Thoughts from the Last Mile Welcome to the VillageReach Blog
02.15 2012

Cyclones and Rapid Diagnostic Tests

I recently joined a few of my VillageReach colleagues in the northern province of Cabo Delgado, Mozambique to start the data collection process for our Rapid Diagnostic Test (RDTs) Consumption study.  As Kassia mentioned in a previous post, VillageReach is conducting a consumption study in order to quantify stock shortages at health centers throughout the province and to better understand the factors contributing to the shortage. The study was prompted by concerns that the supply of RDTs in the province is insufficient to meet demand and the gap between supply and demand is largely unknown.  We believe the shortage may, in part, be due to the fact that the requisitions for tests are based on consumption. In shortage situations, this causes a vicious cycle of under-stocking: insufficient stock leads to stock outs, which leads to lower consumption amounts, which leads to fewer tests ordered the next month, and so on.  Our study is attempting to quantify the difference between supply and demand throughout the province by estimating the true demand for tests.
Over the course of three days, we traveled to five health centers in three different districts and two of the district storerooms to find out what information was available regarding the use and stock of RDTs, validate our assumptions about the type and quality of the data, identify additional data sources, and finalize a data collection plan. We prepared a data collection tool in advance that covered a variety of potential forms that might be in use so that we could test it at the health centers. Once there, I was struck by the amount of information available at health centers but in ways that were difficult to capture as researchers. For example, standardized forms weren’t used across all health centers and the data weren’t captured in consistent ways month to month, or health center to health center. All of this caused us to rethink our data collection methods a bit. Also, some of our assumptions regarding the type of information that would be available didn’t hold up. While our preparations provided us with a good starting place, we still have a bit of work to do to refine the methodology and we look forward to the data collection and analysis!
On our second night in Cabo Delgado, a cyclone off the coast of Mozambique touched ground further south of where we were. While we didn’t experience cyclone intensity, we did have extremely heavy rains and winds and the next morning, on our way to the third and final district, we came to an impassable road due to floods. In fact, the area was so flooded that the resident crabs had climbed up into the trees! During the first two days, we traveled to remote health centers through roads I would never have imagined were passable and yet after the storm, the main road to the district headquarters was completely cut off due to floods.  I took a step back to appreciate that knowing the number of tests that are needed at a health center and ensuring that those tests are available to deliver are just part of the work we do and the challenges that must be overcome in our mission of increasing access to quality healthcare.

Jessica Crawford, HSG Program Associate

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