Application of Drone Technology to Facilitate an Effective HIV Diagnostic and Treatment Services to Children in Rural Malawi
Director,
Grant Organization
Technology to Save Children from HIV is an organization that has been created to serve HIV vulnerable children in rural Malawi through a partnership with ZipLine Drones and UNICEF. Our organization seeks to develop a program aimed at ensuring fast and continuous delivery of HIV test kits, results, and antiretroviral drugs to provide immediate medical attention to HIV positive children. We propose the application of drone technology to facilitate easy and convenient transport of HIV testing supplies, test samples, and medication that has been hampered by the poor state of transport infrastructure in rural Malawi.
We seek $204,000 as funds in order to support the organization’s program. With your assistance, the organization will be able to develop the drone application program to assist in fast access to remote health centers. There has been immense progress in the application of drones in transport and we see an opportunity in applying the technology in the healthcare field.
We believe the application of drone technology will be significant in facilitating HIV testing for children on time and ensure that medical attention is offered before two weeks for HIV-positive children in rural Malawi. This program will be helpful not only to the Malawian government but also to the children who are at risk of dying due HIV-related diseases.
Sincerely
Executive Director
Executive Summary
Technology to Save Children from HIV is a project that incorporates the application of drone technology to help in fast tracking the process of HIV cases management for children in rural Malawi. Children in rural Malawi have been dying of HIV-related diseases because there lacks an appropriate transport infrastructure to facilitate effective delivery of testing and treatment services. In the project, drones will be used to deliver HIV testing kits, test samples and antiretroviral drugs to and from the urban health centers and laboratories to rural health care centers. This will facilitate fast and cost efficient delivery of the services that initially relied on poor transport network that characterizes rural Malawi. The project is set to start July 2016 with pilot projects in selected rural areas. The project would cost approximately $204,000 to facilitate the operational expenses, start-up, salaries, and any other project related costs. Drone technology has already been successfully used in the mailing programs such as it is in the case of FedEx. The application has shown greater potential to provide fast and cost-effective transportation services.
A drone is an unmanned aerial vehicle guided by wireless GPS, cameras, and sensors. The drone technology is capable of delivering goods from point to point without a pilot and in the healthcare application it can be used to shuttle small emergency supplies packages from one depot to remote pickup centers. With healthcare centers located in remote areas, it may be difficult to deliver testing kits, test samples, and drugs considering the conditions of the roads. Drones will revolutionize air medical delivery services, particularly for reaching small and remote areas where access is limited by bad roads and lack of adequate transport infrastructure in Malawi.
Introduction
Technology to Save Children from HIV is a non-profit organization located in Malawi. It was created in partnership with UNICEF with the aim of using technology applications to help reduce cases of mother-to-child HIV transmissions in Malawi’s remote locations. It was founded in 2016 and seeks to serve communities across the remote locations of Malawi.
Approximately 10.3% of the population in Malawi is HIV positive (AVERT, 2015). There have been new cases of HIV infection as a result of mother to child transmission. As a result, the Malawian government has recommended that HIV-exposed infants receive early infant diagnosis of HIV. There have been challenges in relation to slower processes of HIV testing for infants. This has been as a result of poor transport infrastructure, including roads and lack of airport facilities that result in the delayed provision of HIV status results to infants. As a result, there have been increased cases of HIV transmission from pregnant mothers to infants.
The organization is made up of members with expertise in the drone technology and operations as well as highly qualified and experienced administration professionals to ensure the organization is run in an accountable and productive manner. We also have a multicultural team comprised of both foreign and local experts who help to match the scope of the project to the local needs.
Mission
Work with the government of Malawi to promote a HIV-free children population in Malawi
Promote children’s right to live and their wellbeing
Set high standards in attending to the issues of HIV spread in children
Population Served
Technology to Save Children from HIV serves rural/remote communities in Malawi that lack good access to immediate medical care and treatment programs. The population of Malawi is estimated at 12.0 million, of which 91% live in rural/remote areas characterized by poor transportation networks (Floyd et al., 2010).
