Thoughts from the Last Mile Welcome to the VillageReach Blog

Category Archives: Supply Chain

11.21 2014

Last week marked the seventh annual Global Health Supply Chain Summit, which brings together academics, supply chain specialists, ministry of health representatives, bi-laterals, and even private sector logisticians each year to check in, explore new ideas, report on studies, and essentially challenge each other to keep improving supply chain management in the countries where we work.

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10.10 2014

I am a clinician by profession, serving a population of over 30, 000 in the 25 villages that my health center serves. I am the only clinician at the health facility with a single nurse to assist covering when possible.  We recently lost the only health surveillance assistant that was trained as a drug clerk as she has left to pursue a one and a half year course in midwifery. This leaves me as the only clinician and also the only person to manage stocks in the medicine store (pharmacy).  I undertake the majority of dispensing responsibilities as the hospital attendants that sometimes need to fill this role are not knowledgeable about medicines. When it’s month end, I am also responsible for doing the physical inventory and producing a monthly report.  Each of these tasks requires time away from my primary responsibility of treating patients. This results in less time with patients, and inadequate reporting of essential information required to manage inventory. For example, I am not sure the reports that I send are even a true representation of the situation on the ground due to the limited time I have to devote to this task.

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10.07 2014
It seems like a stretch—using Legos to find efficiencies in a vaccine supply chain. But that was the concept we worked with last week in Mozambique with representatives from both national and provincial level Ministry of Health, UNICEF, WHO, and VillageReach, led by the HERMES logistics team taking us through the use of the HERMES modeling tool. The HERMES model, which stands for Highly Extensible Resource for Modeling Supply Chains, allows a ministry of health to simulate different scenarios in a vaccine supply chain by changing the different components to find efficiencies.
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08.28 2014

A few weeks back, my colleague Rachel Powers wrote about VillageReach’s customized deployment of an open-source electronic logistics system (OpenLMIS) in Mozambique, where it is referred to as SELV (Sistema Electrónico de Logística de Vacinas). Along with members of our team, she and I have been closely working together in the development, user testing, and launch of SELV in-country. When I facilitated a week-long training in Maputo in June this year, the excitement I felt about SELV and the positive changes it could bring about was reflected in the faces and attitudes of everyone present in the room. The 15 people being trained included a mix of provincial-level vaccine logistics staff who would use the system regularly and central-level government officials in-charge of country-wide vaccine logistics and monitoring and evaluation of newborn and child health statistics.

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08.11 2014

Since beginning my technology associate internship at VillageReach, I’ve learned that strengthening health systems in developing countries requires reliable health information and improved decision-making capacity at all levels. Without real information on who needs what and where things are going it’s impossible to keep health centers supplied with the commodities they need to treat their patients.

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07.29 2014

When VillageReach began work with the Supply and Awareness Technical Reference Team for the UN Commission on Life-Saving Commodities for Women’s and Children’s Health to document promising practices in supply chain management, I was both excited and daunted.  Excited because there is a growing recognition that strengthening supply chains is a fundamental aspect of increasing access to medicines and quality healthcare at the last mile; daunted because while there is so much work being done to improve supply chains in low and middle income countries, documentation and evidence of these interventions can be hard, if not impossible, to find.

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07.17 2014
How HERMES modeling tools allow decision-makers to see the impact of vaccine supply chain system changes- before they “buy.”

You may not think that the world of fashion relates to vaccine supply chains, but let me make the connection. When shopping for that perfect outfit, sweater or shoe- I can go to a store and try on all kinds of options—different sizes, styles, colors, and all combinations therein. And then, with a lot of help from my friends, I can pick the best option for that particular occasion.  When that purchase becomes outdated, worn out or just doesn’t fit anymore, this process can be repeated.

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07.10 2014

BerturBy Bertur Alface
Medical Chief of Gaza Province in Mozambique
Reposted from Impatient Optimists.org

 

Change does not come easily, particularly to systems that have been operating in a specific way for a long time and where many people have a stake in the decision making. But sometimes it becomes clear that change is necessary to improve how things operate.

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06.17 2014

 loveness By LOVENESS KASIYAMPHANJE                                                 Pharmacy Assistants Training Program- Class of 2015                             

My name is Loveness Kasiyamphanje. I am originally from Ntcheu, in the Central Region of Malawi, but I currently live in Namiyango in Blantyre District. I am pursuing a Certificate in Pharmacy Programme at Malawi College of Health Sciences (MCHS), Lilongwe Campus. The programme was created by VillageReach, the Malawi College of Health Sciences (MCHS) and their partners. The Programme is for two years and I am in the first year.

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06.03 2014

wendy-300x200By Wendy Prosser
VillageReach Program Manager
USA and Mozambique

How many times have you seen “other duties as required” on a job description? It infers any random thing that may not fit perfectly into other well-defined responsibilities but still needs to get done, so there is a high likelihood that it may land on your desk to take care of.

In the Mozambique health system, this has become the catchall phrase for health workers. They are tasked with numerous responsibilities including the supply chain function, resulting in a crisis for human resources for health. A maternal and child health nurse, particularly in a rural area, is responsible for providing antenatal care, assisting with deliveries, vaccinating children, managing data for all health clinic activities, and completing requisitions of commodities to keep drug supplies well stocked.

Basically, a nurse in a rural area becomes a Jack of All Trades and a master of none.

Professor Saracino, the former Minister of Health in Côte d’Ivoire, summed it up well:

“When you use a nurse or a physician as a logistician, you lose the nurse or physician and you don’t get a good logistician!”

In this sense, becoming a “Master of ONE” as opposed to “NONE,” is one aspect of the Dedicated Logistics System (DLS), a different approach to supply chain management that VillageReach is developing, through the Final 20 Project supported by the Bill & Melinda Gates Foundation. The DLS has shifted supply chain management responsibilities to the hands of a few dedicated personnel. The DLS moves supply chain management functions as high up in the supply chain as is geographically feasible, consolidating tasks at the provincial level so that limited resources available can be dedicated. This frees up a health worker’s time to focus on patient care.

When I visit Mozambique and accompany a vaccine distribution, I see the benefits of this system firsthand. The dedicated logistician checks records and manages the stock while the nurse cares for the many dozens of children waiting for her. The DLS has reduced lines and waiting times, enabled the health workers to focus adequately on primary care, and dramatically improved the reliability of the supply chain, thus increasing trust in the health system.

We have documented this approach, and the role of human resource management in improving vaccine supply chains in the Reaching the Final 20 Policy Paper Series, available here.

For more information on the DLS, and VillageReach work in Mozambique

About the Author: As Program Manager, Wendy Prosser is responsible for the design, implementation, and monitoring and evaluation of health system program for VillageReach in Mozambique. Efforts in Mozambique seek to streamline vaccine logistics with an improved logistics management information system and transport services. Wendy has over a decade of global health experience in program development and management, research and analysis, capacity building, and behavior change communications. This experience has taken her to Mozambique, Malawi, Angola, Kenya, and South Africa in various public health settings, starting with Peace Corps in Cape Verde. Wendy holds a MPA in International Development and Global Health from the University of Washington.

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