Since COVID-19 started, most basic services were hugely affected. With the growing pressure over the health sector, governments and partners had to put in place innovative solutions to reduce disruptions of service delivery and minimize the suffering of people.
VillageReach has been working with the government of Mozambique to implement the Last Mile Supply Chain (LMSC) program since 2018, an efficient model for medicines and vaccines distribution, in partnership with private sector companies.
When the first case of COVID-19 was reported in Mozambique in March 2020, LMSC covered three provinces of the country. With the emergence pandemic, the roles and responsibilities of health authorities, from central to district level, private sector and local partners became central to counter the spread of COVID-19, while ensuring that people continue to have access to the medicines they need for treatment.
With that in mind, the Ministry of Health (though the Central Medical Stores — CMAM), VillageReach and the United States Agency for International Development (USAID) pressed forward on their ambitious journey to expand LMSC program to more provinces. From three provinces in early 2020, LMSC is now covering nine of the 11 provinces of the country — Zambézia, Nampula, Inhambane, Tete, Sofala, Manica, Cabo Delgado, Gaza, Maputo province, delivering essential medicines and vaccines to more than 1,100 health centres where the majority of Mozambicans access healthcare.
Aníbal Mudumela, the EPI Manager in Inhambane province, was a key partner in introducing LMSC model in his province. For him, the strong leadership and commitment from CMAM, the buy-in of the model by provincial health authorities, and the full collaboration by district governments are some key factors that led to successful integration of outsourced distributions in a very short period of time.
Based on integrated, outsourced distribution model, introducing LMSC required a rapid shift in the working practices and culture of the main actors at provincial level. Healthcare workers were no longer going to spend time on managing the logistics of vehicles, loading, unloading and distributing medicines, as private companies, with the leadership of warehouse staff, are now responsible for these tasks.
“Of course there are some challenges along the way, particularly related to the adoption of the data visibility technology for vaccines (SELV) as well as harmonizing the distribution cycles of vaccines and medicines, but with our will and commitment, we help each other to overcome these challenges because the gains of this model surpass the challenges”, stated Inácio Mbalate, EPI provincial Director in Nampula.
Even with the constraints posed by COVID-19, LMSC was able to ensure uninterrupted deliveries of essential medicines and vaccines to health facilities. In addition, LMSC was able to seamlessly integrate the transport of personal protective equipment in the routing routine distribution cycle, ensuring that workers on the front line could safely provide basic essential health services at the health facility where most Mozambicans access care.