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Mobile clinics to bring diagnostic tools, medicines, and supplies to local communities. Mobile clinics have long served this function. In recent years, however, various organizations have begun employing them at scale. This suggests that they could play an important role in maximizing the reach of local health officers, while further lowering the transport barriers that keep many Africans from receiving care.
In India, for example, the nonprofit Health Management and Research Institute deployed 475 mobile clinics across Andhra Pradesh in just one year and is using them to improve medical coverage for the state’s massive rural population. Turkey’s government has used mobile clinics to give large portions of the country’s rural population greater access to about 80 medical services. Egypt’s government uses truck convoys to transport temporary hospitals around the country. Comparable experiments are under way elsewhere in India, as well as in Namibia, Nigeria, and other African countries.
While no single best-practice template will work across Africa—budgets, infrastructure constraints, and terrain vary too dramatically—our research suggests that successful models will embody several characteristics.
- Smaller is generally better: vans can cover more of Africa’s diverse terrain and poor roads than larger vehicles can. The vans should be equipped with coolers to transport refrigerated vaccines, medicines, and lab samples to and from faraway health clinics. They should also have a bed to treat patients and to accommodate a doctor or nurse-practitioner on multiday journeys.
- The vans can focus on providing care for chronic conditions and more complex follow-up interventions (say, antenatal care). They should play a primary role in providing direct support for health officers’ activities, as well. A van’s supplies will therefore include test kits, basic medicines, and some equipment (higher-end gear like ultrasounds would be ideal). Services could include education and awareness, screening, diagnosis, treatment, the delivery of supplies, and supplemental training for local health officers.
- Routes must be chosen carefully so that each community can receive a visit at least every four weeks. The key is to minimize travel time and maximize treatment time. Health clinics can serve as a natural base of operations and resupply for mobile journeys, which might take two or three days and cover a number of villages. Whenever possible, trained schedulers in call centers should coordinate scheduling, with input from local health officers.
- Routes must be well advertised and timetables kept so that patients are properly screened and paperwork doesn’t eat into treatment time.
- Finally, maintenance and running costs must not be overlooked. When mobile clinics fail to show up in villages because of breakdowns, patients quickly become disillusioned and a program’s potential declines.
Despite the versatility of mobile clinics, their operating costs are quite reasonable when programs are designed to supplement the work of local health officers (through monthly visits, for example). In fact, we estimate that a mobile clinic staffed by two nurses would cost less than $0.75 per person a year in most African countries.