Landmark first for Africa with Riders and Skoll
10 March 2009
On Thursday, February 19th, Riders for Health along with the Gambian Ministry of Health and a number of other partners launched a new program that that will result in access to health care for every man, woman and child in the country. The vehicle leasing program, called Transport Asset Management (TAM), will include a fleet of new motorcycles, ambulances and trekking vehicles, all fully funded and budgeted for over their entire lifespan.
The Gambia will be the first country on the continent to achieve total health coverage for its entire population and also the first to be able to show impact when health resources reach the population reliably and over time.
Key features of the TAM model:
- TAM is a partnership between Riders for Health, the Skoll Foundation, the Gambian Department of State for Health (DosH), GT Bank and the Global Fund.
- Each health facility will have an ambulance for referrals, a trekking vehicle to facilitate outreach clinics and several motorcycles for individual outreach and public health care workers.
- The vehicles will be wholly owned by Riders, and DoSH&SW will pay for their use on a kilometer-by-kilometer basis.
- The vehicles will be maintained by Riders and when they have reached the end of what Riders considers to be their natural mechanical and economic lives in a fleet operation, they will be replaced with no extra charge to DoSH&SW.
- Riders will be carrying out an extensive monitoring and evaluation program of TAM, and program staff are currently collecting baseline information for the pre-TAM situation.
For the first time, Riders will own all the vehicles and lease them to the Gambian government. With help from the Skoll Foundation Riders has borrowed the capital needed to purchase a fleet of over 240 vehicles, and the Gambian government will repay the cost of the vehicles with the cost per kilometer charge. This means that after five years the capital outlay of the vehicles will be repaid, and Riders will withdraw the vehicles and replace with a brand new fleet at no extra charge to the government.
The key element of the program lies in its financing, which sits in the space between micro-finance and commercial lending. It’s a model that is scalable, working just as well for an entire fleet for any ministry of health as it would for a small NGO working in a local community.
The vehicles will be maintained within Riders’ established expert technical system, staffed in each country solely with nationals of that country – from program director down. The program will enable all of the government’s health staff, outreach workers and health clinics to benefit from available cost-effective transportation that never breaks down.
TAM is the first initiative of its type to be tried in Africa. Vehicle leasing is common-place in the developed world, but without Riders' knowledge and resources to maintain vehicles correctly, it cannot be sustained.
TAM in numbers
TAM Fleet :
- 150 Motorcycles
- 48 Ambulances
- 24 Trekking vehicles
- 17 Support vehicles
- 242 Total
Riders team in the Gambia:
- 8 senior management team
- 38 technicians
- 86 drivers
- 150 Total
The Gambia:
- Total population - 1,709,000
- Area - 11,300 sq km
- Paved roads - 723 km
- Gross national income per capita (PPP international $) - 1,110
- Total expenditure on health as % of GDP (2005): 5.2
Health statistics:
- Infant mortality - 71.58 deaths/1,000 live births
- Under five mortality - 109 deaths/1,000 live births
- Under fives with fever receiving anti-malarial drugs - 63%
- Skilled attendant at birth - 57%
- Institutional delivery - 55%
- Lifetime risk of maternal death - 1 in 32
To see more photographs of the event click here.