Boda Boda Drivers Have Become the Key to Contraceptive Access in Uganda During COVID-19

By Rahmah Namaganda, Medical Detailer Supervisor, PSI Uganda, and Molly Siwula, Sexual and Reproductive Health Project Manager, PSI

As the COVID-19 global pandemic ravages national health systems and supply chains, the need for innovation to ensure continued access to essential sexual and reproductive health (SRH) services has become more important than ever.

In Uganda, where 52% of pregnancies are unintended and 26% of unintended pregnancies end in abortion—76% of which are believed to be dangerous and unsafe—access to lifesaving SRH products and services was already a challenge before the pandemic. PSI Uganda works to meet these healthcare needs by preventing unsafe abortion and increasing access to modern contraception and post-abortion care.

But what happens when a national lockdown makes it difficult—if not impossible—to access these products? PSI has been working on innovative solutions to deliver SRH products to our Ugandan clients while maintaining physical distancing using a form of transportation ubiquitous to the region: boda boda (motorcycle) drivers. Below, learn more about how PSI Uganda is making this happen.

Hoping for the Best, Prepared for the Worst

Disruptions to PSI’s SRH activities due to COVID-19 were expected.

By the time Uganda enforced movement restrictions on public transport on March 22, PSI Uganda had already prepared for the anticipated lockdown. Staff loaded up on stocks of SRH commodities from its warehouses—which would soon be hard to access—and brought them to their offices and medical detailers’ homes.

Travel by private vehicles became prohibited on March 30, which made it impossible for medical detailers to continue their field visits to pharmacies and private health clinics. Pharmacies and clinics typically carry a stock of contraceptive methods, condoms, misoprostol for post-abortion care and medical abortion (MA) combination packs, which can be purchased with a prescription if a woman falls within one of the legal indications.

By the end of March, private providers and pharmacies were already beginning to prepare for stock shortages and a higher cost of business as prices for items like gloves, face masks and sanitizer increased due to high demand.

Shifting to Teledetailing

To minimize staff movement and protect the health of its medical detailers, PSI has shifted from in-person detailing to “teledetailing” to provide continuous support to providers and pharmacies. Teledetailing allows staff to provide correct information on products by mobile phone and WhatsApp and provide assistance to frontline health workers so they can maintain continuity of service for their SRH clients.

As PSI staff spoke with providers and pharmacy staff, orders for PSI’s products continued to roll in, demonstrating that women’s need for essential SRH care wasn’t going away.

From Boda Boda Drivers to SRH Product Distributors

While travel using privately-owned vehicles is banned, boda bodas, East Africa’s ever-present motorcycle taxis, can still operate between 7 AM and 2 PM provided they don’t carry people.

After speaking with providers and pharmacy staff, PSI found that many already have their own trusted boda boda driver whom they use to pick up products from wholesalers. Why not send them to pick up the needed PSI stock?

Boda boda drivers are instructed to pick up orders from PSI while maintaining proper social distancing measures and deliver them to the health center or pharmacy that placed the order. Once delivered, the provider or pharmacist sends a mobile payment to PSI.

PSI covers the boda boda transportation fees so that providers don’t incur additional costs and, most importantly, the transportation fee doesn’t affect clients by driving up the cost of the products they need.

Using these trusted boda boda drivers, PSI was able to reach 30 pharmacies and 47 clinics that were low or stocked out on products between March 31 and April 26.  Despite a nationwide lockdown, PSI’s innovation in teledetailing and using boda boda drivers mean that clinics and pharmacies can continue to meet women’s SRH needs.

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