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Thoughts from the Last Mile Welcome to the VillageReach Blog

Category Archives: Malawi

03.25 2021

A drone flies across remote communities in Malawi. | Photo Credit: Swoop Aero

 

Today, VillageReach and Focusing Philanthropy launched a campaign to raise $2 million. The Drones for Health Deliver campaign aims to increase equitable access to health products and diagnostics for 700,000 people in hard-to-reach areas in Malawi and Mozambique via drone technology.

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03.16 2021

The Honorable Khumbize Kandodo Chiponda MP (second from right), Minister of Health, visits Chileka health center during a PPE donation ceremony.

 

Last year, Malawi received a much-needed shipment of PPE from China. PPE was an obscure acronym for many people prior to COVID-19. Today, these are products for which health workers are desperate. Miraculously, on March 25, 2020 Malawi received a shipment of PPE from the Chinese government. Surgical face masks, surgical gloves, infrared thermometers, medical goggles, boot covers and more were received to meet health workers’ most immediate needs in the country.

Global shortages, international transport challenges, customs clearance and other issues made getting PPE into Malawi a tremendous achievement. But getting PPE in country is only half the battle. A mask sitting in a warehouse is worse than having no mask at all.

As part of the USAID-funded Organized Network of Services for Everyone’s (ONSE) Health Activity, and under the Ministry of Health and Population’s (MoHP) guidance, VillageReach snapped into action. We had to overcome storage limitations, budget constraints and distribution hurdles — and swiftly.  Thanks to 12 years working at the last mile in Malawi, these are the moments we were made for.

We used relationships with government leaders country-wide and knowledge of supply chains at last mile to plan and orchestrate a 10-day distribution in three days.  Within hours we had a plan, within two days trucks were being loaded. My colleague and I traveled over 700 miles with about four hours of sleep over a 48-hour period. We would like to share three pieces of advice.  The first and perhaps most critical, is for anyone thinking of donating equipment in low-resource settings like Malawi.  

Pair your work on logistics with an in-country expert.  While these PPE donations are more than welcome, we urge you to understand the downstream impact. Unlike products procured through usual channels, donations are typically accompanied by little to no consideration for how the donated supplies will make it to end users. The assumption is that getting supplies into a country translates to a fully executed delivery – that is, delivery to the exact place they are needed for use. That’s far from true, especially in resource-constrained settings, where infrastructure and resources to distribute products may not be available.

Be prepared to act quickly. Immediate delivery was essential, both because health workers needed the equipment urgently, and because storage space is finite. Keeping the donated products in central storage, where they would be protected from theft, would have limited the government’s ability to receive and store new shipments it was expecting. To deliver efficiently, we came up with a delivery schedule in a very short amount of time based on a distribution plan the government provided. We prioritized delivering to areas with cases first, and we drove through the night to make sure those places had their PPE first thing the next morning.

Allow for flexibility. All of this required mobilizing people to actually pack and deliver the PPE. This required us to be flexible with people, budgets and time. Our VillageReach staff had to change their scopes of work to provide sufficient manpower to move supplies in a short lead time. Flexibility – both within organizations and from funders – to re-purpose or quickly hire sufficient staff is an important part of the ability to rapidly respond to situations like this one.

Malawi’s COVID-19 Response Team, of which VillageReach is a member, is essential for facilitating responses. The response team supports critical measures by the MoHP to lessen the devastating impact of the pandemic in Malawi. It is through this platform that stakeholders jointly reflect on emerging challenges and identify how their competence and assets can be used to address the challenges.

As the head of Pharmaceuticals in the Health Technical Support Services Directorate, Godfrey Kadewere, said the week of the delivery, “We need to get word out to the secretary and minister that we have supplies flowing to health facilities, this is an exciting development in the face of what looks like an insurmountable challenge.”

In districts like Blantyre, and in most of Malawi’s public hospitals, health personnel were putting on a brave face considering the risks posed by the virus. Distributing this PPE to 25 districts plus central hospitals was an incredible feat. But we’re not done yet – additional efforts are underway by Last Mile Health and others to make sure that we can quantify and procure PPE for the country’s CHWs as well. PPE can mean life or death to a health worker. Our job is making sure that this essential equipment brings life.

