Biography

Joseph G. Mehdeh is a Global Health Infectious Disease Control Transportation expert with over 20 years oexperience. He holds a Bachelor’s Degree in Sociology and Management, Masters in Regional Science, Candidate for Masters in Public Health and studies aLAW, the University of Liberia. He has considerable Health Transportation Management credentials: “Transportation Transformation” World Bank Headquarters, “Strategic Business Management”-Harvard University, “Project Management” at MIIS. Joseph manages a team using “Motorcycle as Innovation for specimens timely referral” for laboratory diagnosis. He supported Liberia health system eradicated Ebola and COVID 19 and stopping transmission of other Infectious Diseases and saving lives.

Abstract

Riders for Health-Liberia’s presentation is anchored on its long-term and successful Specimen courier system that effectively connects rural people to essential Laboratory services, contributing to maintaining Public Health Security in Liberia’s 15 counties, a study conducted by Riders for Health-Liberia’s from 6 June to 25 July 2022.

The presentation is titled: Annual Evaluation Report and Outcome for the Liberia Infectious Diseases Specimen Referral System in Liberia.

This abstract is the result and outcome of the Liberia national Infectious Disease specimen referral project implemented by Riders for Health Liberia annual evaluation conducted in Liberia. The Riders specimen referral system has 33 years’ working experience in some of Africa’s hard-to-reach countries’ terrains with successful (9) years of Global Health Infectious Disease Specimen Referral for diagnosis funding and technical supports in Liberia from the United States Center for Disease Control & Prevention, the World Health Organization, Global Fund, Liberia Ministry of Health and the National Public Health Institute of Liberia from 2015 to present. The Riders system is a network of county-based couriers i.e. former community health volunteers selected, trained, hired, mobilized on AG 200 YAMAHA motorcycles and transport the 24 selected infectious disease specimens and deployed nationwide across Liberia’s 15 counties in the 92 health districts covering the over 900 health facilities using the hub-spoke methods where all specimens are batched at the designated health facilities and immediately transported to the designated testing centers including the National Reference Laboratory and GeneXpert machines for TB/HIV viral load samples testing within 24 to 72 hours of collection. The couriers are based at their respective health districts and county health centers.

This Riders specimen referral system supported the Liberia broken Health Sector in the fight and defeated both global health security threats, the Ebola virus and COVID 19 pandemics. Meanwhile, this Abstract highlight and shares the background of the specimen referral system including the total health facilities/pick up sites covered nationwide and the study area.The methodology inclusive of qualitative and quantitative stratified sampling was used which facilitated the interview of 162 of the over 344 health facilities (pick up sites). Data collection was from 6 June 2022 and 25 July 2022 across all the 15 County Health Teams (100%), (32%) District Surveillance Officers, 10 Lab technicians from the National Reference Laboratory, four (4) key informants within the health sector (NPHIL administrators, National Reference Lab & National Diagnostic Division (NDD), couriers' log sheets, GPS information and Fulcrum data base, focus group discussions and telephone interviews. The findings which proved the impact and satisfaction that the Riders specimen referral system has reduced turnaround time, increased disease surveillance, and stopping transmission of infectious disease such as (Lassa fever, yellow fever, monkey pox, measles, Tuberculosis, etc.) at the community level. The Riders Cloud base digital data mining platform showed that from April 2015 to May 2024 Riders Specimen Referral System has transported 223,051 specimens and covered a total distance of 8,748,380km.  The system helps to keep the suspected patients at their same confirmed location while their specimens are quickly transported and tested at the designated testing centers, results returned and treatments initiated within time to avoid the spread of the diseases. In conclusion, the evaluation revealed that the Riders' specimen referral system using motorcycle innovation to transport infectious disease specimens for laboratory diagnosis in rural Africa, especially rural Liberia with the worst road connectivity, rough and hard-to-reach terrains has strengthened access to diagnostics services at primary-level and improved patient trust. It enhances healthcare-seeking behavior, and has enhanced surveillance nationwide for the rural poor population within the period of study.

Topic: Riders for Health-Liberia’s Specimen courier system effectively connects rural people to essential Laboratory services, contributing to maintaining Public Health Security in Liberia’s 15 counties, study done from 6 June to 25 July 2022.

Background: Management and laboratory diagnosis of infectious diseases in decentralised health systems require an “Effective Specimen Transportation System”. During the period Riders used 60 couriers mobilized on motorcycles to timely transport specimens from 344 pickup points across Liberia thereby connecting over 900 health centres to the Reference Laboratory. Evaluation showed Riders' effectiveness, evidenced by the increased access to laboratory services during outbreaks, reduced Turn Around Time contributing to early case detection, and timely containment of disease outbreaks.

Methodology: 162 of the over 344 health facilities (pick up sites) were interviewed using stratified random sampling. Data was collected between 6 June 2022 and 25 July 2022 from 15 County Health Teams (100%), 30 (32%) District Surveillance Officers, 10 Lab technicians from the National Reference Laboratory, four (4) key informants within the health sector (NPHIL administrators, National Reference Lab & National Diagnostic Division (NDD), couriers' log sheets, GPS information and Fulcrum data base, focus group discussions and telephone interviews. Quantitative and qualitative methods were used to triangulate the findings.

Findings: 47%, (162) of 344 health facilities (pick up sites) were interviewed. 160 of these Health facilities interviewed (99%) indicated that they are satisfied with Riders for Health Liberia activities at their facilities.  For which 49% (79) health facilities interviewed indicated that the specimen transport network impacted service delivery at their health facilities while, 24% (39) facilities said it has Improved Patient care, 18% (29) facilities said it has increased sample collection and 8% (13) said it reduced disease transmission. Before Riders came, only 25% of samples reached testing laboratories within 24 hours. Now, an average of 90% reached laboratories within 24hrs. For 12 months from April 2022 to March 2023, Riders picked up 28 specimen types. From April 2015 to May 2024 Riders Specimen Transport System has transported 223,051 specimens and covered a total distance of 8,748,380km. 100% of Lab staff interviewed indicated that there is reliability and consistency in the current system for referring samples by Riders.

Conclusion: Riders' system has strengthened access to diagnostics services at primary-level and improved patient trust. It enhances healthcare-seeking behaviour, and has enhanced surveillance nationwide for the period of study.