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Thoughts from the Last Mile Welcome to the VillageReach Blog

Tag Archives: infrastructure

08.04 2017
CCPF hotline workers settling into the new call center in Lilongwe

This week, Chipatala cha pa Foni (CCPF) or “Health Center by Phone” moved its operations from Balaka, a rural community in southern Malawi, to its new facility in the capital city of Lilongwe. As we packed up the phones, headsets, and files, I was struck by how symbolic the moment was. This move is more than a change of location. It represents the progress of CCPF many years in the making: from a maternal and child health service in one district to a comprehensive health hotline accessible to more than 5 million people across the country. From this new facility, CCPF will have the proper infrastructure and operational capacity to become Malawi’s first government-run national health hotline, a goal we are on track to reach by December of this year. At that stage, the service will be accessible to over 17 million Malawians. Having supervised this program for one and a half years, I feel privileged to have had the opportunity to work with the Government of Malawi Ministry of Health, our dedicated CCPF teams, and all of the donors and partners who have made this day possible.

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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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01.06 2017
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Patuma and her family outside her home in Malawi. Patuma used CCPF to get information about her daughter’s Epistaxis.

I recently returned from a trip to Malawi where I had the opportunity to visit several families who have benefited from Chipatala Cha Pa Foni, or Health Center by Phone, a toll-free health hotline in Malawi that connects individuals directly with trained health workers who provide information, advice and referrals over the phone. One of those visits was with the Richards family who live in Kazondo Village in Balaka, a district in southern Malawi.

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10.26 2016

dscn0082Today marks my second day of a two-week tour to visit the VillageReach offices in Malawi and Mozambique. My mission? To get a firsthand perspective of the “last mile” and document our work through the words and stories of those who benefit directly from VillageReach programs. Unlike most of our program staff who travel regularly to the field, this is my first time traveling to Africa. I came as prepared as I could, following all the recommendations from the travel clinic, purchasing electric chargers and outlet converters, buying out all of the bug repellent at my local drugstore, and overpacking. But today, all of these preparations and details that I’ve been so focused on for the past few weeks seem insignificant in light of the experiences I’m having — and will continue to have over the next two weeks.

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10.13 2016

Communication is constant and ubiquitous – something we do with nary a thought throughout our lives. It’s so natural in fact that we tend to take it for granted. After all, when was the last time you engaged in a meta-conversation about the efficacy of a discussion you just finished? Alternatively, when did you last work on improving your lexis or grammar? If you’re like me, it’s been a while. Because our communication styles seem perfectly adequate for our daily personal lives, we tend to focus on more pressing concerns. For a technologist, that likely involves implementing some aspect of a project… and failing. Lack of communication is often the problem.

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A Clinic on the river in Benin

Software shops don’t tend to advertise it, but programming and IT are risky business. An IBM study found that nearly 60 percent of projects fail and that human, rather than technological, factors play a dominant role. Miscommunication is among the surest ways to kill a project. Sponsors may be misinformed about progress and withdraw support after subsequent disappointment. Business analysts may misunderstand users’ needs, developers may misinterpret analysts’ requirements, and because software development is often a collaborative endeavor, developers may even misunderstand one another. A lot can go wrong and — statistically — probably will. Our collective communication skills are simply not as good as we’re inclined to think.

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10.03 2016

untitled-design-2Simple ideas can be powerful – a point driven home during my recent trip to Uganda. While I was there, I had the opportunity to tour the Ugandan national medical stores, where medicines for the entire country are warehoused. The head of sales and marketing showed me how each and every commodity that the Government of Uganda procures is marked as a way to safeguard against theft. Every layer of packaging is embossed: “GOVERNMENT OF UGANDA. PUBLIC USE ONLY. NOT FOR SALE.” Even individual tablets are marked “UG.” The government builds this requirement into its procurement contracts with suppliers. I walked away completely floored. What a simple yet brilliant idea to solve a persistent supply chain problem.

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08.09 2016

As a global health innovator, VillageReach invests great time and effort in exploring how new technologies can be applied to address existing heath systems challenges. Often, this means considering how health system improvements can be leveraged to solve more than one problem at a time. Take, for instance, the emerging Zika virus threat: while VillageReach does not coordinate emergency disease response, our work improving routine transport of medical commodities could be used to strengthen emergency efforts. Similarly, emerging and innovative technologies, such as unmanned aerial vehicles (UAVs, commonly referred to as drones) could add to this comprehensive approach to healthcare improvement.

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07.22 2016
Jessica Crawford spoke about health delivery in last mile contexts.
Jessica Crawford spoke about health delivery in last mile contexts.

Global health innovation requires us to think beyond an individual product – it’s about creating space for “last mile thinkers” to meet with the scientists and engineers whose work influences medicine availability and healthcare access in low- and- middle income countries. This is how VillageReach found itself on a stage next to representatives from GlaxoSmithKlein, Pfizer, Washington Global Health Alliance, and the Controlled Release Society, engaging in conversations about what medicine delivery means in the context of global health.

Tremendous time, resources, and efforts are invested in developing new, more effective medicines that can improve quality of life – some of these medical breakthroughs have promise to control or eliminate diseases that costs thousands of lives each year. But the challenge of delivering these innovations in low-resource settings remains a pervasive barrier to improving health care access and outcomes. New products have unintentionally strained fragile health systems. Health supply chains for example, designed decades ago, struggle today to deliver a wider range of medicines to larger populations. Infrastructure and human resource challenges limit the impact of these innovations. Life-saving medicines sit on shelves in a warehouse, or expire in broken refrigerators at a rural health facility – many of us who live and work at the last mile of rural communities are familiar with this “innovation pile-up.”

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03.28 2016

Could UAVs Reduce Waiting Time for Pediatric HIV Test Results?

UAV in Malawi
Photo: UNICEF – Children observe the UAV launch in Malawi

I have experienced quite a few “firsts” since joining VillageReach, but by far one of the most exciting is the experience participating in the first tests of Unmanned Aerial Vehicles (UAV) (commonly known as drones) for HIV sample transport* in Malawi. VillageReach is currently working with UNICEF and Matternet, a leading UAV company, to test and assess the feasibility of UAVs, with critical implications for the treatment of HIV in children.

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03.24 2016

Over the past year and a half in Benin, VillageReach has supported the Agence de Médecine Préventive (AMP) in their work to pilot and scale Logivac, an informed push distribution system for immunization commodities.

Starting as a pilot in a single health zone in 2014, this system will be deployed in approximately one-third of the 34 health zones nationwide under the name Logivac+ by July, 2016. Working with AMP, VillageReach has helped deploy and adapt OpenLMIS, locally called the Systeme Informatisé d’Information Logistique (SIIL), collecting data and providing the information needed to improve the informed push system. Over the past weeks, VillageReach and AMP have been working to determine program needs and ensure that SIIL is up-to-date as Logivac+ moves to scale.

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