Key Elements of the Sample Transport System

Periodic maintenance of motorcycles for specimen transport system following pre-planned preventive maintenance modules

Our sample transport vehicles operate in very harsh terrains and maintenance is one of the pillars of our Sample Transport system. We maintain our fleet of motorcycles and 4-wheeled vehicles used for sample transport on preventive maintenance basis. Sample transport couriers are taught how to carry out daily basic checks on their motorcycles which helps them to carry out minor adjustments and pick up and report faults before they develop into failures or result in breakdowns. Our motorcycle technicians visit the couriers on routine schedules for comprehensive technical follow ups on the motorcycles and replace parts before they fail and cause breakdowns. Outcome

• Reduces occurrence of breakdowns and hence less downtime and more motorcycle capacity which makes scheduling and quick response possible

• eliminates accidents caused by motorcycle mechanical failures

Training for couriers in riding and handling of specimens (Road Safety, Bio safety and Bio Security)

Infection Prevention Control training- Bio-Safety and Bio Security

• Bio Safety

Personal and environmental protection is key when transporting laboratory samples. Our couriers undergo Infection Prevention and Control (IPC) training designed to teach them on what to do and what not to do during pickup and delivery of samples in order prevent themselves from being infected, infecting others and contaminating the environment. For example, none of our couriers in Liberia who have transported highly infectious zoonotic samples for Ebola, Lassa fever, yellow fever, etc have been reported to be infected, which is a testimony to the good quality of the IPC training given to them.

• Bio Security

We are sensitive to the Global trending bio-security concerns. Our sample transport designs take this into consideration in terms of our equipment, routing, supervision, reporting and accountability. For six (6) years in Liberia (2015 to 2021), our couriers moved over 120,000 samples and we have managed to account for all samples transported.

• Rider/driver training (Road safety)

Our couriers undergo a through and rigorous training in defensive motorcycle rider training before they start picking samples. The training enables the couriers to handle the tough off-road terrains as well as the urban traffic conditions. Every year our couriers are given a refresher training in order to make sure that they continue to adhere to what they were taught.

• PPE

Each courier is equipped with the proper riding gear in order to enhance their safety when riding the motorcycles. Our ISO certified PPE for our couriers protects them from the adverse weather conditions and personal infection.

• Routing and Scheduling

One of the critical stages in developing an effective sample transport system is the design of the routes and scheduling. The primary objective is to achieve a target saturation level in the most economical way and routing efficiency is also critical for the samples turn-around time. Riders uses Cluster routing, Relay system and ‘Hub and spoke’ method for routing of samples to the laboratory.

• Management of the specimen transport system

• Use of dedicated couriers

Riders utilises dedicated couriers, this is also coupled with high standards in managing of a large number of staffs. Riders can also build capacity to cadres from the MoH dedicated to carrying samples. Dedicated couriers ensure

• standards for collection and transportation can be monitored and followed

• the system is reliable

• quick turnaround times which helps in specimen viability for temperature

• sensitive specimen for results to be reliable

• Sample Cold Chain

It is critical to maintain samples transported to the laboratory under acceptable temperature range for laboratory viability. In Liberia, Riders setup and maintains a dedicated Sample Cold Chain system across the sample transport network for overnight storage of transit samples. On routine basis, our trained Cold chain technician visits all the samples cold chain units for maintenance. This has greatly minimised samples rejection due to poor storage from the point of collection through the relay centres to the laboratory.

Monitoring and Evaluation- Includes the mobile data management and GPS

On a daily basis our M&E team receives and manage sample transport data from all couriers’ activities. We use a specialised mobile data collection software to track real time samples pick up and drop off. We also make use of telematics, using the GPS, to track and monitor our fleet of motorcycles as they pick and drop specimens in their routes.

• includes vehicle uptime, vehicle utilization and other logistics data

• health centre interviews, financial data

• courier activity/sample volumes through mobile data collection software