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Trained front line health care professionals; midwives, nurses and environmental technicians, who serve rural communities are stuck, because no transport, or unreliable transport is the norm. Here’s why:

In most African countries, private transport is expensive and public transport is practically non-existent outside major cities.
The vehicles that are present are usually unreliable. This is in part because there is no network of dealerships outside the major cities or service centres to keep vehicles well maintained, and no reliable supply chain for genuine replacement parts and very few trained technicians.
The terrain is often difficult with many unsurfaced tracks and rocky steep gradients.
There is little or no support or emphasis on safe rider/driver training.
And then comes the rainy season!

As a result, trying to deliver even the most basic healthcare – immunisations, bed nets, condoms, medication – is extremely challenging. Stock outs – when healthcare facilities run out of commodities – are very common.

The challenges

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Riders contribution to the UN Sustainable Development Goals

SDG 3 – Riders’ primary focus is on giving access to healthcare for remote communities. A lack of reliable transport for professional health workers is one of the major barriers to improving global health.

SDG 5 – Riders strive for gender parity with women employed at all levels within the organisation, from leading our organisation as country directors to less ‘traditional’ roles including workshop technicians.

SDG 6 – Outreach health workers mobilised by riders ensure safe, clean drinking water is available to remote communities and schools within the countries it operates.

SDG 8 – Riders is an African led organisation and employs nationals of the country it operates it.

SDG 11 – By showing the benefits of what a well managed fleet of vehicles can achieve and training drivers and riders in maintenance and road safety, Riders contributes to road safety.

SDG 17 – Riders partner with government ministries, local and international organisations and is a member of Catalyst 2030; a group of social entrepreneurs who promote partnerships to achieve the Sustainable Development Goals.

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Riders’ paradigm shifts in fleet, health, leadership, digitisation, and looking towards a climate conscious future

Digital transformation

Net-zero

carbon future

Health innovations

Time

Systems and behavioural change

Fleet management

African-led organisation

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Riders addresses the root cause:

The lack of understanding the importance of, and the prioritisation, of fleet management for health services delivery.

Digital transformation

Net-zero

carbon future

Health innovations

Time

Systems and behavioural change

Fleet management

Training for mechanics
Stores and fuel management
Automotive supply chain managed
Rider and driver training
Rider safety standards & PPE

African-led organisation

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Riders innovates to expand health services and reach, with a strong focus on last-mile communities.

Digital transformation

Net-zero

carbon future

Health innovations

Time

Systems and behavioural change

Health innovations

National sample referral systems with UN3373 standards
Emergency patient transferal - Uhuru X
Medical supply chain logistics - emergency patient transfer, vaccines, supplies.
Mobilising health workers - training, daily maintenance checks, M&E.

Fleet management

African-led organisation

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Riders decentralises from a UK based organisation to repositioning the operating countries at the forefront under African leadership.

Digital transformation

Net-zero

carbon future

Health innovations

Time

Systems and behavioural change

Fleet management

African-led organisation

Move from UK-led to African-led and establishment of Riders management council
National capacity growth
Establishment of Two Wheels for Life as funding and advocacy partner

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Riders embraces, innovates and pioneers digital advancements across all fleet and health activities.

Digital transformation

Net-zero

carbon future

Health innovations

Time

Systems and behavioural change

Digital transformation

Mobile data collection
Vehicle tracking
Route optimisation
Visual data management
Data informed management decisions

Fleet management

African-led organisation

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Riders looks towards a climate conscious future.

Digital transformation

Net-zero

carbon future

Health innovations

Time

Systems and behavioural change

Net-zero carbon future

Carbon off-setting
Electric vehicles
Alternative power technologies for office power
Benchmarking and target setting
Carbon footprint calculation and reduction plan
Waste management - vehicles, parts, oils.

Fleet management

African-led organisation

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Riders programme development, replication and independent organisation establishment

Continuous

learning

Needs assessment and analysis

Operational peer review

and evaluation

Implementation and monitoring

Resource mobilisation

Strategic planning

Healthcare provision

START

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Replicating the model

Invitation from government

Deploy international team of technical & leadership experts

Build relationships with key stakeholders - MofH, NGO’s, etc.

