Thoughts from the Last Mile Welcome to the VillageReach Blog

Category Archives: Notes from the Field

11.16 2016

Having just returned from a visit to Malawi and Mozambique, I had the opportunity to meet with many health workers who contribute to and shape VillageReach’s work at the last mile. Most of them  work in incredibly rural and remote locations, challenged by many of the barriers we talk about most frequently at the last mile – lack of infrastructure, human resources, information, and access to medicines. One of the health workers that made an indelible impression on me was Mackson Khalawako. Mackson joined VillageReach in September 2008 as a Health Surveillance Assistant (HSA). In this role, he serves a population of around 1,000 from two villages: Bakili and Makande. In addition to the health surveillance assistant’s duties facilitating community clinics for vaccinations, growth monitoring and health education, Mackson also helped to implement and continues to run a village clinic for children under 5.

Mackson and his fellow HSA deliver vaccines and dother supplies for the village clinic

Mackson and his fellow HSA deliver vaccines and other supplies for the village clinic

VillageReach supports HSAs as part of the Kwitanda Community Health Project which aims to address healthcare through a community-led and managed approach, supporting health interventions that address the most critical needs of the community. I caught up with Mackson at the Bisani clinic for children under five, held in a small, two-room structure that was built brick-by-brick by the community members last year. Previously, the clinic had been conducted outside under a tree, not uncommon for village clinics in rural communities like Kwitanda. His performance has won the hearts of many people in his catchment area, and it’s easy to see why.

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11.15 2016

OpenLMIS, SELV, iSC. To most people these acronyms don’t mean much. To me, they tell a story of getting vaccines to the most remote communities in Mozambique. Sistema Electronico de Logstica de Vacinas (SELV) is the local name of a software used to record information about where vaccines need to go and how they are going to get there – an implementation of OpenLMIS, a logistics management information system (LMIS). As the Information Systems Officer at VillageReach, it’s my job to provide technical assistance and support for this critical software.  The BETA version of  OpenLMIS 3.0 was launched last week, representing a major milestone in the evolution of software that continues to demonstrate the import and impact of robust information systems at the last mile.

photo-3Over the last few weeks, my colleagues and I traveled to five provinces around Mozambique to talk about SELV. In some provinces like Cabo Delgado, SELV is an established tool. In others like Maputo City, SELV is brand new. VillageReach and the Ministry of Health are just beginning to expand the reach of SELV to all eleven provinces, so this trip provided me an opportunity to meet stakeholders, introduce myself as a resource, and find out how we can better support SELV within the immunization supply chain.

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10.26 2016

dscn0082Today marks my second day of a two-week tour to visit the VillageReach offices in Malawi and Mozambique. My mission? To get a firsthand perspective of the “last mile” and document our work through the words and stories of those who benefit directly from VillageReach programs. Unlike most of our program staff who travel regularly to the field, this is my first time traveling to Africa. I came as prepared as I could, following all the recommendations from the travel clinic, purchasing electric chargers and outlet converters, buying out all of the bug repellent at my local drugstore, and overpacking. But today, all of these preparations and details that I’ve been so focused on for the past few weeks seem insignificant in light of the experiences I’m having — and will continue to have over the next two weeks.

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06.22 2016

In 2014, Africa.com published a list of the 10 jobs that will be the most sought in Africa in the near future. It comes as no surprise that logistics and supply chain management related jobs made it to the list, identifying supply chain managers as a driving force of economic growth in Africa.

Me & Dr Mukengeshayi, SG of DRC

Speaking with Dr. Mukengeshayi Kupa, Secretary General of the Ministry of Health, DRC

After attending the recent Immunization Supply Chain Leadership Conference in Abidjan, I felt that this was also true for the public health sector. The eleven African countries represented were all speaking with one voice: they need the right person at the right place to lead the next generation of immunization supply chains (iSC).

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12.01 2015
Today the world recognizes World Aids Day – a day to unite in the fight against HIV and to support the millions of people around the globe living with HIV.

In conjunction with World Aids Day, Médecins Sans Frontières (MSF) has published a new report – Empty Shelves, Come Back Tomorrow – evaluating the current incidence of HIV for four of the worst HIV-affected countries in sub-Saharan Africa including Mozambique.  In the country, 11% of the adult population is HIV positive, but only 45% of those affected receive the required level of treatment.   As the report notes about Mozambique “… there is no funded regular last mile delivery and stockouts are seen at facility level.”

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08.26 2015

As the VillageReach Field Officer in Gaza province, Mozambique, I work closely with the DPS (Provincial Directorate of Health) and the EPI manager, logistician, and the medical chief to make sure that the vaccine supply chain is performing in the most efficient way and with high quality results.

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08.20 2015

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.

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08.13 2015
Malawi village clinic

VillageReach HSA, Pemphero Katondo leads Jailosi Village clinic

As a Community Health Facilitator for VillageReach in Malawi, I see the impact of Community Case Management (CMM), a strategy that promotes the early care-seeking behavior, assessment, diagnosis, recognition, and appropriate treatment for childhood illnesses at the community-level.

Over the last few years, CCM has evolved into a more comprehensive strategy that addresses the three main diseases that commonly kill young children under 5

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06.26 2015

Olivia Vargas is currently in Mozambique conducting a midline evaluation of the ColdTrace pilot program, a remote temperature monitoring system for vaccines currently operating in the southern portion of the Gaza Province where she recently visited a vaccine warehouse as inspiration for this blog.

Vaccines come with a lot of accessories. They are the friend that shows up with four suitcases for a weekend getaway. The friend that packs for every possible weather scenario, and the friend that takes the longest to get ready to leave the house. I learned this lesson while in the Mozambican province of Gaza. I got a tour of the provincial warehouse where all the vaccines are stored before they are distributed to district health centers and remote health posts.

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Malawi healthcare worker