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Tuesday, June 18, 2024

Zim marching towards universal health coverage with faster diagnostics

Story by Abigirl Tembo, Health Editor

ZIMBABWE is making significant strides towards achieving universal health coverage, with the Integrated Specimen Transportation (IST) Programme transforming the delivery of samples to labs.

In the past, Zimbabwe’s healthcare system was hamstrung by a slow and inefficient system for transporting medical samples.

This led to delays in diagnosis, particularly for HIV patients, who rely on timely viral load test results to monitor the effectiveness of their treatment.

A collaborative effort by the Ministry of Health and Childcare, Biomedical Research and Training Institute, UNDP, the Global Fund, and PEPFAR has, however, transformed the process to create the Integrated Specimen Transport (IST) system.

This model created in 2021 has yielded remarkable results over the years through utilising motorbikes and vehicles to collect samples from clinics and deliver them to labs for testing.

“UNDP, working with the Ministry of Health and Childcare, is working in 23 districts, of which we have 94 riders that are helping us accelerate the delivery of these samples and ensuring we get the right result on time. And we also work with PEPFAR, which currently covers about 40 of the districts. So all together, we have something like 63 districts being covered. But essentially, what is intriguing to us is the impact we’ve been able to achieve so far.

“Where before 2019, about 400,000 samples were done every year, we’re now over a million samples, which is, again, one of the best results you can ever think about. Also when it comes to the issue of the impact on the ground, and also when it comes to the issue of the impact on the ground, I just want to re-echo the fact that it’s not only about the number, but before 2019 when we started the full collaboration on this IST initiative you realised that it takes about four to six months before the sample collected translates into meaningful results on the ground, but now it takes just about 72 hours which is three days which is a tremendous achievement globally. This has helped us to contribute to the 95 95 95 targets and Zimbabwe is one of the very few countries that have been able to accomplish this task before the timeline of 2025,” said UNDP Resident Representative, Dr Ayodele Odusola.

Director General Biomedical Research and Training Institute, Director Dr Shingai Munyati weighed in saying, “The IST program put BRTI on the map a lot. We are an implementing partner for the Ministry of Health and Childcare. The funding is coming from UNDP and the Global Fund. So, this is an IST UNDP-run project on integrated sample transport. We house the project here at BRTI and ensure that in terms of financial management, in terms of grant management, in terms of personnel issues, employment contracts, and so forth, those are all hosted by BRTI. And so, through this program, we have contributed a lot in terms of IST, the integrated sample transport, as already explained, being the different samples for TB, HIV, cholera, and any outbreaks. But, the IST program and through our partnership with UNDP, I think we have contributed a lot.

“I think, as already explained, it’s cost-efficient and it’s very innovative. Having your riders transporting from the districts, from the different clinics to the districts, and then from the districts to the different provincial laboratories so that there’s a system that has been put in place that ensures efficient and fast delivery using riders funded and supported by UNDP. We have provincial vehicles that also assist in that regard. And I think the contribution of BRTI has been immense in terms of implementation. But working hand in hand with the Ministry of Health and Childcare, mainly with the directors of lab services.”

A case in point is Mpilo Central Hospital which has witnessed tangible improvement in patient care with faster turnaround times and increased testing volume as explained by Mpilo Central Hospital Chief Medical Officer, Dr Narcisius Dzvanga, “So the turnaround time for most of the specimens has been shortened because of this integrated specimen transportation. This was introduced in 2021 and Mpilo has got four riders, as we call them, who cover the Bulawayo Metropolitan province. We have seen an increase in our specimens from 5,000 to 10,000 per month. And this is a mix of TB, as well as HIV for viral loads. This has resulted in efficient tracking and accountability of both specimens and results. It has seen a significant reduction in specimen rejection rates with now less than 1%. This also led to a reduction of turnaround time for most of the specimens with a time of 14 days on average.”

Rolled out in 2021, the IST program is now in 63 districts and 2000 health facilities, where the objective is to address the specimen and result transportation gap by offering a well-coordinated specimen transportation system.

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