Optimized sample transport (OST) is a method of transporting clinical samples from healthcare facilities to the hub using demand created through healthcare workers generating unstructured supplementary service data (USSD) messages. Before October 2023, OST was implemented in five districts of Phalombe, Mzimba North, Rumphi, Lilongwe, and Salima. In December 2023, R4H scaled up the OST to six districts of Zomba, Chiradzulu, Mulanje, Chikwawa, Blantyre and Mangochi. These districts were selected based on the high HIV burden, the possibility of plasma HIV viral load scale-up, high volumes of antiretroviral (ART) clinics, and longer distances from the health care facilities to the hub.
As part of the OST scale-up, R4H conducted USSD clinical sample volume reporting training for a total of 710 healthcare works drawn from 238 healthcare facilities in the six new OST scale-up districts. The participants included the health care facility in charge, HIV diagnostic assistants (HDAs), and the facility TB officer. The training took place from the 7th to 21st December 2023. The OST scale-up will introduce system efficiencies such as timely pick up of samples from health care facilities to the hub, reduced empty trips, and efficient usage of fuel plus motorcycles.