Problem Statement
Malawi has one of the world’s highest HIV infection rates in children and this has not only become a national concern but a global concern as well. There have been many cases of death in rural Malawi linked to the poor HIV services delivery as a result of bad roads and inefficient transport systems. The poor transport infrastructure limits the possibility of delivering HIV tests and treatment services in a fast and cost-effective manner. In 2014, it was approximated that 10,000 children in remote areas of Malawi died from HIV-related diseases due to lack of immediate medical attention (Government of Malawi, 2015). It is from this point of view that Technology to Save Children from HIV believes the use of better transportation services can help to address the service delivery problems faced by the rural Malawi population.
Children need immediate medical attention within two weeks once they are found to be HIV positive. However, there are less than 10 laboratories nationwide in Malawi that serves the entire national population. The limited number of laboratories puts the rural/remote children population at risk of HIV-related diseases. It usually takes months for the results of blood tests for children to be delivered because of reliance on motorbike taxis for delivery services. The motorbike taxis often delay due to bad weather that affects the roads and financial problems. This makes it difficult for the children in the rural areas to access some of the vital testing and medical treatment services on time. When children do not take the HIV tests and enroll in treatment programs on time, other diseases such as Malaria and other infections may contribute to their early death. This is because the HIV virus weakens the body’s immune system. This makes the children more vulnerable to HIV-related deaths. It has been historically known that pediatric HIV care has been provided in urban health facilities in which there are better specialists and diagnostic resources (Fayorsey et al., 2013). This puts the children in the rural areas in a disadvantaging position.
The simplified treatment and diagnostic approaches based on the use of drones would allow for the decentralization of services for specialized health systems to primary and community health care providers. This would see antiretroviral therapy administration moving from doctors to nurses and community healthcare workers. That means that many children will be able to access HIV diagnosis and treatment services without traveling to major health centers with laboratories. This will also significantly reduce the expenses incurred when locals seek HIV treatment services. According to a Stylus Publication Report (2010), the decentralization of HIV treatment in Malawi will bring the children closer to the point of care and this will put more children on treatment on time. The simplified approach will thus ensure the delivery of broader HIV-related health services for children. When children are able to receive diagnosis and treatment even before the elapse of two weeks, their chances of survival significantly increases.
The drone technology can be able to transport the HIV testing kits to the rural community health care centers at a speed of 100km/h. This means the kits and samples can be delivered to and from the laboratories and the local health care centers within hours or within a single day. This means children will be tested on time because they can access testing kits and have the samples transported to the laboratories within the same day for analysis. For HIV-positive children, antiretroviral drugs can be delivered to the local health care centers for delivery and administration. The current transport infrastructure cannot support such a fast and efficient transport services as the drone. This is the main strength point of this program- to ensure fast delivery of HIV diagnostic and treatment materials.
Objectives
Technology to Save Children from HIV aims to serve the rural Malawi population based on the effectiveness brought by the incorporation of drone technology in the health care sector. The initiative of the program is built on the tenet of the global concern about the rising cases of children mortality due to HIV-related diseases. This program brings forward a program aimed at incorporating the use of Drones to help reduce deaths caused by HIV-related diseases in rural Malawi. The program is carried out collaboratively with the UNICEF, Civil Aviation Authority, and the Malawian government. With all the requirements in place, the program is likely to become operational within a month from start up. The organization seeks to deliver an efficient program supported by the years of grassroots involvement of the UNICEF to serve the local underserved population in regard to health care services. The organization also seeks partnerships with the local Malawi government and the drone company to help tailor the program to suit the local conditions and infrastructure.
Technology to Save Children from HIV seeks to use drones to fulfill the following objectives:
Facilitate fast and convenient transfer of HIV test kits, blood samples, and antiretroviral drugs from the laboratories to the remote healthcare centers
Proposed Activities
Technology to Save Children from HIV will work with UNICEF, ZipLine Drone Company, and the Malawian Government through the Ministry of Health as well as the Malawian Civil Aviation Authority. The specific tasks include:
Activity 1: Project Committee Formulation- 1 Week
Develop a project committee comprising of a Director, Head of Operations, and a Chief Project Coordinator to facilitate technical and operational support. The committee will discuss project schedule, project budget, status of success factors, and major implementation decisions. The project committee will also allow the local communities to propose a volunteer facilitator of their choice to assist them in project formulation. The facilitators chosen by the community will undergo project management training with the members of the project committee. The committee will handle aspects including:
Onsite Assessment
Set up requirements
Budgeting
This phase will be useful in the establishment of a skilled administrative group that understands the project different dimensions to facilitate the startup of an effective and comprehensive project program.
