Thoughts from the Last Mile Welcome to the VillageReach Blog
08.08 2016

Beyond “Good Enough”: System Design in Zambia

DSCN3523Immunization supply chains have not changed much since they were first conceived in the 1970’s. Most ad-hoc efforts to improve these systems, like increasing storage or transportation capacity, have not been effective in dealing with modern day demands on these systems. It is estimated that between 2010 and 2020, immunization services will require twice the storage and transport capacity to manage four times the vaccines. With this unprecedented expansion, workers at all levels of the supply chain feel the burden of supply chain inefficiencies. This extra burden, particularly at the service delivery points, results in low vaccine coverage rates at the last mile. Supply chain managers are beginning to challenge the status quo of their supply chains and embrace innovative approaches for improved performance.

VillageReach, along with CIDRZ and the Zambian Expanded Programme on Immunization (EPI), held a workshop last week in Lusaka to take a holistic look at immunization supply chain (iSC) in Zambia. This workshop brought together national EPI programs managers, decision makers and key stakeholders to identify potential options to make the iSC more efficient.

DSCN3585Exploring system design is a necessary part of transformational changes in Zambia. Rather than narrowly focusing on aspects of the supply chain independently from one another, system design is a comprehensive approach that considers the complete end-to-end supply chain, from distribution and inventory policies to information systems and human resources. It creates the blueprint for how a supply chain should run, how the components of the supply chain system fit together and interact. Originally employed in the private sector, system design has proven to be effective in other countries immunization supply chains such as Benin and Mozambique.

Not one person in the room is still driving the same car they were forty years ago, why should we still rely on the same immunization supply chain?

DSCN3669The workshop in Zambia was full of lively discussion, inspiration and new ideas. The participants recognized that the current iSC is not sufficient, and were committed to finding ways to improve its performance. Participants were not looking for solutions that are “good enough” for the moment, but had a longer-term vision for impact, improvements, and building on EPI management capacity.

This workshop provided a space to try out “crazy ideas.” Discussions about new approaches considered too risky to try in practice allowed stakeholders at different levels to engage in conversation about why these ideas might just work. By identifying the strengths of these bold ideas, workshop participants began to understand how transformational change could impact the national iSC.

The people who eat the same salt don’t quarrel with each other.

Collaboration and integration are key to any system design activity, as the participants highlighted at the workshop. “Smart” integration – finding ways to include vaccines in existing supply chains without diminishing performance – would mean bringing partners together from diverse sectors to find points of collaboration that would be beneficial for everyone.

This workshop was a starting point in an ongoing process of identifying areas of opportunity, trying innovative approaches, and evaluating the impact on the immunization supply chain in Zambia. This group of energetic, dedicated and driven leaders are now using new tools and ideas to create concrete steps for moving their iSC forward.

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