1. Bodas For Life UC Berkeley & The Blum Center Presentation to Uganda Ministry of Health 21 August 2008

2. Today’s meeting agenda Purpose of today’s meeting: To share our team’s findings from fieldwork and to discuss a plan for program sustainability Program background Recent findings Challenges Partnerships & Sustainability Replicating in other districts Moving forward with next steps

3. Bodas For Life is an ongoing collaboration UC Berkeley and MOH have worked together since 2006 Program objective: Improved access to routine and emergency health care services in rural Uganda through the availability of safer and cheaper boda rides MOH begins collaboration with Blum Center; together select Bodas For Life Indicators of success: Community access to trained boda riders, higher-quality emergency health services, community empowerment Pilot program operates in 2 districts Plan for sustainability: Establish partnerships with NGOs, corporations, and district leaders for ongoing financial and operational support New partnerships are pursued (to ensure sustainability) FALL 2006- 2007 FALL 2007-2008 FALL 2008 - Beyond

4. Bodas For Life program starts in fall of 2007 The current setup of the program is largely decentralized 2 district coordinators 2 participating districts (Nakaseke & Kyenjojo) 40 participating health centers 80 boda riders trained in first-aid skills 1 national director

5. Normal operations of Bodas For Life Riders and Health Workers collaborate to help patients Patient or HC Worker contacts B4L driver B4L driver assesses situation and provides First Aid Care B4L driver transports patient to appropriate HC HC Worker confirms B4L transport on logbook After 10 rides, B4L driver receives fuel voucher

6. Today’s meeting agenda Program background Recent findings Challenges Partnerships & Sustainability Replicating in other districts Moving forward with next steps

7. Bodas 4 Life is operational in two districts Patients are accessing health services via B4L rides # of rides/month Average distance Average cost Free rides Nakaseke1414km1230 ugsh10% Kyenjojo1615.4km1709 ugsh13%

8. Bodas For Life address critical health issues Malaria, pregnancy among the many reasons patients take B4L rides Top patient complaints Boda contact method User age profile

9. Leadership is core to program success Additional components support program sustainability Community Enthusiasm Funding for fuel vouchers, rider supplies Availability of supplies and staff at HCs District Leadership

10. B4L services recognized as valuable Multiple stakeholders take initiative to reinforce and expand offerings Providing new and supplementary First-Aid training Re-filling First-Aid kits for boda riders Health workers helping boda riders do more Transporting HC workers to field Distributing medical supplies to field and health centers Encouraging health-seeking behavior Boda riders offering related services Integrating B4L into Village Health Teams (Kyenjojo) Planning to incorporate part of B4L into district budget District leaders embracing B4L program

11. Early signs point towards program success Anecdotal evidence indicates improvement in overall health care access Patients describe Bodas for Life riders as: Timely (boda bodas arrive more quickly, especially at night) Reliable (boda bodas will show-up, even in remote areas) Less expensive (many riders give a discounted or free ride) Easily reached by phone (riders on call; numbers publicized in the community) Preliminary results: An increase in patient volume (+20%) for more than half of Kyenjojo health centers served by B4L No increase in hospitals not served by B4L

12. Trained riders respond quickly and reliably Bodas For Life provides rides that otherwise would not have happened Bodas For Life patient Mrs. K., 19, lives in Kakabara (Kyenjojo District). She has used B4L several times including for malaria and during her most recent pregnancy. She heard about B4L via the local radio program and uses the village pay phone to call the rider, who comes to her house in only 30 minutes. She lives more than 6km from the health center, which is sometimes too far to walk when she is sick or pregnant. She likes the service, has recommended it to her friends, and thinks B4L is very valuable “because of the reduced price and because they arrive soon.”

13. Today’s meeting agenda UC Berkeley Program background Recent findings Challenges Partnerships & Sustainability Replicating in other districts Moving forward with next steps

14. Challenges persist despite B4L successes Solutions do exist to address these issues ChallengeProposed solution Operational Increase retentionImproved selection process More frequent trainings/check-in Promote program awareness among patients and health workers Radio programs Village health teams Address the needs of most remote patients Beyond program scope External Availability of supplies and staff at health centers

15. Today’s meeting agenda Program background Recent findings Challenges Partnerships & Sustainability Replicating in other districts Moving forward with next steps

16. Bodas For Life moves towards sustainability Long-term partnerships are needed as Blum Center funding ends Current Efforts Distribution of VHT curriculum Replenishment of First-aid kits by health centers District officials requesting limited funding for fuel subsidies “Train-the-Trainer” model Future Efforts Absorption by NGO Corporate sponsor (CSR, PR, Marketing, Advertising) Two-year funding cycle ends in 2008

17. Today’s meeting agenda Program background Recent findings Challenges Partnerships & Sustainability Replicating in other districts Moving forward with next steps

18. Bodas For Life can be replicated De-centralized model allows districts to initiate program independently Bodas For Life is currently operating in two districts and other districts have expressed interest in participating in the program Recommendation Provide a standardized program description and toolkit for Bodas For Life: Criteria for identifying new districtsDetailed program operating instructions Creative methods for obtaining funds & supplies Marketing & communication guide Bodas for Life tool-kit includes:

19. Today’s meeting agenda Program background Recent findings Challenges Partnerships & Sustainability Replicating in other districts Moving forward with next steps

20. Moving forward, MOH support is critical The Berkeley team will need guidance in the pursuit of additional funding. UC Berkeley: Pursuing partnerships for additional funding Finalize Bodas For Life toolkit for replication into additional districts Ongoing communication with Kyenjojo and Nakaseke to refine program UC Berkeley officials will return in October 2008 Uganda Ministry of Health: Help find local contacts at potential funding organizations Provide ongoing support and encouragement as Bodas For Life seeks funding

21. Thank you!