By Michael Gwarisa in Bulawayo
Zimbabwe has scaled-up disease diagnosis, treatment as well as improve success monitoring management of patients at the back of an Integrated Specimen Transportation (IST) system, the HealthTimes has learnt.
Funded by the Global Fund, through the United Nations Development Programme (UNDP), the IST program is being implemented by the Ministry of Health and Child Care (MoHCC), through the Biomedical Research and Training Institute (BRTI).
The IST program was rolled out in 2021, and is now in 63 districts and 2000 health facilities, where it aims to address the specimen and result transportation gap through offering a well-coordinated specimen transportation system. At conception of the project, the Ministry of Health, through support from its partners designed the IST system, to collect samples from lower-level health facilities to higher end facilities, using motorbikes and in some instances vehicles.
Briefing Journalists during a media familiarisation tour of the project in Bulawayo and the Midlands Provinces, Mr Agrippa Mutambara, the National IST Coordinator in the Ministry of Health and Child said the project has transformed the specimen transportation trajectory in Zimbabwe.
Previously we did not have anything and if someone wanted to be tested, they would be asked to go to a hospital where there is a laboratory,” said Mr Mutambara.
“Because at times people didn’t have bus fare or because they don’t understate why they have been asked to go for testing or screening, they would not go, and we would have high mortality out there people dyeing and getting worse without any attention. We have had to design a system which uses motorbikes stationed at the labs, they go to the clinics, and they pick us samples and bring them to the labs for testing.”
To date there are 341 clusters, served by 280 motorbikes and eight provincial vehicles. Out of these, 94 riders in 23 districts are supported by the Global Fund Investments. Additionally, 29 bikes in PEPFAR supported 40 districts are also supported by the Global Fund.
Mr Mutambara added that the current system has improved on the accountability of the specimen being collected from all the 2000 facilities within the ministry of health, and the facilities are getting serviced by the motorbikes at least twice or three times per week.
“We also take the samples to the higher labs where they are also tested and the results are also returned. We are carrying any sample that requires testing from any health facility to the nearest lab. Previously, we didn’t have such as function and some samples that were collected would rot out or they would be misplaced and people would not get their results,” he said.
Funding for the IST project has increased from US$3.7 Million under the Global Fund grant Cycle 6, to US$5.1 Million which has been allocated under Cycle 7.
Dr Ayodele Odusola, the UNDP Resident Representative in Zimbabwe said the turn-around time for samples has greatly improved since the rollout of the IST project in Zimbabwe.
“When it comes to the issue of the impact. Prior to 2019, when we started the full collaboration on this IST initiative, you realise that it would take about four to six months to get the results back but not now it takes at least 72 hours to get the results. This is a tremendous achievement not just locally but also at a regional and global level,” said Dr Odusola.
He added that before 2019, approximately 400,000 samples would be processed annually in Zimbabwe. The numbers have since gone up to over a million samples per year. He also said the IST has contributed to Zimbabwe attaining the 95-95-95 target before the year 2025.
Investments in the IST has also significantly improved treatment monitoring and diagnostics not only for HIV and AIDS, but also for infants born with or exposed to HIV, TB patients, and various other illnesses. Specimens like urine, stool, malaria parasites, and blood for different tests are routinely transported through this comprehensive system, demonstrating its versatility.
Dr Shungu Munyati, the Director General BRTI said, “..the IST program is cost efficient and very innovative having our riders transporting samples from different clinics to the districts and then from the districts to the different provincial laboratories.”
Before implementation of the IST project, the past sample transportation system faced significant hurdles that hindered effective treatment, including for People Living with HIV. According to the UNDP/GLOBAL Fund, these challenges led to ineffective coordination, disjointed communication and collaboration between healthcare facilities and laboratories resulted in delays and errors, delayed results among other issues.
