TRANSPORT MANAGEMENT

Table of Contents

Transport refers to the act or process of transferring or conveying people, goods, or materials from one place to another.

It involves the movement of individuals, objects, or substances by various means such as vehicles, vessels, or even through digital networks.

Transport is essential for carrying out both, Facility-Based and Non-Facility-Based community health care services. These include:- bicycles, motorcycles and vehicles depend on level of Health facility. For such transport means to be useful for the intended results, some minimal management procedures or instructions need to be instituted.

Procedures for Managing Bicycles, Motorcycles, and Vehicles in Health Service Transport

To ensure the effective management of bicycles, motorcycles, and vehicles in health service transport, it is important to implement certain procedures and instructions. While the specific procedures may vary depending on the level of the health facility.

Keeping an Updated Inventory Record:

Maintain a comprehensive inventory record of all bicycles, motorcycles, and vehicles used in health service transport. This record should include details such as the make, model, registration number, and condition of each vehicle.
Regularly update the inventory record to reflect any changes, such as additions or disposals of vehicles, and identify any discrepancies or missing vehicles.
Use the inventory record to track the usage, maintenance history, and availability of each vehicle.

Servicing and Maintenance:

Establish a regular servicing and maintenance schedule for all bicycles, motorcycles, and vehicles. Such as oil changes, tire rotations, and brake checks to ensure the vehicles are in optimal condition.
Conduct routine inspections to identify any issues or defects that may affect the safety or performance of the vehicles.
Keep detailed maintenance records, including dates of service, performed tasks, and any repairs or replacements made.
Train staff members responsible for servicing and maintenance on proper procedures and safety protocols.
Address any reported issues or concerns to minimize downtime and ensure the vehicles are always available for use.

Transport policy:

Every health care organization must make a transport policy that governs their transport. It should be adhered to by all workers and managers.
Authorization and Use of Vehicles: The transport policy should clearly define who is authorized to use the organization’s vehicles and under what circumstances. It should specify the procedures for requesting and obtaining authorization to use a vehicle. The policy should outline any restrictions on carrying passengers or items in the vehicles.
Vehicle Maintenance and Disposal: The transport policy should include guidelines for the maintenance and upkeep of vehicles. It should specify the procedures for regular inspections, servicing, and repairs of vehicles. When disposing of old vehicles or purchasing new ones, the policy should adhere to relevant regulations, such as the Public Procurement and Disposal Authority (PPDA) Act 2014 for government and PNFPs.
Compliance and Training: All workers and managers should be made aware of the transport policy and their responsibilities in adhering to it. Regular training sessions should be conducted to ensure that employees understand and comply with the policy. The policy should be reviewed periodically to incorporate any necessary updates or changes.

Managing transport information:

In healthcare organizations, it involves keeping track of various documents and records related to vehicles, journeys, fuel usage, maintenance, and compliance.

Vehicle Log Book: The logbook proves your ownership of a vehicle. In addition, the vehicle logbook works as a summary of the vehicle’s key statistics: make, model, engine, etc. Log book is a book in which someone records details and events relating to something for example a journey or period of their life or a vehicle
Vehicle Journey Cards: Some organizations use journey cards or a book to record all the journeys made by each vehicle. This helps in tracking the total distance traveled and the amount of fuel consumed for each journey.
Fuel and Maintenance Receipts: It is important to keep receipts for fuel purchases and maintenance repairs. These receipts provide evidence of expenses and can be used for accounting and auditing purposes.
Tax Licenses: Healthcare organizations must ensure that all vehicles have valid tax licenses. These licenses should be kept up to date and readily accessible for inspection.

Planned Preventive Maintenance

It involves periodic maintenance tasks such as replacing oil, fluids, and grease; inspecting for wear and tear on moving components; and replacing components according to the manufacturer’s recommendations and regular inspections.
Objectives: Investing in maintenance to avoid breakdowns, Increasing the reliability of vehicles and Reducing overall running costs.
Implementation: Planned preventive maintenance is achieved through daily checks, defect identification, and regular servicing.

Inventory of Transport:

Inventory refers to a detailed list of equipment, instruments, infrastructure, and buildings, including transport, available in a unit.

Information to Collect:

Make and model of the vehicle.
Year of manufacture.
Engine and chassis numbers.
Registration number.
Main use.
Activity or program it is allocated to.
Seating capacity.
Running condition.
Person responsible.

Importance of Carrying out Inventory of Transport:

Prevents misuse of transport.
Facilitates good supervision.
Aids in scheduling use.
Restricts use to named individuals.
Supports the use of log books.
Enables the enactment of enforceable policies on private use.
Ensures strict daily vehicle checks.

