Table 2

Strengths, weaknesses, opportunities and threats (SWOT) analysis of drone projects in Madagascar, Malawi and Senegal

  • Government support and engagement (eg, ministries of health, defence, transport, including civil aviation authorities) are indispensable to implementation

  • National, multisectoral stakeholder committees are important to guide and coordinate activities and raise awareness

  • Value of community engagement and acceptance efforts has been demonstrated

  • Drone-specific flight regulations have been developed in all countries in reaction to the increased use of drones (with varying current implementation status)

  • Competitive tendering for drone operator has resulted in identification of most suitable technology

  • Local human resources, skills and institutional capacity-building efforts contribute to locally owned and operated projects

  • Favourable operating environments (eg, testing corridor in Malawi) have facilitated testing of new technologies by different users

  • Feasibility testing resulted in first successful bi-directional flights and dummy cargo transports

  • Accompanying studies (eg, acceptability, health outcomes, cost-effectiveness analyses) increased the body of evidence and lessons learnt to guide future implementation

  • Standard operating procedures for drone operations have been developed

  • Parallel use cases in other sectors, eg, agriculture, conservation, disaster response, have increased interest, advocacy, ease of implementation and acceptance of drone use and created synergies

  • High international visibility was achieved bringing attention to the use case

  • Lengthy and delayed development of drone regulations

  • Limited in-country technical capacity

  • Lengthy and costly importation of technology and equipment into country

  • Need for technology switch mid-projects (technical challenges and unavailability from operating provider)

  • Limited readiness of technology in real-world settings (eg, GPS interference) leading to need for technology development on site (software and hardware)

  • Difficulty sourcing funding for activities beyond proof-of-concept or small-scale implementation

  • Lack of business cases in-country, partly due to lack of implementation beyond proof-of-concept

  • Scarcity of data on, eg, performance, impact, acceptability, partly due to recent implementation

  • Political awareness and desire to work with drones is increasing

  • Political interests are aligned with drone project objectives

  • Positive feedback from communities on the potential use of drones for health

  • African Drone and Data Academy will build local skills and entrepreneurship opportunities

  • Supportive regulatory environment enables drone use in absence of final regulations

  • Wealth of lessons learnt by the pioneer implementers of bi-directional drone use encourage project continuation and guide new projects

  • Drone testing corridor provides opportunities for different types of drones to be tested by different users

  • Donor interest to fund existing and new projects

  • Potential for cost-effectiveness compared with conventional transport

  • Increasing number of use cases reaching more people in need of healthcare

  • Occasional unreliability of currently available technology (hardware and software)

  • Limited technical expertise and capacities in-country leading to dependency on external/international service providers

  • Competing interests between in-country health stakeholders

  • Sensitivity and potential dangers of delivery of blood or biological samples

  • Unsecured funding to continue activities, potentially reversing health gains

  • Local health sectors reliant on donor funding with limited ability to assume financial responsibility