Global Health Ideas

Finding global health solutions through innovation and technology

FROM THE FIELD: Home Health Visits on Bicycle

Case Study: Arisen Woman and the Bicycle Empowerment Network (BEN)
Cape Town, South Africa

Hey! Was that a nurse on a bicycle? Yes – with bicycles, home health care workers from Arisen Woman are doubling the number of patients they see per day.

There is currently a shortage of health workers in South Africa.  Home health care workers care for the most vulnerable populations – patients who cannot travel to health facilities, or who are near death but not in hospice care. The patient population is composed of young children, the escalating population of adult patients with late-stage complications of AIDS/TB and chronic diseases, and the elderly.

After the carers learn how to ride a bicycle, patient care improves as they are able to make more regular patient visits, and able to devote more nursing time to patients that was previously lost to walking between patients. “Before, I was walking door to door.. It took me an hour to get 2 children, and when I got my bike, I only took 15 minutes to get 5 children. It was very good to see I could get quicker with my work.” Katrina Matthews. The health workers are much less tired, as they are not walking 4+ hours each day on their patient rounds, and can bring more medications with them.

In much of South Africa, health workers often walk door-to-door to see their patients, which limits them to a small radius. In programs with better funding, a driver will transport the workers back and forth between patients. However, this also restricts patient reach, as the workers must stay in the same area to facilitate pickups by car. With bicycles, each worker is completely independent and can see patients within a 15 km radius. Arisen Woman encourages carers to promote exercise for their patients, and seeing the home health care worker arrive on a bicycle sets a great example.  The bike is an ideal vehicle for Africa, for in areas with poor road conditions, biking is very safe, as traffic must slow down to negotiate roads.

Financially, bicycles are a small initial investment, with minimal maintenance costs. In comparison, motorized transport requires daily transport fees, or if the program owns vehicles – constant fuel expenses and significant maintenance.

And finally, this also benefits the carer, who is usually paid per patient seen, so improving productivity increases their income significantly.

“It was one of the luckiest days of my life, when I got my bike.” Ruwayda Dickenson, home health care worker – Arisen Woman.

Listen to an interview on the project with Andrew Wheeldon, Managing Director of the Bicycle Empowerment Network (BEN).

The Bicycle Empowerment Network’s project on improving health worker transport with bicycles is supported by the Institute for Transport and Development Policy (ITDP) and is being tested in Ghana, Senegal and South Africa.

Part 1 in a series on bicycles and health in Africa.


Written by farzaneh

November 17, 2006 at 11:01 am

Posted in Access to Health

3 Responses

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  1. […] FROM THE FIELD: Home Health Visits on Bicycle from Technology, Health & Development. “In Cape Town, South Africa, Arisen Woman and the Bicycle Empowerment Network have partnered to get home health care workers on bikes and doubled their patient reach.” […]

  2. Arisen Women is specifically dealing with hospice care, chronic diseases and care for children.

    For specific transport and maternal mortality questions, Dr. Kate Molesworth at the Swiss Tropical Institute wrote a review of research on this topic. They have launched a networked research collaborative to test pilot projects in various locations.

    Here is her webpage

    Here is the literature review she did that has specific details on maternal mortality and transport.


    August 7, 2007 at 6:19 am

  3. If you can tell me, how well has this program helped, specifically for reducing maternal mortality? Any statistics? Who in your organization might I be able to speak with regarding the transport issues that come up when emergency obstetrical care is needed and a woman needs to be transported to a health center. Anyone in your organization that might have special knowledge of these issues?

    Dr. Jennifer Shaw

    July 23, 2007 at 11:18 am

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