Importance of Transport Management in Health Facilitie

Resource Optimization: Transport is a valuable resource that should be managed like any other asset. By efficiently managing vehicles, health facilities can maximize their utilization and achieve better outcomes without necessarily increasing the number of vehicles.
Impact on Service Delivery: Well-managed transport systems ensure that vehicles are available when and where they are needed, enabling timely delivery of healthcare services to patients.
Cost Considerations: Transport management can help minimize costs including purchase, maintenance, repairs, insurance, fuel, and replacement, freeing up resources for other needs of healthcare.
Third Largest Cost: In many health service delivery settings, transport ranks as the third largest cost after staff and medicines. Proper management of transport can help optimize spending in this area and allocate resources more effectively.
Protection of Vehicles and Equipment: Proper maintenance and use of vehicles extend their lifespan and reduce the need for repairs and replacements. This saves money and ensures that vehicles are always in good working condition.
Time Savings: Improved transport management allows for more efficient use of vehicle time, reducing delays and improving overall service delivery timelines.
Safety: Good maintenance and respect to safety protocols not only save time and money but also save lives. Well-maintained vehicles are less prone to breakdowns, reducing the need for repairs and replacements.
Reduced Liability: Effective transport management helps prevent accidents and injuries, reducing the risk of legal liability for health facilities.
Accident Prevention: Effective transport management helps minimize the risk of accidents and injuries. This protects not only the vehicle operators and users but also pedestrians and other road users.
Positive Public Image: Well-managed transport systems contribute to a positive public image for health facilities. On the other hand, poorly managed transport can lead to negative publicity and a loss of public trust.
Compliance with Regulations: Transport management must comply with relevant laws and regulations to ensure the safety and well-being of all road users. This includes adhering to traffic regulations, maintaining proper documentation, and ensuring vehicles are in compliance with legal requirements.
Divers responsinilities are respected: Ensuring the availability and use of safety equipment (e.g., warning triangles, first aid kits, fire extinguishers). Wearing high visibility clothing and other protective gear. Carrying essential tools and supplies (e.g., puncture repair kits, tow ropes, spare fuel)

Uses of Transport in Health Facilities

Emergency Medical Services (EMS): Transport plays a critical role in emergency medical services, enabling rapid response and transportation of patients to hospitals or specialized care facilities. EMS vehicles, such as ambulances, provide life-saving transportation for individuals in critical condition.
Medical Supply Delivery: Transport is important for the timely delivery of medical supplies, such as medications, vaccines, laboratory samples, and equipment, to healthcare facilities. Small quantities can be transported by foot or bicycle to community health workers.
Administrative Support: Use of public transportation for administrative tasks to conserve available vehicles for health service delivery.
Supervision: Technical support, program inspections (e.g., sanitation, water source protection).
Training:Transport for facilitators and participants during field visits and study tours Delivery of training materials and equipment (e.g., computers, projectors)
Health Outreach Programs: Transport is utilized in health outreach programs, where healthcare professionals and support staff travel to remote or underserved areas to provide medical services, health education, and preventive care.
Mobile Clinics: Transport is essential for mobile clinics, which are equipped vehicles that bring healthcare services directly to communities. These clinics provide primary care, screenings, vaccinations, and other essential services, particularly in rural or isolated areas.
Patient Transfers: Transport is involved in transferring patients between healthcare facilities for specialized treatments, surgeries, or higher levels of care.
Meetings: Attendance at meetings at various levels (e.g., Ministry of Health, district, sub-district, community.

N.B: Walking remains the most reliable method of transportation for lower-level health facilities. Other means of transportation (e.g., bicycles, vehicles) are necessary for larger distances, bulk deliveries, and emergency situations.

MANAGING INFRASTRUCTURE

The maintenance of the buildings that make up the unit is the responsibility of the in charge.

Problems such as

leaking roofs,
broken toilets and repainting and repairs due’

should be reported to the local ministry of works representative or the person who is responsible for the actual repairs.

Sometimes the ministry of works (MOW) is unable to carry out the necessary repairs and authority is then given for the work to be sub-contracted to commercial builders.

Before such work can be carried out, it MUST be put out to tender. Tenders are offers by suitably qualified contractors to carry out the work with a statement of cost and of how long the work will take. Tenders are submitted in sealed envelopes. A tender committee, made up of various officers, opens all the tenders at the same time and compares them. The builder who best meets the requirements, even if the price is not the lowest, is awarded the contract and asked to carry out the work.

The tender system is used to avoid corruption and favoritism and loss of government/organizational money through inflated estimates. Work awarded without tendering will not be paid for by the government/ most organizations even if it involves small amounts. Inspect all the buildings including staff quarters (if there are any), once a week or once a fortnight, with one or two other staff, to check on the general standard of cleanliness. Necessary maintenance can be considered at the same time. Fire risk should be considered. Buckets of sand should be available if there are no other extinguishers.

Extinguishers need routine inspection to see if they are intact and up to date. Effective security is always difficult in health facilities. It (security) can be improved by limiting access to doors and gates and under observation by guards. After duty hours these doors must be closed and locked. Make sure the watch man/Askari knows who to inform in case of emergency.

Importances of infrastructure management in health facilities.

Operational Efficiency: Well-managed infrastructure ensures that healthcare services and facilities operate efficiently and effectively. This includes planning and structuring the built environment, equipment, access, information technology systems, and processes to facilitate high-quality, accessible, responsive, and safe services.
Emergency Preparedness: Infrastructure management becomes particularly important during times of crisis. Health facilities rely on vital resources such as electricity, water, and oxygen. Having backup plans in place, such as emergency generators, ensures continuity of care even during disruptions in the supply of essential resources.
Patient Experience and Well-being: Well-planned and managed infrastructure supports improved standards of patient care and well-being. Factors such as the design of healing environments, access to green spaces, and consideration of the sensorial environment can positively impact patient experience, reduce stress, and contribute to better health outcomes.
Staff Well-being: Infrastructure management should also prioritize the well-being of healthcare staff. Facilities that provide amenities like shops, cafes, prayer rooms, and access to green spaces can contribute to a positive work environment and support the well-being of staff, which is important for ensuring better healthcare.
Sustainability: This can involve implementing energy-efficient technologies, utilizing real-time measurements and control systems, and reducing carbon emissions. Building sustainable healthcare infrastructure not only helps protect the environment but also optimizes operational costs and improves resource management.

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