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Thoughts from the Last Mile Welcome to the VillageReach Blog

Tag Archives: NGO’s

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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01.10 2017

With the New Year upon us, I wanted to take this opportunity to reflect on some of the most important milestones that you, our partners and donors, have helped us to achieve this past year. With your support, we are reaching more people, proving the potential of emerging innovation, and working with new partners to increase access to quality healthcare at the last mile.

Reaching More


_x8a8078Chipatala Cha Pa Foni (CCPF, or “Health Center by Phone”) expanded
 to three additional districts in Malawi, reaching an additional 400,000 people, and ensuring that mothers like Patuma have access to health information, advice and care, no matter where they live. Airtel remains central to this growth as we work with the Ministry of Health towards national scale-up. New ventures like CCPF for Adolescents and collaboration with Johnson & Johnson are helping to enhance the quality of the service and expand its
potential to reach and serve more.

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07.19 2012

We recently sent out this latest update … here’s our news in case you missed it …

Malawi

  • update on our work to improve maternal and newborn health in Kwitanda
  • the latest on our Chipatala Cha Pa Foni (health center by phone) program, part of the Innovations for Maternal, Newborn and Child Health initiative
  • Mozambique

  • new update to our Mozambique Dedicated Logistics System (DLS) program
  • collaboration with the William Davidson Institute (University of Michigan) Supply chain & logistics study: new research to quantify the logistics challenges for a variety of medical commodities
  • Dr. Seth Berkley, President of the Global Alliance for Vaccines and Immunization (GAVI) visited the DLS program
  • Technology Initiatives

  • ODK Scan: update on our collaboration with the University of Washington’s Computer Science & Engineering to improve the quality of data collection
  • OpenLMIS: new website with updated details on activities and partners
  • Social Enterprise

  • VidaGas: our collaboration with the ghdLABs program at MIT, to evaluate the marketplace for our social enterprise in Mozambique
  • New Additions to Our Team

    Malawi:

  • George Chinkwita – Project Officer, Kwitanada Economic Development Initiative
  • Erin Larsen-Cooper – Program Associate
  • Mozambique:

  • Antonio Gaspar Tomboloco – Field Officer, Niassa Province
  • See here for details …

    Updated Financial Report

  • our recently posted 2011 independent financial audit
  • We welcome your questions and comments,

    Allen Wilcox
    President

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    08.06 2009

    Over at the GiveWell blog, they’ve been asking some difficult but incredibly important questions about international aid projects.  Back in July, they explored the goal of sustainability.  Like GiveWell, we’ve noticed that sustainability is more and more often included as a requirement from funders yet it often remains vaguely defined and difficult to quantify.  VillageReach decided to establish businesses precisely because we believe that for many infrastructure gaps in the health system, they are the only truly sustainable way to address the problem.  And our social business VidaGas is a self sustaining organization, but as GiveWell notes, it has been a larger challenge achieving sustainability on the program side.  Even though we attempted to plan for long-term sustainability from day one in our Mozambique program, it has been challenging to convince the government to maintain the system even when we can show evidence of significant success.  The inertia of the status quo is a powerful obstacle to sustainable change.

    So, this begs the question- how do you define and measure sustainability and how important should it be as a goal of a program?  This is especially important when you consider that sustainability often ends up being a trade-off with other qualities- for example, in order to make our program as sustainable as possible, we try to only include elements that we know the government is capable of carrying on after we leave- this can mean sacrificing impactful elements  because they are too expensive, too labor intensive or just too unprecedented for the government to assume control of.   GiveWell concludes that sustainability should be considered “a desirable goal, but not a reasonable requirement.”  The goal of sustainability is fundamental to VillageReach but a more candid conversation about what this truly means could be of enormous benefit to funders and implementers alike, both of whom tend to through the word around without really questioning its value.  On a similar theme- Phillip LaRocco has a humorous note to the “development posse” about lightening up- admitting when things are difficult and cutting through the clichés (of which sustainability certainly must be one of the most ubiquitous!) to truly impact the communities we serve.

    GiveWell also explores investing in a small charity.  They note that “giving to VillageReach is a high-risk, high-upside proposition” and honestly, we couldn’t agree more.  VillageReach is proud of its dynamic and innovative approach- our President Allen is fond of saying that our theory of change boils down to “we see, we do, they see, they do.”  Basically, we recognize the problem and because we are small and agile we can create a customized model to address it and then advocate for both the recognition of the problem and the adoption of our model to others.  GiveWell was impressed by our rigorous monitoring and evaluation of our program, an expensive proposition that many small non-profits forgo because they view it as a luxury.  We, however, see quantitative evidence of impact a fundamental necessity in order to convince others of the value of our model.   But it is true that the same things that make us high-impact and allow for change on a scale disproportionate to our size also mean that we don’t have the security of a large, highly diversified non-profit working in a well understood area.  We rely on donors to recognize both the problem of last mile health system strengthening and the value of our solution.  We are thrilled to have GiveWell endorse our approach and we hope to report more success in the future.

