By Johnson Siamachira
HARARE, (New Ziana) – In the heart of Shamva district in Mashonaland Central Province, Rosemary Sibanda revs her motorcycle, ready to embark on a mission that embodies hope for thousands. Each day, she navigates up to 130 kilometres, visiting health facilities to collect medical samples that could change lives.
“The distances are vast, and many people struggle to reach testing facilities. I transport samples because I know my family, my friends, my community—anyone—may need this service one day,” she says, her voice steady yet filled with urgency.
Sibanda is not just a rider; she is a lifeline in Zimbabwe’s transformative Integrated Specimen Transportation (IST) programme, which is reshaping the country’s healthcare landscape.
This model, created in 2021 through a collaborative effort by the Ministry of Health and Child Care, Biomedical Research and Training Institute (BRTI), United Nations Development Program (UNDP), and the Global Fund, has yielded remarkable results.
The IST programme utilises motorbikes and vehicles to collect samples from clinics and deliver them to laboratories for testing. Despite strides towards universal health coverage, Zimbabwe’s healthcare system once struggled under the weight of inefficiency.
Delays in transporting medical samples meant that patients often waited weeks, or even months, for critical test results. “Before we developed the system, we had no formal sample transportation,” recounts Dr. Raiva Simbi, Director of Laboratory Services at the Ministry of Health and Child Care (MOHCC).
The absence of a coherent system not only delayed diagnoses but also jeopardised the health of vulnerable populations, particularly those living with HIV. For many, the consequences of prolonged waiting times were dire.
Fidelis Muchanyiri, a beneficiary from Mudzi district, recalls the struggle:“Long back, we would be tested for viral load, but the blood would not be used. I had to be tested over and over.” Living far from healthcare facilities, he faced not only the physical distance but also financial barriers.
The Global Fund, through the UNDP, intervened in 2021, investing US$3.7 million under Grant Cycle Six and an additional US$5.1 million for Grant Cycle Seven. This initiative aimed to unify fragmented systems that had led to inefficiencies and inequities in healthcare access.
“As a collective partnership, we aimed to support the government ministries and departments to achieve the goals outlined in Zimbabwe’s National HIV and AIDS Strategic Plan,” explains Dr. Ayodele Odusola, the UNDP Resident Representative for Zimbabwe.
The IST programme employs a hub-and-spoke model, with district hospitals acting as hubs receiving samples from over 2,000 lower-level facilities. This innovative approach has revolutionised the sample transport process, significantly reducing turnaround times.
“When we started, it took four to six months for samples to yield results; now, it takes just about 72 hours,” says Dr. Simbi, reflecting on the programme’s impact. The initiative has expanded to cover 44 districts. “The progress we have made with IST has been phenomenal,” says Prisca Chikwanda, Laboratory Medicine Branch Chief at Centers for Diseases Control (CDC) Zimbabwe.
“More than 1,600 facilities can now access laboratory services, resulting in timely medical interventions for over 1.2 million people living with HIV.” Evidence Makombe, Provincial Chief Laboratory Scientist in the Midlands Province, says, “The IST system has supported the viral load scale-up programme because we are releasing results in a shorter period or a shorter turnaround time.
There is increased confidence within the facilities, within the clinics and customers. Now, we are also experiencing better outcomes in patients because they are receiving their results on time, and the clinicians are then able to manage the patients.”
“Where before 2019, about 400,000 samples were done every year, we’re now over one million samples, which is, again, one of the best results you can ever think about,” says Dr. Odusola. Sibanda’s role as an IST rider extends beyond mere transportation.
She meticulously checks patient details, ensures sample integrity, and packages specimens for transport. “The cooler box has a biohazard container inside to carry blood samples and ice packs. It also has a thermometer to maintain the cold chain,” she explains, emphasising the importance of preserving sample quality.
Her daily routine embodies resilience and dedication.“When I first started riding, it was challenging to cover such long distances. But now, I feel empowered,” she adds. As one of the 280 IST riders, Sibanda’s efforts contribute to a network that has dramatically improved patient care. The results speak for themselves.
Mpilo Central Hospital in Bulawayo reported a 50 per cent increase in samples processed monthly. “The turnaround time for most specimens has shortened significantly,” says Dr. Narcisius Dzvanga, Chief Medical Officer.
“We’ve maintained our International Organization for Standardization (ISO) certification, ensuring efficient tracking and accountability of both specimens and results.” The IST programme has not only improved healthcare delivery but also fostered a sense of community and collaboration among stakeholders.
Dr. Shungu Munyati, Director General of the BRTI, highlights the importance of integration: “The costs of transporting samples in an integrated way are greatly reduced compared to parallel, uncoordinated systems.”
As Zimbabwe pushes towards universal health coverage, the IST programme serves as a model for effective healthcare delivery in low-resource settings. “We are now showcasing the system to other countries, demonstrating how we have developed it and how it has changed the landscape of testing in the country,” Dr. Simbi says proudly.
Zimbabwe’s journey towards universal health coverage is far from over, but the advancements made through the IST programme provide a beacon of hope. With continued investment, innovative practices, and the unwavering dedication of individuals like Sibanda, the nation moves closer to a future where quality healthcare is accessible to all.
Through collaboration, commitment, and a focus on human stories, Zimbabwe stands at the threshold of a healthcare revolution—one that promises a healthier, more equitable future for its people.
New Ziana