Local employment

Quality control training and standard setting

Transfer of power from international team to local Riders leadership or independent organisation established

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Theory of Change

The Theory of Change model shows how Riders activities are intended to stimulate short, medium and long-term outcomes to achieve sustainable development goal 3: Ensure healthy lives and promote well-being for all at all ages. The theory of change model shows a level of influence of the organisation in relation to the hierarchy to achieve this system change.

Riders outputs from activities and operations will:

Provide greater healthcare coverage
Improve sample integrity and turnaround time
Improve community education
Improve the safety of couriers travelling alone in remote challenging locations
Improve vehicle maintenance and servicing
Increase fuel use visibility
Route optimisation opportunities
Digital data informed management decisions
Use real-time data to improve feedback mechanisms to the Ministry of Health and other reporting partners
Build capacity and personal development into the Riders staff and partner organisations

When moving up the levels of outcomes, from short through to long-term, Riders acknowledges that they are not the only organisation working on the wider national health system. Allowing for the assumption that Riders activities will strengthen the mobility of health services, communities will have access to life-saving treatments and professional medical staff at the last-mile, and contribute to faster diagnosis for patients with infectious diseases. Additionally, Riders will also be able to support the Ministry of Health through sharing data on potential infectious disease geographical hotspots through data analysed from the field, and to supply health facilities with deliveries of medical commodities, aiming for zero stock-outs. Along with data-driven fleet management, these improvements will ensure a value-for-money health intervention.

Finally, it is assumed that these positive changes will contribute to reliable, predictable, and safe health services which will create behavioural change in the population as they gain confidence in the health system, leading to increased public uptake, which will ultimately contribute to a healthier population and a raised quality of life for those on treatment.

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Long-term

goal

Short-term outcomes

Activities

Inputs

Theory of Change

Grants & donations

In-kind donations

Riders +30 years experience of fleet maintenance and management and designing and delivering health services in sub-saharan Africa

Two Wheels For Life human & financial resource

Technology partners

Sample transport for infectious substances

Services delivered by over 700 Riders for Health staff in 4 countries: The Gambia, Lesotho, Malawi, Nigeria

Emergency health transport

Rider and driver training

Fleet

management

Improved health service delivery

Improved fleet management

Route optimisation

opportunities

Increased fuel use visibility

Improved community education

Mobilising health related organisations, inc: Ministries of Health, International and community based NGOs.

Greater healthcare coverage

Improved sample integrity and turnaround time

Reliable, predictable, and safe health services

Access to life-saving treatments and professional medical staff at the last-mile

Faster diagnosis for patients with infectious diseases

Value for money health intervention supported by data-driven management decisions

SDG 3: Ensure healthy lives and promote well-being for all at all ages

Service delivery contracts

Improved vehicle maintenance and servicing

Medium-term outcomes

Outputs

Influence of Riders

Social investment financing

Medical supply chain logistics

Outreach healthcare

Mobilising other non-health related government and public organisations.

Increased

rider safety

Ability to identify possible infectious disease geographical hotspots

No medical commodity stock-outs

Operations

Digital data informed management decisions

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See following page for publications, research, and awards.

Long-term

goal

Short-term outcomes

Activities

Inputs

Theory of Change - causation links

Sample transport for infectious substances

Services delivered by over 700 Riders for Health staff in 4 countries: The Gambia, Lesotho, Malawi, Nigeria

Emergency health transport

Rider and driver training

Fleet management

Improved health service delivery

Improved fleet management

Mobilising health related organisations, inc: Ministries of Health, International and community based NGOs.

Reliable, predictable, and safe health services

Ability to identify possible infectious disease geographical hotspots

Faster diagnosis for patients with infectious diseases

Value for money health intervention through data-driven management decisions

Healthy population

Medium-term outcomes

Evidence

Outputs

Medical supply chain logistics

Outreach healthcare

Mobilising other non-health related government and public organisations.

