Moreen Kiiza, 38, found it easier to attend antenatal visits and reach a health facility in time for childbirth. This was possible due to affordable transport through a community motorcycle service and regular savings for healthcare. As an expectant mother living far from a health facility, the journey to receive maternity care can be as important as the care itself.

The cost of transport, the distance to a health facility and the availability of a reliable means of travel can all influence whether a mother receives medical attention when she needs it.

Moreen is a member of Tweimukye Village Savings and Loans Association (VSLA) in Bunyangabu District, Uganda’s Rwenzori region. Through the Decent Work and Social Protection project funded by the Kingdom of Belgium, her VSLA group received a community-managed motorcycle to transport members to health facilities, making it easier for expectant mothers and other community members to access healthcare.

The motorcycle became an important part of Moreen’s journey through pregnancy and childbirth, helping her travel to a health facility for antenatal care and eventually for delivery. This is because, for many expectant mothers in rural communities, accessing antenatal care requires more than knowing when to visit a health facility. It also means finding reliable transport and having enough money to pay for the journey.

Moreen was familiar with this challenge. Transport costs to some health facilities can be high, making regular visits difficult for households with limited financial resources.

According to Moreen, transport to facilities such as Kibiito Health Centre can sometimes cost as much as UGX 20,000 for a return journey. Having access to the motorcycle managed by her VSLA group offered a more affordable alternative.

"I like using the group motorcycle because it is readily available, and they usually charge a subsidised fare compared to others," she explains.

During her pregnancy, Moreen used the motorcycle three times to attend antenatal care visits at Kasunganyanja Health Centre. For each return journey, she paid only UGX 6,000, significantly reducing the transport expenses associated with seeking maternity care.

The importance of reliable transport became even clearer when Moreen's pregnancy reached the advanced stage. When the time came for her to give birth, she once again relied on the VSLA motorcycle to travel to the health facility. It was the fourth time she had used the motorcycle during her pregnancy.

This time, however, the journey was particularly important. She needed to reach the facility in time to receive professional maternity care. "The health workers were happy that I reported on time," she recalls.

While regular antenatal care helps expectant mothers monitor their pregnancies, reaching a health facility promptly for delivery is equally important. In communities where transport can be expensive or difficult to arrange, access to an affordable motorcycle can help address one of the practical barriers to seeking timely maternal healthcare.

As a member of Tweimukye VSLA, she had also embraced saving for health to help meet medical expenses whenever they arose. She initially began contributing UGX 1,000 per week to the group's health savings fund. Over time, recognising the importance of having sufficient financial resources available during pregnancy and childbirth, she increased her weekly contribution to UGX 10,000.

Her decision was motivated by the need to strengthen her financial preparedness and ensure that she could access a sufficient loan from the group if additional expenses arose during delivery. Through consistent saving, Moreen accumulated UGX 300,000 in health savings.

Fortunately, Moreen gave birth normally and did not have to use much of her accumulated savings. The money she had set aside, however, remained valuable. Rather than withdrawing from the saving-for-health initiative after childbirth, she decided to continue contributing to the group. "These savings will support me and my baby in case illness arises," she says.

Her decision reflects an important aspect of financial preparedness: healthcare needs do not end with childbirth, as families continue requiring medical assistance.

Moreen's experience is part of a broader community transport initiative implemented under the Decent Work and Social Protection project. Through the initiative, 15 motorcycles were provided to selected VSLA groups to improve transport to health facilities, particularly in hard-to-reach communities.

The motorcycles are managed by the groups and provide transport services to both members and other community residents. Under the arrangement, group members benefit from subsidised fares, paying half the prevailing market rate, while non-members are charged the normal market rate.

This model seeks to address two important community needs: improving access to healthcare and creating an income-generating activity for the savings groups. At the same time, income generated from transporting passengers provides an additional revenue stream for the groups managing the motorcycles.

Approximately 5,057 patients have been transported to health facilities using the 15 motorcycles provided to the selected VSLA groups. The motorcycles have also generated approximately UGX 44.5 million (EUR 10,800) in income for the groups.

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