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06.03 2019

Many youth in Malawi are told that contraceptives are only for married adults. Yet so many of Malawi’s young people have expressed an unmet need. There are also unique experiences, preferences and challenges that adolescent girls and boys face in understanding, accessing and using contraceptives in Malawi. VillageReach worked with young researchers to tap into real insights that advance the development of sexual and reproductive health services and products tailored specifically for young people.

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05.16 2019

“A reason, a season or a lifetime” is a saying that I can appreciate, and with the transition of the Kwitanda Community Health Project (KCHP) to Maikhanda Trust it was a season for VillageReach. In 2008, VillageReach began its journey, alongside the JBJ Foundation, to support the Ministry of Health and Population (MoHP) to achieve better results for maternal and child health in the Kwitanda community of Balaka district in Malawi.

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03.31 2019

I’ve been fortunate to work with pioneering government leaders across sub-Saharan Africa, people who are leading their countries to identify and introduce solutions for pressing health challenges. There are many reasons that some new ideas take off while others fizzle.  But when it comes to reaching remote populations, Malawi didn’t let complexity get in the way.  Instead, the government chose to figure out some of the practical details.  

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12.20 2018

A Success Story

Kelliter Chizinga conducting her pharmacy practicum training. Photo Credit: Hope Ngwira

Pharmaceutical management is something that Kelliter Chizinga had always wanted to study and pursue as a career.  In November 2016, Chizinga’s passion for being of service to the community motivated her to enroll at the Malawi College of Health Sciences in Lilongwe in a two-year pharmacy assistant certificate program that aimed to train and deploy 650 pharmacy assistants across Malawi by 2020.

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06.19 2018

Benat Kalebe is a pharmacy technician at Ntchisi District Hospital, Malawi.

On any given day, you may find Benat Kalebe organizing his storeroom or dispensing medicines at the Ntchisi District Hospital. He may be working in the hospital’s different wards, providing support for the nurses and doctors while keeping a close eye on the stock levels of the medicines they use. But Benat is more than the hospital’s pharmacy technician. He is a conduit for life-saving medicines for 16 health facilities throughout Ntchisi District in Malawi.

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06.01 2018

Laiford at work in Mbang’ombe 1 Health Center drugstore

Mbang’ombe 1 Health Center is in the back yard of Lilongwe International Airport. In terms of access to quality health services however, the facility might as well be far from Lilongwe. At approximately 50 km from the Lilongwe District Health Office and Central Medical Stores, the facility serves a rural community. It has one clinician, four nurses, 11 Health Surveillance Assistants (HSAs) and several support staff who serve over 5,000 households, a total population of 24,762 people. The facility has never had pharmacy personnel.

Laiford Nandolo is one of the two HSAs that help manage the drugstore in the absence of a trained Pharmacy Assistant. Although Laiford has over 10 years of experience as a health worker, most of his drugstore clerk experience has been on the job without formal training, except a one-day training he received back in 2014.

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03.27 2018

Reposted from Skoll Perspectives

Izizi ndi Zathu Zomwe. This is ours. That’s the name my team of adolescent researchers has given a groundbreaking public health initiative—a close study of their peers’ needs, behaviors, and preferences related to contraceptives. That name signals the importance of the qualitative, context-specific information required to succeed in such an initiative—proximity is necessary to develop the new approaches that will improve healthcare access for all. The data from this study will assist product manufacturers and policy stakeholders to address the unique and specific contraceptive needs of young people.

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11.30 2017

Vaccines are stored in refrigerators and other cold chain equipment in order to maintain proper temperature. Photo Credit: Paul Joseph Brown

Vaccines are extremely sensitive to temperature. They must remain between 2 and 8 degrees Celsius in order to remain viable. Outside of this temperature range, vaccines become less effective at preventing diseases. Because of this, the storage and handling of vaccines need careful attention. The equipment and devices used to ensure vaccines stay in the right temperature range are known as the “cold chain.” When vaccines are transported, stored in a refrigerator, or used in an immunization session, the cold chain keeps the temperature right. Significant investments have been made in updating cold chain equipment in many countries, but overall performance remains a significant concern.

With our new partner Bull City Learning, VillageReach is strengthening the vaccine cold chain in Malawi. Using human-centered design principles, we are creating an easy-to-use, interactive, digital manual on refrigerator maintenance and repair. By providing this tool for cold chain technicians, we hope to improve routine maintenance of essential equipment used to keep vaccines at the right temperatures.

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