Thoughts from the Last Mile Welcome to the VillageReach Blog
08.20 2015

Preparing for Rotavirus in Mozambique

Ready, set, go! And they’re off!

That’s how the introduction of Rotavirus happened in Mozambique. The country has been planning on this for a while, but, as often happens, it seems to come down to the wire to work out the details of how to get more than 1 million vials of Rotavirus vaccines out to more than 1,400 health centers across the country.

Rota vaccine team Niassa, Mozambique

The DPS EPI team, Niassa

Here in the province of Niassa, we are now ready! We just completed a two-day planning meeting to work out the details of how to distribute this initial batch of rotavirus vaccines to all health facilities. The meeting was organized on a RESOLVE theme—the Program for Optimizing Vaccine Logistics (in Portuguese).

VillageReach has been collaborating with the Ministry of Health, UNICEF, WHO, and the Provincial Health Directorates to develop out models of the supply chain, working with the HERMES Logistics Modeling Team. The HERMES tool is a software platform that allows users to generate a detailed simulation model of any vaccine supply chain.

DSC00172

a simulation exercise

a simulation exercise

In practice,  it’s a tool that gave us insight into the vaccine supply chain and constraints we will face with the introduction of Rotavirus. Specifically, health facilities that won’t have space in the fridge; specific transport routes that won’t have sufficient capacity to deliver all current vaccines plus Rotavirus; and where we would be missing opportunities to reach kids with vaccines because of stock-outs due to a poorly functioning supply chain.

The process helped us use the results of HERMES to identify challenges and constraints, and come up with solutions for the immediate future

 The process of RESOLVE helped us use the results of HERMES to identify challenges and constraints, and come up with solutions for the immediate future with this first batch of Rotavirus AND to think about longer term implications and how to optimize the overall system. It gave us the space to think about those ‘crazy ideas’ that may not be so crazy:

EPI Logisitician and VillageReach Field Officer

LEFT: Herman Roche, EPI Logistician, and me (Gregorio Janeiro) redesigning-transport loops for vaccine-distribution

  • Idea 1: We redesigned and optimized the current transport loops to match what resources we have (two trucks and two drivers) in order to ensure the needed capacity for the new vaccine to be included in the transport.
  • Idea 2: In one district, where we use boats to get to three health centers, we came up with the idea of taking fuel with us to pay for the boat ride, instead of needing cash to rent the boat, which is always more difficult to arrange.
  • Idea 3: Have the national level truck drop some of this initial batch of Rotavirus along the way at district deposits since the HERMES model shows that we won’t have enough space at the provincial level for all the Rotavirus that is being delivered.

Turns out, crazy ideas may not be so crazy.

So, now that this initial plan is organized and we are ready to receive Rotavirus and distribute it to the health facilities,  we can start to think of longer term planning for system optimization. In an effort of continuous improvement and with the HERMES tool and RESOLVE approach, we are now ready to find efficiencies in the overall system– not just for Rotavirus, but for all vaccines and all children of Niassa.

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