Abstract
Purpose: Drones can provide reliable on-demand delivery of medical commodities to healthcare facilities that are hard-to-reach via land-based transportation. Although drone delivery has been implemented in several countries in sub-Saharan Africa as a means of improving supply chain logistics, there is little evidence of the impact of drone delivery on supply availability, service utilization, quality of care, and health outcomes in low- and middle-income countries (LMICs). This study aims to quantify the impact of drone delivery on supply availability, quality of care, and health outcomes in rural Madagascar.
Participants: Study participants will include healthcare providers and exiting clients at 109 public-sector healthcare facilities and women of reproductive age living in the catchment areas of these facilities in three regions of Madagascar (Alaotra Mangoro, Atsinanana, and Vatovavy Fitovinany).
Procedures: This is a cluster randomized experiment in which 109 hard-to-reach public healthcare facilities located in three regions of Madagascar will be randomly assigned to receive either drone delivery or standard land-based delivery of medical supplies. Prior to facility randomization, we will first stratify by the seven districts and by a binary measure of facility remoteness. This will ensure treatment balance across the districts and by facility location.
Each study arm will contain approximately 54 facilities, which, on average, serve approximately 9,000 people. Pre- and post-intervention data will be collected at both the facility and individual level to estimate treatment effects.