Activity 2: Operational Certification- 1 Week
Provide necessary information concerning the operations of the drones to the Malawian Civil Aviation Authority for operational and maintenance certification. This activity is meant to confirm the compliance of the drone operations with the operational safety requirements.
The project is a compliance-based project that must be done to remain in compliance with a civil aviation regulation, standard, law, or other directive. Compliance with the major areas of the civil aviation codes is part of the total certification picture. In this phase the operational manager and project coordinator will familiarize with the civil aviation requirements and how they relate to drone operations in Malawi. This phase helps to achieve appropriate operational operations to help in providing transport services while observing the local law and regulations.
Activity 3: Training and familiarization- 1 Week
In relation to the training and familiarization phase, emphasis will be put on service and technical operation. This is meant to benefit the people operating on the ground and in the control domains to ensure the safety of flights and effectiveness of operations. Members of both the technical and administrative positions will be facilitated with training services to ensure that the operations are safe and in compliance with the civil aviation standards. This phase also involves the documentation of the operating and maintenance costs and any other relevant information necessary concerning other aspects of drone operations that may affect the costs of operations.
It also involves the documenting of the operational aspects of drone flights, including the flight endurance, flight paths under consideration, landing area size and locations, maximum take-off load, and reliability of the flights.
Activity 4: Testing- 3 days
Training programs involve the organization, the ZipLine drone company, and the civil aviation authority. The testing phase involves the technical operational personnel and involves launching of drone flights with sample load materials to selected rural areas. It also involves inspection of the drone technical functionalities, take off centers and potential landing areas. It also involves obtaining geographical information to help in understanding the terrain in the local areas to identify landing areas. This phase seeks to establish specific landing areas and to identify areas that may require revision or further analysis.
Activity 5: Formal Project review- 1 day
The presentation of operational and technical results the project committee and other stakeholders. It also involves the formal presentation of the project by the project manager and project team members to the sponsor and stakeholders to verify the accuracy of the requirements. The formal project review allows the team to identify weaknesses in the project process and focus on areas where the team is lacking in. At the end of the project, the entire team will conduct an analysis of what occurred and what could be done differently. The benefit of this phase is that it will allow the project to proceed satisfactorily and the administrative and operational domains of the project would be based on effectively determined paths.
Project Evaluation Plan
For the assessment of how effective the program will be, the project committee will be involved in a survey program in which they will provide information to evaluate the management of the program. The information will help to identify problem areas that may be imminent and recommend areas of improvement.
Project Committee Information
Monthly reports will be developed by the project committee in which information about specific operational and technical aspects will be recorded by the operational manager and analyzed. Aspects such as maintenance information and frequency of activities will be recorded and analyzed. This will enable the identification of areas that may require more budgetary allocation or cut downs.
Data about technical operation costs will be documented and analyzed for comparison with the operating costs associated with the use of motorbike taxis. The comparison will be used in the assessment of how cost-effective the program is as compared to traditional strategies.
Community Information
The community served is an important stakeholder in the program as beneficiaries. Every month the project committee coordinators will collect information from the communities in the rural areas concerning their views about the effectiveness of the program. The information will be used to access the challenge areas that characterize the program services and any effects that the technical and operational aspects of the operation of drones would have on the local communities.
