Outsourcing can provide governments with access to efficient, reliable services that leverage the private sector’s know-how and existing assets. Partly due to the COVID-19 response, there is an increasing focus on using private sector logistics firms for in-country public health logistics operations, mostly for warehousing and transportation. In addition to competition, using multiple suppliers, through a multi-supplier strategy, can have major benefits.
Through the years, VillageReach has brokered public-private partnerships successfully, and it believes that the global health sector is just scratching the surface of possibilities. To promote this model, this briefing was produced to share learnings on the important topic of multi-supplier strategy based on VillageReach work introducing private sector capacity into public health supply chains.
A história da VillageReach começou em Moçambique há mais de 20 anos, onde começámos a trabalhar para fortalecer cadeias de abastecimento e levar produtos de saúde às pessoas. Hoje, a nossa abordagem de concepção de cadeias de abastecimento, em colaboração com o Ministério da Saúde (MISAU), contribuiu para o aumentou da vacinação em crianças e ajudou a garantir a disponibilidade de medicamentos para as comunidades em zonas de difícil acesso.
VillageReach’s story began in Mozambique over 20 years ago, where we started work to strengthen supply chains and get products to people. Today, our supply chain design approach, in collaboration with the Ministério da Saúde de Moçambique (MISAU), has increased childhood vaccinations and helped ensure health products are available to under-reached communities.
Functioning cold chain equipment (CCE) for vaccine storage is an essential component of an end-to-end cold chain. A three-part process was developed to identify priority areas for CCE deployment and thus reduce inequities in immunization coverage. This approach involves analysing the relationship between available cold chain storage capacity, the required cold chain capacity to immunize target populations and current programme performance (such as coverage and equity). Read the report.
This paper describes four challenges to last mile supply chain financing and draws from our collective experience supporting last mile supply chains, primarily in sub-Saharan Africa:
1. Delayed or inefficient fund disbursement prevents timely health product distribution;
2. Inefficient use of available funds constrains their impact;
3. Insufficient financing for last mile supply chain operations impedes activities; and
4. Actual supply chain costs are unknown.
Uma ferramenta interactiva para navegar rumo às soluções próprias do governo que têm impacto sustentável em escala. Veja aqui: https://www.villagereach.org/wp-content/uploads/2021/02/SpringImpact-JourneyToScale-portuguese.pdf
Um aumento do número e variedade de medicamentos em Moçambique significa um maior acesso aos produtos de saúde necessários para muitos moçambicanos. No entanto, volumes maiores, custos mais elevados e a extensão dos cuidados de saúde a mais comunidades podem sobrecarregar até as cadeias de abastecimento mais sofisticadas. O Ministério da Saúde de Moçambique (MISAU) começou a implementar um plano denominado Plano Estratégico de Logística Farmacêutica (PELF) para ajudar a enfrentar estes desafios. O PELF concede direitos à Central de Medicamentos e Artigos Médicos (CMAM) a integrar plenamente a cadeia de abastecimento com o objectivo de melhorar a distribuição de todos os produtos de saúde em todo o país.
VillageReach has partnered with stakeholders at local, regional and
global levels since 2015 to explore the use of unmanned aircraft systems
(UAS) for health. UAS, also referred to as unmanned aerial vehicles
(UAVs), or drones, are being evaluated for integration into health systems
alongside traditional land- and water-based modes of transportation.
Drones have the potential to improve the availability of health products,
increase equity of access, and save time and money compared to ground
transportation particularly in geographically challenging areas.
Uma vez comprovado o impacto de uma solução, a nossa abordagem é a transição da sua gestão e/ou operação para o governo. Acreditamos que esta
abordagem oferece maior probabilidade de uma solução alcançar um impacto duradouro à escala.
Notre démarche consiste à transférer au gouvernement, la gestion et les opérations de toute solution ayant fait ses preuves. Cette approche permet, d’assurer la pérennité et l’impact à grande échelle d’une solution.
A surge in the number and variety of medicines in Mozambique means greater access to needed health products for many Mozambicans. Yet larger volumes, higher costs and extending health care into more communities can tax even the most sophisticated supply chains. Mozambique’s Ministry of Health (Ministério da Saúde or MISAU in Portuguese) began implementing a plan called Plano Estratégico de Logística Farmacêutica1 (PELF) to help address these challenges.
Benefits of integration include optimizing the use of resources, maximizing transport and storage utilization, leveraging cost savings and decreasing health worker time on logistics.
The Liberia Ministry of Health’s National Eye Health Department is rolling out vision screening and dispensing of eye glasses within the community health system in 2020 in partnership with EYElliance, a coalition increasing access to eyeglasses. VillageReach is working with these partners to integrate eyeglasses into the community health supply chain to allow for vision screening and dispensing of eye glasses to be provided by Community Health Assistants in Liberia.
OpenLMIS is a powerful, open source, electronic logistics management information system (LMIS) purpose-built to manage health commodity supply chains. OpenLMIS offers a host of features that are all interlinked to provide seamless data exchange and optimize data visibility and analytics. All of the features can be used in conjunction with each other or there is an option to de-activate any features that are not relevant.
