Thoughts from the Last Mile Welcome to the VillageReach Blog
10.19 2016

Reflections on RHSC 2016

Last week, the Reproductive Health Supplies Coalition (RHSC) brought together hundreds of the top minds in global reproductive health issues at the Coalition’s 17th Annual Meeting. This meeting provided a forum for discussing the many triumphs and continuing challenges of reaching 120 million additional women with reproductive health services by the year 2020. Access to reproductive health commodities allows women to decide if and when to have children. This ability is not only a human right, it can be a life or death situation for many women and young girls. Increasing access to reproductive health is also one of the most effective and cost-efficient ways to reduce infant and maternal deaths.  As an active member of the RHSC’s System Strengthening Working Group, VillageReach eagerly engaged in this week of conversation and idea exchange. Many of the central themes reflect the work of VillageReach, allowing us to bring our experience and expertise to the conversation while learning and growing from the experiences of our partners.

Why is the Last Mile so critical to the supply chain?

rhsupplies2016-02Establishing an effective health system necessarily requires strengthening the system all the way to the end user. Effective supply chains are no different. Having commodities and health supplies available at the national or regional level does not guarantee access to patients if systems at the last mile are weak. Innovation pile-up, overburdened health workers, and limited resources can all contribute to low commodity availability, leaving patients without a full range of reproductive health commodities. There are no simple solutions to strengthening these last mile systems – barriers are complex and resources are limited. However, this meeting demonstrated an inspiring commitment from donors, governments and organizations to ensure that reproductive health commodities end up in the hands of them women who need them. At this year’s meeting, there was an increased emphasis on the last mile, including inter-organizational partnerships and new approaches that are beginning to make an impact on quality reproductive health services. This focus on last mile systems continues to grow in the global health sphere – providing new ideas, resources, and dedication to overcoming these barriers.

How can we address the unique needs of youth in reproductive health?

VillageReach’s Matthew Ziba presented on increasing access to youth-friendly services in Malawi.

There are now 1.8 billion young people between the ages of 10 and 24 in the world, and improving their access to healthcare is essential – particularly for reproductive health. Stigma against youth accessing reproductive health services and commodities from parents, community members and healthcare providers limits youth access to services and undermines their confidence in the health system. With the support of the Reproductive Health Supplies Coalition’s Innovation Fund, VillageReach is looking for new ways to leverage the Pharmacy Assistant Training Program to address the unique needs of youth. Pharmacy assistants in Malawi will provide mentorship and guidance in rural health centers in order to strengthen last mile supply chains and provide youth-friendly services. Many of these pharmacy personnel are youth themselves and have an inherent understanding of the barriers facing youth at the last mile. Coupled with the DREAMS Innovation Challenge, utilizing the Chipatala cha pa Foni (Health Center by Phone) mobile health hotline, VillageReach is working with communities to identify and strengthen the avenues youth take in accessing reproductive health services while strengthening the range of reproductive health commodities available to them.

How can innovation be applied to the reproductive health space?

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Hands-on learning at RHSC 2016.

Many organizations are trying to find new and unique ways to address the barriers to health. Data visibility was a key theme of this year’s meeting and many partners spoke of their dedication to creating a global visibility and analytics network (VAN) to improve data sharing between major donors, analyze stock availability versus need, and re-route commodities to where they are most needed. New technologies, like unmanned aerial vehicles (UAVs), are being considered to address distribution challenges in hard-to-reach areas and are already being tested in Ghana to deliver contraceptives. However, understanding the unique challenges facing reproductive health is essential to ensure these innovations answer the actual needs of the system. For example, many reproductive health commodities are heavy and bulky, making transporting them with current UAV technology challenging– so determining when and how this technology can be applied in a cost-effective manner is an important first step. Innovation is necessary for moving the health system forward, but it needs to be done appropriately and with the end result in mind.

How do we share lessons across sectors within global health?

One of the biggest takeaways from this conference was the similarities between experiences – between countries, between supply chains, between public and private sectors, and between global health focus areas. Many of the core tenants of VillageReach were reflected in this meeting: the importance of partnerships, the focus on people, the need to change mindsets – the  lessons we learn every day in our work. These are important conversations, and bringing a variety of partners together at meeting like this helps turn these conversations into action. Sharing experiences allows the global health community to collectively strengthen access to quality health services at the last mile – no matter what those health services are.

This week of enriching conversation will improve VillageReach’s approach to last mile healthcare. New ideas, new partnership, and a renewed determination to address barriers to quality health is what propels our work.

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