Access to life-saving treatments and professional medical staff

No medical commodity stock-outs

Grants & donations

In-kind donations

Riders for Health +30 years experience of fleet maintenance and management and designing and delivering health services in sub-saharan Africa

Two Wheels For Life human & financial resource

Technology partners

Service delivery contracts

Social investment financing

Operations

Route optimisation

opportunities

Increased fuel use visibility

Improved community education

Greater healthcare coverage

Improved sample integrity and turnaround time

Improved vehicle maintenance and servicing

Increased

rider safety

Digital data informed management decisions

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Political	Economic	Social	Technological	Legal	Environment
Political stability, Safety regulations, Employment laws.	Inflation, Interest rates, Country economic growth, Staff retention rates, Economic policies in relation to health financing.	Demographics, Health, Gender equality, Disability prejudice, Behavioural change. Quality of life Political and policy influence of the project.	Technological advancements, Lifecycle of technologies, The role of the Internet, The spending on technology research by the donors and social investors, Rate of innovation	Health and safety laws, Data protection laws, Personal information gathering.	Climate change Use of fossil fuels Use of paper Recycling
The Fragile States Index lists operations countries as: Nigeria 14th, Liberia 31st, Malawi 43rd, The Gambia 51st, Lesotho 60th. The Gender Inequality Index lists operations countries as: Lesotho 60th, Nigeria 158th, Malawi 172nd, The Gambia 174th, Liberia 176th. Riders for Health established over 30 years ago. UN3373 specification compliance for sample transportation packaging. Riders follow all employment laws in each country they operate.	All programs are monitored for all country level economic fluctuations, including in it’s procurement activities. Investment in Riders staff through personal development and working conditions safety improvements. Economic gains through monitoring of vehicle use and fuel consumption. Sustainability gains through daily motorcycle preventative maintenance plans and scheduled servicing. Riders operations are contracted by ministries of health and other funding partners inc. CDC, Global Fund, Chemonics. Riders operations are run by national staff and collectively employ over 700 people.	World Bank Human Capital Project statistics: Lesotho, The Gambia, Liberia, Malawi, Nigeria. 47 million people are now reached with improved care because of Riders. Limited access to essential public services, such as water and sanitation, poses an extra risk for transmission of COVID-19. 18% of COVID-19 cases in Lesotho are facility-based health care workers, hence need to reduce courier time in facilities. Behavioral change through creating a reliable, predictable, and safe health system will encourage more people to be access the health system. More people being tested and receiving diagnosis back quicker will help to get patients on to treatment sooner. Riders help shape the MotH's primary health care strategy through delivery of reliable, predictable, and safe health services.	DataKind, GeoTab, and Commcare, Riders for Healths’ digital partners are leading innovators in technology for health. Engagement with global digital health forums and partnerships. Digital transformation to be continually developed through Riders continuous improvement process to include further innovations. Funding streams to finance digital transformation currently being targeted. Current innovations being developed by Riders include mobile data collection, vehicle tracking, Optical Character Recognition and a Health Campaign Optimisation Tool.	Rider safety - riding kit specification meets high safety standards. Rider safety improvements through vehicle tracking and lone-worker monitoring including remote challenging locations. Digital data not stored on mobile phones. No patient sensitive information recorded by Riders. High level of patient confidentiality and security of information through digital apps.	World Bank Climate Change Portal country profiles: Lesotho, The Gambia, Liberia, Malawi, Nigeria. Responsibility as a leading health fleet management organisation to mitigate against CO2 emissions in already climate change sensitive environments. Route optimisation opportunities to create efficiency in carrying capacity and vehicle use. Fuel monitoring will help to reduce carbon emissions. Removal of paper-based log sheets from operations reporting. All old motorcycle parts removed when servicing are recycled.

ISSUE

RIDERS IMPACT

PESTLE analysis

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Our services

Riders provide world class transport management services to governments and non-government-organisations dealing with healthcare and developed specifically for the environments where they operate: