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Category Archives: Supply Chain

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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05.23 2014

Reposted from the Bill and Melinda Gates Foundation BlogImpatient Optimists 5.6.2014

As a Technical Officer with VillageReach, I am responsible for working with our partners at the provincial health department and in the health centers to support new cold chain monitoring technology.  In this role, and in my experience visiting rural health centers, I see firsthand the many challenges that exist in infrastructure, issues that greatly impact the cold chain and viability of vaccines. Energy in our communities is unreliable, so often times the refrigerators that store vaccines and other medical commodities lose power for hours or even weeks at a time.  Health workers struggle to balance the time needed to adequately treat patients with their other administrative duties, and fixing a broken refrigerator is not part of their training.   As all of these situations effect the viability of vaccines, they also affect the children who need them.  A better cold chain can save lives. That is why I am excited about the opportunity to observe a simple new technology solution that I think could have great impact in solving these challenges.

While technology has become more and more common in addressing issues of health care in low resource communities, the most effective solutions are usually the most accessible and inexpensive, and ColdTrace is an example of such a technology. ColdTrace is a low cost solution that leverages the power, coverage and availability of mobile telecommunications services in remote/hard to reach areas to improve response time to problems in the Cold Chain Storage System.  ColdTrace is a low-cost cellular phone which has a sensor added to it that can read and monitor temperature. VillageReach is working with Nexleaf to deploy and test ColdTrace devices in 90 health centers in Mozambique starting in May 2014.

How it works: 

New ColdTrace technology developed by Nexleaf provides SMS alerts with real-time information for cold-chain monitoring in Mozambique.

The phone with the built-in temperature sensor is installed in a central position of the fridge that holds the vaccines.  The phone records the temperature at pre-configured intervals. When temperatures go out of the stipulated range, i.e. 2°C – 8°C for a pre-defined period, text messages are sent from the ColdTrace device to clinic staff. If the problem is not resolved within a certain period, escalated messages are sent to the District EPI  (Extended Programme on Immunizations) Officer. If the problem is still not resolved, another escalated SMS is sent to the Provincial EPI Officer. Because this communication all happens so quickly, the time it takes to actually fix the equipment and get it back to operational is much faster than it would typically be.  The SMS sets in motion a communication that is continually managed and repeated in the daily status messages until the problem is resolved. All the data is gathered and processed by ColdTrace and is uploaded to a central server and summaries of these data are sent on a monthly basis to the Ministry of Health.

What are the benefits of ColdTrace to immunization programs?  

Through this initial deployment, we aim to show that ColdTrace:

  • Gives time back to health clinic staff enabling them to focus on their primary job of caring for patients instead of maintenance issues.
  • Decreases the time it takes to identify a problem and coordinate the resources to fix it due to an immediate and ongoing communication that initiates with ColdTrace.
  • Provides the Ministry of Health in Mozambique with critical data needed to evaluate the performance of various clinic response times, as well as different models of refrigerators, helping to improve informed decision-making.

I look forward to seeing the results of ColdTrace in Gaza Province so that VillageReach can share what we have learned about this new technology along with our partner, Nexleaf, and help bring a cost-effective, sustainable solution to more communities in need of cold chain support.

Reposted from the Bill and Melinda Gates Foundation Blog: Impatient Optimists 5.6.2014

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