From the Field: Home Health Care Workers on Bikes

Posted: 05 Nov 2006

Related to: Healthcare Logistics in Africa, Bridging Distances: Healthcare & Transport, South Africa
Contributed by: Farzaneh - Technology, Health & Development

Hey! Was that a nurse on a bicycle? Yes - with bicycles, home health care workers from Arisen Woman are doubling the number of patients they see per day.

There is currently a shortage of health workers in South Africa.  Home health care workers care for the most vulnerable populations - patients who cannot travel to health facilities, or who are near death but not in hospice care. The patient population is composed of young children, the escalating population of adult patients with late-stage complications of AIDS/TB and chronic diseases, and the elderly.

After the carers learn how to ride a bicycle, patient care improves as they are able to make more regular patient visits, and able to devote more nursing time to patients that was previously lost to walking between patients.

“Before, I was walking door to door.. It took me an hour to get 2 children, and when I got my bike, I only took 15 minutes to get 5 children. It was very good to see I could get quicker with my work.” Katrina Matthews. The health workers are much less tired, as they are not walking 4+ hours each day on their patient rounds, and can bring more medications with them.

In much of South Africa, health workers often walk door-to-door to see their patients, which limits them to a small radius. In programs with better funding, a driver will transport the workers back and forth between patients. However, this also restricts patient reach, as the workers must stay in the same area to facilitate pickups by car. With bicycles, each worker is completely independent and can see patients within a 15 km radius.

Arisen Woman encourages carers to promote exercise for their patients, and seeing the home health care worker arrive on a bicycle sets a great example.  The bike is an ideal vehicle for Africa, for in areas with poor road conditions, biking is very safe, as traffic must slow down to negotiate roads.

Financially, bicycles are a small initial investment, with minimal maintenance costs. In comparison, motorized transport requires daily transport fees, or if the program owns vehicles - constant fuel expenses and significant maintenance.

And finally, this also benefits the carer, who is usually paid per patient seen, so improving productivity increases their income significantly.

“It was one of the luckiest days of my life, when I got my bike.” Ruwayda Dickenson, home health care worker - Arisen Woman.

The Bicycle Empowerment Network’s project on improving health worker transport with bicycles is supported by the Institute for Transport and Development Policy (ITDP) and is being tested in Ghana, Senegal and South Africa.