Budget
The major areas that have been identified in the budgetary aspect of the program include the personnel, space and facilities, equipment, project staff travel and consultation, materials, communication and other expenses associated with implementation and evaluation of the program. The salaries and wages are calculated based on standard rates and the cost of equipment and facilities are based on the stipulation by the providing organizations. Below is the breakdown of the budget:
Personnel:
Salaries and Wages
Project manager (fulltime) $8,000
Project Coordinator (fulltime) $6,000
Operational manager (fulltime) $3,000
Accountants (fulltime) $3,000
Fringe Benefits $5,000
Space and Facilities:
Control Center Rental: $80,000
Utilities and Maintenance: $35,000
Equipment:
Purchase of Drones: $10,000
Take off Facilities: $5,000
Project Staff Travel and Consultation
Transport: $5,000
Consultation $2,500
Per Diem: $2,5000
Materials:
Office Supplies: $20,000
Protective Gear: $5,000
Communication
Company Website $1,000
Postage $1,000
Telephone $2,000
Other Expenses:
Implementation and Evaluation $10,000
TOTAL $204,000
Sustainability
Conclusion
HIV-related deaths are a major national issue in Malawi, and that has elicited a global reaction. The problem has been worsened by the lack of an effective transportation infrastructure that is hindering access to vital HIV testing and treatment services. That has put many children in rural Malawi at a disadvantaged position. The application of drones in health service delivery is the apex of the program. The project will be undertaken in partnership with other organizations, including the ZipLine Drone Company that specializes in the production and operation of drones, UNICEF, Malawian Civil Aviation Authority and the local communities targeted. The new project aims to help the disadvantaged children in rural Malawi who cannot be able to access HIV diagnostic and treatment services on time by using drones to facilitate efficient transportation of HIV test kits, test samples, and antiretroviral drugs. The project is expected to cost $204,000 and will be fully operational in approximately a month after funding. Funding this project will be an important step towards saving the children in rural Malawi from HIV-related deaths. The success of the program will be evaluated from a professional perspective in which the operations of the drones will be analyzed and from a communal perspective to help in understanding the potential areas that may need improvement. Handing over to the local government and NGOs is part of the exit strategy. An important consideration in the project is involving the community in the project completion and implementation. This will help to forge a partnership and the community will understand and be prepared for the transitions. The project committee will work with the community to prepare a plan for transferring responsibilities to the local government health ministry. The committee will assist the community to establish an agreement with the local government technical bureaus for major technical operations management that may be required in the future.
References
AVERT. (2015, May 1). HIV and AIDS in Malawi. Retrieved from http://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/malawi
Fayorsey, R. N., Saito, S., Carter, R. J., Gusmao, E., Frederix, K., Koech-Keter, E.,Abrams, E. J. (2013). Decentralization of pediatric HIV care and treatment in five sub-Saharan African countries. JAIDS Journal of Acquired Immune Deficiency Syndromes, 62(5), e124-e130. Retrieved from http://files.icap.columbia.edu/files/uploads/Decentralization_Article.pdf
Floyd, S., Molesworth, A., Dube, A., Banda, E., Jahn, A., Mwafulirwa, C., & French, N. (2010). Population-level reduction in adult mortality after extension of free anti-retroviral therapy provision into rural areas in northern Malawi. PloS ONE, 5(10), e13499. Retrieved from http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0013499
Government of Malawi. (2015). Malawi AIDS Response Progress Report 2015. Government of Malawi. Retrieved from http://www.unaids.org/sites/default/files/country/documents/MWI_narrative_report_2015.pdf
Stylus Pub. LLC, UNAIDS. (2010, July). UNAIDS Outlook Report July 2010: Special Section-State of the AIDS Response. Outlook, 2, 46-54. Retrieved from http://data.unaids.org/pub/Outlook/2010/20100713_outlook_report_web_en.pdf
Appendices
Letter from Christian Health Association of Malawi
Christian Health Association of Malawi (CHAM)
PO Box 30378- Lilongwe.
Area 14, Lilongwe
Executive Director,
Technology to Save Children from HIV,
We are pleased with the initiative that seeks to make use of technology to ensure that children in rural Malawi are saved from the tragedy that is HIV-related deaths. The problem of HIV-related deaths is a product of the country’s limited resources that has affected the effectiveness of the transportation infrastructure. As an organization committed to ensuring that critical areas of Malawi’s health sector are improved, we welcome your idea to make use of drones to save the lives.
We welcome your organization to Malawi and promise to support the initiative to the best of our ability.
CHAM Secretariat
