If someone asked me “what’s a van?” in the US, I’d probably say a big-ish vehicle meant to efficiently move people and stuff from point A to point B. In Africa, these large people movers are called minibuses, kombis or any of a hundred other terms, except van. So when someone asks me about “VAN” in the African context, it means something very different. VAN is an acronym for “Visibility and Analytics Network.” In Nigeria, where VillageReach is working on the VAN project, it represents a new, more holistic approach to vaccine delivery and achieving a healthy, functioning supply chain. Though our VAN doesn’t have four wheels, it’s still purposefully designed to move things around more efficiently.
I come from the tech world, where there’s often a focus on the product to the exclusion of everything else. Large technology companies can get away with this… most of the time. However, in places where technology awareness and appetite is much less ubiquitous, it’s crucial to look at technology use in a more inclusive way: not just the product, but who will be using it, how they will be using it, and why they will be using it. This is especially true when we speak about social services like healthcare. While this may seem obvious, approaching problems with a rigorous application of VAN principles is a new development in global health.
At its most basic, VAN encourages adopting relevant private sector supply chain techniques by looking at health through three primary lenses: technology, processes and people.
When you order something online, you are able to track your order moment-by-moment as it moves from its source to a truck, to an intermediate warehouse, perhaps to your local post-office, all the way to your very own doorstep. However, this level of end-to-end visibility is difficult to realize in many immunization supply chains. The infrastructure and standardization that make this visibility possible is often missing in the global health context. As the old adage goes, “If you can’t measure it, you can’t manage it”. When it comes to improvement, visibility is key. Appropriate technology gives us this visibility and is the first step toward improvement.
Raw data is only the start of our journey. Without knowledge and guidance to interpret that data, it’s impossible to make improvements. This is where the process piece comes in. VAN promotes the idea of collecting only those pieces of data (indicators) which you can easily analyze and act on to achieve positive results. VAN guides us to have clear thresholds for action when looking at these indicators. If indicator X is below threshold Y, do action Z. The visibility that technology provides, combined with processes that inform action gets us much closer to our goal of an improved supply chain and brings us to our most important component – people.
Imagine if your doctor was also your pharmacist and the clinic office manager to boot. This is the reality for many health workers in the developing world. Not only do they see patients and document cases, but they are often responsible for dispensing and ordering medicines. Given the pressing nature of patient care it is no surprise that logistical work is often the lowest priority for these professionals. The VAN framework encourages us to recognize logistics not as a secondary concern of health workers, but rather the primary concern of logisticians. VAN promotes the professionalization of a core group of logisticians armed with the data and processes to take responsibility for the health of their supply chain.
VAN encourages a more holistic approach to supply chain improvements. By implementing software tools that provide access to crucial data, defining indicators and clear management actions based on the values for those indicators, as well as creating a cadre of professionals responsible for improving the supply chain. VAN represents a new, data-driven approach to supply chain improvement, and I am excited to play a role, helping to drive this innovation forward.