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Category Archives: Mozambique

02.01 2017

Versão português

With the endorsement of the Addis Declaration on Immunisation, African leaders demonstrated their commitment to life-saving immunizations.  The Declaration names a number of components – ten, in fact – crucial to realizing the full benefits of immunization.  But there are many more pieces in the day-to-day work of getting vaccines to children.  These are the pieces I think about as I do my part in reaching global vaccine goals.

Depending on the day, I’m thinking about things like this:

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01.31 2017

English Version

Com a aprovação da Declaração de Adis Abeba sobre a Imunização, os líderes africanos manifestaram o seu compromisso para com as imunizações que salvam vidas. A Declaração indica várias componentes – de fato dez – que são decisivas para realizarem-se os plenos benefícios da imunização. Mas existem muitos mais elementos no trabalho quotidiano de fazer chegar as vacinas às crianças. Estes são os pedaços nos quais penso enquanto dou a minha contribuição para alcançar as metas para as vacinas a nível mundial.

Dependendo do dia, estou a pensar em coisas tais como as seguintes:

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01.20 2017

Em Moçambique, um grupo de parceiros tem trabalhado em colaboração com o governo para melhorar o acesso aos medicamentos na última milha. Uma abordagem inovadora reuniu os conhecimentos da VillageReach, Médicos Sem Fronteiras (MSF) e de uma empresa local 3PL, Confiança Absoluta, para apoiar a meta do governo provincial de Tete, de alcançar as comunidades mais remotas com vacinas e medicamentos contra o HIV. Essa abordagem, chamada de Terceirização dos Serviços de Transporte (TST), usou o sector privado para distribuir vacinas, medicamentos contra o HIV, e kits médicos para os serviços de saúde. Um novo estudo explora o potencial desta abordagem, enquanto o governo está projetando expandir de um projeto piloto para a província completa e além.

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01.19 2017

Collaboration is at the heart of a unique public-private initiative to increase availability for a range of health products in Mozambique. Tete provincial health authorities, Médecins Sans Frontieres (MSF), and VillageReach have partnered with the private sector company Confianca Absoluta to bring HIV medicines, vaccines and medical kits to rural health clinics. A new case study looks at the first six months of this initiative. It outlines the details of the partnership, benefits to date including increased availability and efficiency, and considerations for governments interested in outsourcing as a way to improve transport for essential medicines.

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09.28 2016

In late August, VillageReach welcomed a team of Wharton Business School students to work on a short-term pro bono consulting project, aiming to develop a diversification strategy for VillageReach in Mozambique.  Although the team spent only nine days on the ground in Maputo, the project had been months in the making, starting with an initial dialogue between Ruth Bechtel, the Mozambique Country Director, and Wharton team leader Joelle Birge back in fall 2015. Coming from a variety of backgrounds, these four students were inspired to travel to Mozambique by their common interest in international development and global health. Joelle describes the work this team accomplished:

oneProject planning began with a series of calls between VillageReach and the Wharton team to refine the project scope and map out work plans and deliverables. Together with VillageReach, we decided that one of the best ways to leverage the team’s time in Maputo would be conducting interviews with public health stakeholders to gain an outside-in perspective on current areas of need and opportunity.  Over the course of the spring and early summer, we conducted research on donors, NGOs and government organizations operating in Mozambique public health and used this research to work with VillageReach on defining a list of priority stakeholders to interview.  This interview list served as the jumping off point for structuring the our on-the-ground work in Maputo.

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09.20 2016

final-20-report-coverWhile visiting rural health units outside Montepuez district in Mozambique, I met a mother at Naioto clinic. It had taken her two hours to get to the facility, with a baby on her back. She was happy to stand in a queue for vaccines for her baby because vaccines were available. The nurse at the clinic, Ana Bendita Miguel, remembers times when she had to turn these mothers away. Prior to ensuring regular, monthly distribution of the provincial delivery truck, it wasn’t uncommon for Bendita to ride a bus to the district centre, a difficult trip of 68km to collect vaccines. In addition to taking Bendita away from seeing patients at the clinic, the bus fare cost her 240 MZN (around $3.30), which was not refunded. In those days she said, “when I didn’t have money for bus fare, I couldn’t prevent the stockout.”

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09.09 2016

Reposted from Next Billion

truck4_moz_2014Vehicle graveyards are an all-too-common sight for those of us who work in global health. These long-forgotten vehicles serve as reminders to the underlying obstacles faced by transport systems throughout Africa. Routine maintenance required to keep cars, trucks and motorcycles moving simply does not happen, shortening the lifespan of the vehicles that are essential to delivering health commodities to the most remote communities.

For the donor community, these vehicle graveyards are a reminder of the weak return on investment for these expensive, short-lived machines. Many institutions are declining to fund the capital expenditure required to purchase vehicles, parts or storage facilities. Insufficient capital is just one of the contributing factors limiting the transport capacity of a health system.

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06.17 2016

The differences between West Africa and Southern Africa are well known, even if partially built on generalizations and stereotypes. There are personality differences, language differences, different foods and ways to eat, different and distinct rhythms heard in discotecas. While regions and individual countries are culturally unique throughout Africa, many share the same challenges and goals when it comes to improving their health systems. A few of these similarities stood out when the Ministry of Health in Mozambique hosted a team from the Ministry of Health in Togo this past week. IMG_6533The Togo team—Dr. Napo-Koura Gado Agarassi, Secretary General of the MoH; Dr. Ayi Hervé D’Almeida, Director of Procurement and Inventory Management; Dr. Amevegbe Kodjo Boko, National EPI Director, MoH, Togo – came to Mozambique to better understand how this country runs its supply chain for health commodities and what lessons can be learned between the two countries.

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05.06 2016

Reposted from the Bill and Melinda Gates Foundation Blog: Impatient Optimists 5.6.2016

I recently returned from a week in Mozambique with a goal of learning about new immunization supply chain models and observing their impact.  I also wanted to better understand opportunities and constraints for taking this work to scale — in Mozambique and across other Gavi-eligible countries.

In 2013, the Gates Foundation began working with five provincial governments in Mozambique, the national ministry of health, and VillageReach on a new system for delivering vaccines.  The new system represented big changes over their current design.  It takes a holistic approach – reconfiguring the transport system, re-assigning roles and responsibilities of personnel, obtaining and using data differently, and integrating supervision and cold chain maintenance into monthly vaccine distributions. I was able to get a first-hand view and see some impressive results of this “next-generation” system while in southern Mozambique’s Gaza Province. In Gaza, there’s now a much better chance that when children show up at a health center for immunizations, the vaccines will actually be there.  Vaccine stockouts have dropped from 43% in 2012, before the province revamped their system, to routinely less than 3% today.

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02.22 2016

I was thrilled to witness President Nyusi launch the rotavirus vaccine in Mozambique last fall. Tens of thousands of little Mozambicans will be spared severe dehydration, even death, due to rotavirus-induced diarrhea – if the vaccine reaches them. And herein lies the problem.  When a vaccine sits in a national or district warehouse, a truck, or a broken “fridge,” it cannot save lives. 

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