,500 vehicles across eight African countries, Riders produce results for partners like you.
- Maximised vehicle longevity
- Predictable vehicle downtime due to preventive maintenance and outreach maintenance
- Reliable supply chain of high-quality replacement parts
- Safer, vehicle-friendly and reliable riders and drivers, which can lead to reduced accidents
- Long-term cost savings through more efficient operations
- Increased time of administrators focused on the health care programme due to outsourcing of vehicle management to a reliable partner
- Predictable budgeting and no unexpected repair costs
- Regular reporting on vehicle usage
Preventive maintenance is a very common term across many different types of equipment; it even has the same meaning in health care in terms of prevention, or mitigating the risk, of disease. Riders employ this risk mitigation strategy for vehicles, to help prevent the occurrence of vehicle breakdowns (described later) from factors we can control. This involves putting a system in place to control factors of vehicle maintenance and servicing, which, if not addressed, could lead to breakdowns. So, a preventive maintenance system is designed to prevent stoppages that can be avoided. It also includes a quick systems recovery in the event of something happening which could not have been predicted (e.g. a puncture).
Preventive maintenance is a result of a predetermined need by a vehicle. This need is attended to in a maintenance unit or a site set aside for such. Preventive maintenance does not require complicated equipment. Complicated equipment can be considered a waste, as outsourcing for rare incidences is a cheaper alternative when considering the return on capital of that equipment.
Preventive maintenance involves changing an item or a part before it causes a vehicle to breakdown. This normally follows manufacturer’s recommendations, or what we recommend once we take into consideration the terrain factors in a particular geographical area.
Preventive maintenance is synonymous with servicing. There are two types of servicing, minor servicing and major servicing.
Minor servicing involves changing of oil, oil filters and greasing
Major servicing can be seen as minor servicing plus; meaning in addition to a minor service it will also include (for example) wheel hub and bearing servicing, or wheel alignment. These factors will be known before hand and predicted and thus predetermined
As the vehicle part is predetermined, we name it a replacement part rather than a spare part. This is because it replaces a worn vehicle part. A vehicle part is held as a spare in case something unforeseen happens.
A vehicle breakdown is the mechanical failure of a vehicle resulting in it being unavailable for its intended use. Breakdowns can be caused by many factors. Riders aim to control these factors to ensure that breakdowns are minimised. However, breakdowns can occur due to factors outside our control. If breakdowns occur due to anything outside our control e.g. manufacturers’ failures, we don’t consider it as a breakdown we can control.
What we can control
- Training for vehicle users: Vehicle users are trained by Riders to drive/ride safely, carry out daily checks, and notify a technician of any anomaly on a vehicle.
- Preventive maintenance conducted by trained technicians: Technicians are trained to follow predetermined schedules of maintenance and inspect signs or outcomes of adherence to daily checks when servicing.
- Supply chain for genuine replacement parts: Riders has established supply chains for genuine replacement parts. If the correct replacement parts are not provided at the time and place, they are needed, this may result in a breakdown.
- Programme/operations management: Oversight and coordination of the programme.
Repair is synonymous with putting right what has broken. A repair implies that a breakdown has occurred, e.g. a vehicle has suddenly stopped and needs to be repaired so that it can start working again. Vehicles are repaired in a workshop which should be well equipped to be able to deal with any eventuality. Repair normally requires complicated equipment because it deals with the unknown, e.g. equipment to help in towing, diagnosis and putting right the problem. This naturally requires more time and is expensive to correct in relative terms. Generally, repairs can and should be outsourced to workshops with the capacity and equipment for this type of issue. As mentioned, this outsourcing is usually less expensive than procuring costly and sophisticated equipment for relatively low utilisation.
Downtime is linked to the operations of the specific vehicle and the tasks it has to do e.g. sample transport, emergency referrals, drug distribution etc. Downtime is inevitable. There are two kinds of downtime. One is planned (according to a schedule), which relates to planned preventive maintenance; the other is unplanned, connected to breakdowns and other unscheduled events, such as punctures. Downtime is when the vehicle is being serviced, as this takes away the vehicle from its normal duty. The difference is normally the time it takes; preventive maintenance will have a shorter down time as compared to repairs.
At Riders we see vehicle ‘workshops’ to be affiliated with repairs and breakdowns. But since we advocate for preventive maintenance, we use the term vehicle maintenance units (VMU) to remind us that we generally maintain vehicles rather than repair them.