For more than a decade, VillageReach has been engaged with community and governmental partners on the ground in Mozambique to redesign the vaccine supply chain system through the Dedicated Logistics System.
The Dedicated Logistics System
(DLS)
International vaccine coverage rates hover around 80% and 1.5 million children still die from vaccine preventable diseases. While vaccines and other medical commodities are widely available, delivering vaccines and reaching the final 20% of children in many countries is still a significant and complex challenge. Key decision makers do not have data visibility to accurately forecast and respond, transport issues prevent reliable deliveries, and health workers struggle to adequately deliver care given the immense demands placed on them.
Improving reliable access to vaccines under these constraints requires a system-wide approach in order to achieve long-term, sustainable impact. For more than a decade, VillageReach has been engaged with community and governmental partners on the ground in Mozambique to redesign the supply chain model. Together with our partners, VillageReach is a leading contributor to the international effort to prioritize supply chain system design through proven innovations like the Dedicated Logistics System, or DLS.
The DLS introduced new efficiencies to Mozambique’s vaccine supply chain resulting in
- significant increases in fully vaccinated children
- dramatic reduction in stock-outs, and
- reduced government operating costs
Key Partners
- Mozambique Ministry of Health
- Bill & Melinda Gates Foundation
- Foundation for Community Development (FDC)
- UNICEF
- WHO
Scaling the Innovation
The DLS currently serves more than 500 health centers and a population of over 8 million.
The DLS operates as a cost-share model and is government-run and managed. VillageReach currently provides technical assistance to provincial ministry of health authorities to support implementations and operations of the DLS in five provinces.
The key components of the DLS are:
- A simplified, streamlined distribution process involving re-assignment of tasks, level jumping and optimized delivery routes
- An open source information management system, OpenLMIS (locally referred to as SELV) provides real time data for more accurate data collection and utilization
- The introduction of a Field Coordinator role; a specialized worker who delivers vaccines and supplies, repairs equipment, collects and reports data, and provides active and ongoing supportive supervision and training, allowing frontline health workers to focus on patient care
See how key elements of this approach differ from the typical multi-tier approach, and the impact of these changes on vaccine availability and cost:
Learn More:
- Lessons Learned in Reaching the Final 20: Building a Next-Generation Immunization Supply Chain in Mozambique
- LIÇÕES APRENDIDAS EM ALCANÇAR O PROJECTO FINAL 20
- DLS 2015 Performance Report
- DLS Wins Global Health Supply Chain Award
- The Role of System Design for Improved Immunization Supply Chains
- The Importance of Peer-To-Peer Learning
- MOH: A Time for Change
- Who are the Final 20?
- Final 20 Policy Paper Series: Financial Flows, Change Leadership, System Design, Human Resources, Cold Chain, Data for Management
- Boletim – Últimos 20
- Dr. Ramos Mboane, Perspective from Mozambique
Impact
An independent impact evaluation and complementary costing study revealed the following results of the Dedicated Logistics System (DLS) as compared to a controlled province:
- DPT-HepB3 vaccine coverage rates increased from 68.9% to 95.4% for children age 24-35 months.
- All other vaccines had similar increases resulting in an average coverage rate of 92.8%.
- The reported monthly incidence of stock outs in rural health centers decreased from 80% to 1%.
- Up-time of the cold chain increased from approximately 40% before the project to 96% over a year after the conclusion of the project.
- The DLS model was 17% more cost-effective, at $5.03 per child fully vaccinated with DPT-HepB3 compared to $6.07 per child vaccinated in Niassa where VillageReach was not engaged.
- The DLS system was also 21% less expensive per vaccine dose delivered: $1.18 per dose delivered vs. $1.50 per dose delivered.
From the Field
Now, the patients come every day, because they know that they will find vaccines.
I don’t have to worry about going to collect vaccines, now they bring enough quantities.
The Final 20
With additional support from the Bill & Melinda Gates Foundation, the DLS is now the cornerstone of the Final 20 Project, an effort to encourage new models of vaccine supply chain system design in Mozambique and globally in order to reach the final 20% of children who currently do not have access to life-saving vaccines.
VillageReach’s innovative approach to vaccine distribution formed the basis for the 2013 Gates Vaccine Innovation Award given to Margarida Matsinhe, VillageReach Field Officer in Mozambique. In 2014, Margarida was also named by Melinda Gates as one of nine world-wide leaders who are “changing the vaccine game.”
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