Prospects for leveraging private sector logistics firms to support rural access to healthcare : some insights from Mozambique

Abstract

For many rural communities across southern Africa, access to even the most basic healthcare is not guaranteed. Competing demands by public sector agencies for limited transport resources, plus poor vehicle maintenance standards, prevent public health system motor pools from being available consistently to reach health centers on a regular basis. The irregular availability and use of transport also results in higher overall costs of distribution of medical commodities due to vehicle breakdowns, higher rates of product wastage, and higher personnel costs per successful delivery. As a result, medical commodities including vaccines and essential medicines are not provided reliably or in sufficient supply, needlessly impacting the health of these communities. This paper reviews current transport practices within the Ministry of Health (MISAU) and highlights existing trends in commercial transport with a view to presenting considerations in which the two sectors could collaborate to achieve improved reliability and increased efficiency of the distribution of medical commodities. A mixed method approach was employed to gather, review and process information. The field research was conducted from September to November, 2013 as well as from January to February 2014 ? before and after the onset of the rains. The research findings indicate in the main that MISAU recognizes the mounting challenges it would face in continuing to support the current model ? and the missed opportunities to broaden access to healthcare. In response, it is pursuing a path of decentralization and private sector engagement in order to capture and realize greater efficiencies and develop a more sustainable and equitable path for improvement.