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Thoughts from the Last Mile Welcome to the VillageReach Blog

Category Archives: Supply Chain

11.30 2017
Vaccines are stored in refrigerators and other cold chain equipment in order to maintain proper temperature. Photo Credit: Paul Joseph Brown

Vaccines are extremely sensitive to temperature. They must remain between 2 and 8 degrees Celsius in order to remain viable. Outside of this temperature range, vaccines become less effective at preventing diseases. Because of this, the storage and handling of vaccines need careful attention. The equipment and devices used to ensure vaccines stay in the right temperature range are known as the “cold chain.” When vaccines are transported, stored in a refrigerator, or used in an immunization session, the cold chain keeps the temperature right. Significant investments have been made in updating cold chain equipment in many countries, but overall performance remains a significant concern.

With our new partner Bull City Learning, VillageReach is strengthening the vaccine cold chain in Malawi. Using human-centered design principles, we are creating an easy-to-use, interactive, digital manual on refrigerator maintenance and repair. By providing this tool for cold chain technicians, we hope to improve routine maintenance of essential equipment used to keep vaccines at the right temperatures.

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10.26 2017
Melissa West and Sid Rupani from LLamasoft sharing the use of system design and modeling for supply chain improvement at the TechNet Conference.

Donors and NGOs around the world are investing in technologies that promise to make vaccines available to children everywhere. Many of these innovations took center stage at last week’s TechNet Conference, reflecting the enthusiasm to try something new. But maybe what we need is not necessarily something new – just something different.

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10.12 2017
In DRC, an interactive workshop was used to introduce modeling to Ministry of Health officials.

Through my work optimizing supply chains, I have truly come to realize the importance of looking at “the big picture.” If every detail matters in the effective operation of a supply chain, it is also critical to connect the dots and understand how functions interact. Getting health products to remote health centers is no straightforward endeavor—there are many complex steps and processes involved that can make it difficult to visualize the larger, connected system.

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08.30 2017
The first distribution of the Next Generation Supply Chain Initiative at the Konongo Health Center in DRC.

I am proud to announce that last month a team composed of provincial government and VillageReach staff successfully conducted the first direct distribution of vaccines and family planning commodities in the Equateur Province of the Democratic Republic of Congo. Under the Next Generation Supply Chain Initiative, this constitutes a major milestone worth celebrating. It represents more than a year of planning and advocacy to engage government leaders and partners (UNICEF, ECC CORDAID, SANRU, OMS, and Croix Rouge) to take bold steps toward change to ensure more reliable delivery of vaccines and other essential health commodities to “the last mile”, often the most remote and hard-to-reach communities in DRC.

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04.28 2017

World Immunization Week is a perfect time to reflect on global priorities and our commitment to the Global Vaccine Action Plan (GVAP). This framework guides the work of organizations around the world to reach every child with life-saving vaccines. It is also a way to measure our collective success. Accurately measuring our progress against GVAP targets is central to moving the needle globally, but we need to be confident in the data.

I recently heard a ministry official summarize the challenges to increasing immunization in an area suspected to have a high number of unimmunized children. This was very different from the story told by the numbers. The administrative coverage rates (based on census numbers and the reported number of administered vaccine doses) for the region were well over 100%. Surveys designed to provide a baseline comparison in the same area reported lower numbers, but the data still showed surprisingly high coverage – above 80%. People at this meeting quickly said they were ‘tired’ of hearing about coverage rates because of the well-known data quality issues. This frustration with data quality has echoed at nearly every immunization stakeholder meeting I’ve attended. Clearly inaccurate data is less meaningful – and less useful. It could be worse than no data at all.

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02.17 2017

At the 2017 African Union Summit, Heads of State endorsed the Addis Declaration on Immunization, which demonstrates convincing political support to improve equitable access to vaccines.  Now countries must embrace the hard work required to deliver immunizations and other health commodities to all citizens. Only when governments lead with a strong vision, supported by donors and non-governmental organizations (NGOs) in a collaborative effort, will large-scale impact be achievable. In places like the Democratic Republic of Congo (DRC), new approaches are bringing the government together with these groups – and seeing greater collaboration between donors in support of government efforts.

Motorbike on a canoe.
Transport in remote parts of DRC include boats and motorbikes.

Leaders in the DRC have committed to overhauling the country’s dozens of supply chains, developing a highly-functioning, efficient system capable of reaching even the most remote populations. The terrain and sheer size of the DRC make this uniquely challenging. Health officials recognize that traditional supply chain models are not sufficient, and are actively seeking new approaches. But they cannot do it alone. VillageReach is one of many organizations supporting the government’s quest to develop, test, implement and scale strategies that can improve this essential mechanism for providing healthcare.

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02.03 2017

Version française

As someone who has dedicated his life to public health, I am thrilled to see Africa’s leaders making a bold commitment in support of immunization. The African Union endorsement of the  Addis Declaration on Immunization (ADI) demonstrates that vaccines, and the proper health systems to deliver them, play a significant role in the future of our continent.

Measles and many other diseases preventable by vaccination have a devastating potential. Even a few years ago, rural communities had a saying: to know how many children you have in your household, wait for the measles. Measles epidemics have decimated children in times past. This was the case of the Mankanza territory in the province of Equateur, located 220km from the provincial capital, Mbandaka, and accessible only by water. Many, many children were buried because the measles vaccine had not yet come to their communities until 1996. The few survivors can still recall the impact of these measles epidemics. Even with sub-optimal immunization coverage, once the vaccine came, no epidemics occurred.

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02.03 2017

English Version

Comme quelqu’un qui a consacré sa vie à la santé publique, je suis ravie que les dirigeants Africains se soient engagé ardemment à soutenir la vaccination. L’adhésion de l’Union Africaine à la Déclaration d’Addis-Abeba sur la vaccination démontre que les systèmes de santé adéquats pour la livraison des vaccins jouent un rôle important dans l’avenir de notre continent.

Les maladies évitables par la vaccination—tel que la rougeole—ont des conséquences catastrophiques. Il y a quelques années, les habitants de plusieurs communautés rurales en RDC disaient :« il faut attendre le passage de l’épidémie de rougeole pour savoir combien d’enfants tu as dans ton ménage ». Dans le passé, ces épidémies étaient responsables de la mort de nombreux enfants. Cela a été le cas du territoire de Mankanza dans la Province d’Equateur en RDC. Mankanza se situe à 220 km de Mbandaka (chef-lieu de la province) et est une zone totalement riveraine. Le vaccin contre la rougeole a été mis à disposition vers les année 1996. Dans les années précédentes, cette maladie aujourd’hui évitable a emporté des milliers d’enfants simplement parce qu’ils n’étaient pas vaccinés. Malgré la faible couverture vaccinale, à partir de l’introduction du vaccin contre la rougeole, aucune épidémie n’est survenue dans cette contrée, et les rares survivants peuvent encore témoigner à l’impact mortel de cette maladie dévastatrice.

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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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Malawi healthcare worker