VillageReach launched a landscape analysis in 2019 to identify EIR implementations in Low and Middle Income countries (LMICs) and identify lessons in sustainability, implementation planning, functional requirements and improving equity. This research, begun in spring 2019, was part of planning for the implementation of an Electronic Immunization Registry (EIR) in Mozambique to increase vaccination coverage and equity, improve data quality and resiliency, and address health care worker data burden. The findings have influenced our approach to this work and are presented as a means of sharing these insights more broadly.
A4 size. In its efforts to provide quality health services to its citizens, the Government of Mozambique and USAID have partnered with VillageReach to design and implement a streamlined and effective last mile supply chain system. This piece is an overview of the Last Mile Supply Chain (LMSC) program.
Once we prove a solution’s impact, our approach is to transition its management and/or operation to the government. We believe that this approach provides the greatest chance for a solution to achieve sustained impact at scale. VillageReach launched an initiative called Transitioning Well in 2019 to guide our approach and engage stakeholders in transitioning solutions.
This lays out the process for creating a tool in partnership between the Liberia Ministry of Health, VillageReach and Last Mile Health to determine PPE needs related to COVID-19. We are sharing in case it may assist others with the forecasting and quantification process. You can access the tool here.
This tool was developed in partnership between the Liberia Ministry of Health, VillageReach and Last Mile Health to determine PPE needs related to COVID-19. It is being updated as needs and country context changes. We are sharing in case it may assist others with the forecasting and quantification process. Please reference a summary of this process at www.villagereach.org/arming-community-health-workers-for-battle/.
Too often, vaccines and other essential health products are not available when and where they are needed, particularly in under-served populations. VillageReach has developed a four-step guide for governments and implementing partners to purposefully consider equity in supply chain design, with a particular focus on reaching four populations: the urban poor, people living in conflict settings, remote or rural populations and migrants.
Ensuring that health products are available and accessible for everyone is a critical part of primary health care, and essential to achieving universal health coverage.However, high quality health products are not always available when needed, particularly in under-served populations: urban poor, remote or rural communities, migrants and people impacted by conflict. Supply chains can be adapted to be responsive to people’s needs and preferences. VillageReach developed a four-step guide for governments and implementing partners to purposefully consider equity in supply chain design.
Over the past 20 years, VillageReach has worked with governments to design and implement supply chains that reduce costs and improve product availability without the need for major infrastructure investments. VillageReach has identified five promising design options that address common supply chain challenges, even for the hardest-to-reach communities. Our experience shows that health and EPI programs can implement one or more of these options, tailored to the country context.
The Malawi Ministry of Health and Population (MoHP) and VillageReach developed Chipatala cha pa Foni (CCPF) – “Health Center by Phone” – as a community-based hotline in the Balaka district of Malawi. This summary shares the findings of a 2018 impact evaluation of the program.
A summary of interviews with nearly 40 stakeholders that explores practical challenges to government adoption of solutions where sustained impact at scale
requires government ownership, management or operation and gathers input on forming a collaborative network to address these challenges.
In Côte d’Ivoire, a public-private partnership called M-Vaccin
planned to use mobile technology to improve vaccine coverage in 50
health districts across the country. The French telecommunications
company Orange, in collaboration with Gavi, the Ministry of Health
and VillageReach, customized an application that uses text and voice
messaging to inform caregivers about the importance of vaccination
and send appointment reminders in local languages.
VillageReach, in collaboration with the William Davidson Institute at the University of Michigan (WDI), has worked to develop a highly configurable Excel-based tool that assists governments in low and middle-income countries (LMICs) to conduct low-cost, agile cost modeling exercises. With support from the Reproductive Health Supplies Coalition, Gavi, the Vaccine Alliance and the Bill and Melinda Gates Foundation, VillageReach and WDI have worked together to develop, test and socialize this rapid and flexible cost modeling instrument.
VillageReach partnered with the Mozambique Ministry of Health (MISAU), and technology provider Logistimo to develop an innovative ridesharing program for lab samples called SampleTaxi. Like Uber has revolutionized ridesharing for passengers, SampleTaxi is helping increase the efficiency and speed of medical specimen delivery in Sofala province, Mozambique, without adding new vehicles to the system.
The Malawi Ministry of Health and Population and VillageReach developed Health Center by Phone as a community-based hotline in the Balaka district of Malawi. Health Center by Phone extends the reach of the health care system to every community by providing access to certified health and nutrition information and services via a toll-free number.
The Pharmacy Assistant (PA) Training Program in Malawi is contributing to a robust pharmaceutical workforce through the introduction of a two-year certificate-level training program focused on improving medicines management and pharmaceutical practice in health centers.
This document focuses on creating a more efficient, effective and resilient supply chain with the Next Generation Supply Chain Initiative in the Democratic Republic of Congo. It summarizes the five pillars of transformation, the benefits to the health system, and considerations for scaling or adapting the initiative within and beyond Equateur Province.
VillageReach works with governments to solve health care
delivery challenges in low-resource communities. Our
programs increase access to quality health care at the last
mile, or the point at which services are delivered.