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    07.01 2009

    We are excited to annouce that VillageReach has been rated as a top charity by GiveWell. GiveWell is an independent, nonprofit charity evaluator- founded by two ex-hedge-fund analysts, GiveWell brings a metrics-based business mentality to the table with their rigorous and thorough analysis of charities.

    givewell-logo

    It is incredibly refreshing to be asked about more than just our overhead to program ratio- as Anne mentioned in a prior post, we’re always thinking about what metrics we should be measuring our work by and how best to share our successes with our supporters.  We’ve been working back and forth with the guys from GiveWell for the past couple of months and been thoroughly impressed with the amount of work they put into each analysis they do.  We are incredibly proud to have passed their high standards!

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    06.11 2009

    We all know that operation of any health center requires a variety of external inputs- energy, transport/logistics (delivery services), and communications systems to name a few. In wealthy countries, these services would normally be provided by the commercial sector. In focusing efforts on the “last mile,” however, any and all of these commercial services are simply not available or are so expensive to procure that they are not operationally viable.

    At VillageReach we focus on energy, transport/logistics and communications, the “Enabling Services” that are required to fulfill the mission of VillageReach programs. When implementing health care programs in regions with weak or nonexistent Enabling Services, NGO’s have traditionally elected to handle the provisioning of Enabling Services internally. Trucking in generators, fuel and other supplies directly supports the program objectives but it does little to provide Enabling Services to the surrounding community. It is widely recognized that a successful and sustainable program intervention creates and uses local capacity. The VillageReach model and programs to date have as a guiding principle the creation of local capacity not only for last mile health care infrastructure but also for the Enabling Services that support that infrastructure.

    To sustain the improvement in health and decrease in mortality that is the core of the VillageReach mission it is necessary to create permanent health care resources in last mile communities. Sustainability requires that Enabling Services be available, be reliable and can be procured at affordable rates for the long term. In order for Enabling Services to be available for the long term the customer base must be substantially larger than just the rural health care clinic and therefore must include a vibrant market in the local community. The lack of Enabling Services in many of these rural situations clearly shows that sufficient market demand does not exist today for a viable commercial business. It’s a classic chicken and egg problem – VillageReach is moving forward as a catalyst with creating basic demand for Enabling Services as part of its programs to support last mile health care and incubating the required commercial business for the services.

    So, why is social enterprise required in the VillageReach model? Because without established Enabling Services as one of the key elements in the intervention – the VillageReach programs would not achieve the required sustainability and would become yet another solution that fails to provide the long term impact when transitioned to local operation.

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    06.08 2009

    So who is paying attention to medical distribution systems and more specifically to the innovation pile-up we highlighted in the last post?

    There are 4 main categories of players: Governments, NGOs, multi-lateral organizations (WHO, UNICEF) and public-private alliances.  While there are many, many important and interesting stakeholders in the field, the most interesting evolution over the last decade has been the ways these groups cross boundaries to find creative ways to work together.

    When Global Alliance for Vaccines and Immunization (GAVI) was established in 2000, it had an enormous impact on the field of vaccines.  GAVI refocused attention on vaccine-preventable diseases which waned in the 90’s after the highly successful immunization campaigns of the 70’s and 80’s. gavi-logoAnd as a public-private partnership funded by donor governments and private organizations such as the Bill & Melinda Gates Foundation, it brought serious financial resources to the table (over $2 billion of net assets in 2007).  Currently, GAVI supports 72 low and middle-income countries in vaccine financing and procuring.  While considerable resources at GAVI have been directed towards augmenting the supply of existing vaccines and developing new vaccines, GAVI and its stakeholders are increasingly beginning to consider the inadequacies of the health systems into which these vaccines must enter.

    One particularly interesting initiative is The Optimize Project, a joint collaboration between the WHO and PATH.  The Optimize Project seeks to identify and advocate for the “immunization systems and technologies for tomorrow.”  Funded by the Gates Foundation, the Optimize Project is a recognition that discovery and development of vaccines is only half the battle.

    Here at VillageReach, it has been exciting to see the development of enthusiastic recognition and articulation of the problems of logistics at theLast Mile.

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