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Pharmacy Assistant Training Program Overview

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.

Increasing Access to Health Products in the DRC

September 27, 2018
Increasing Access to Health Products in the DRC

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.

News from the Last Mile

May 23, 2018
News from the Last Mile

VillageReach Newsletter from May 2018

Who is preparing the next generation of immunization supply chain professionals?

“Countries can no longer rely on a handful of appropriately trained individuals to distribute vaccines worth tens of millions of dollars. Any improvement to vaccine delivery will require a substantial increase in the number, training, and retention of logistics staff.”

Root cause analysis underscores the importance of understanding, addressing, and communicating cold chain equipment failures to improve equipment performance

Vaccine cold chain equipment (CCE) in developing countries is often exposed to harsh environmental conditions, such as extreme temperatures and humidity, and is subject to many additional challenges, including intermittent power supply, insufficient maintenance capacity, and a scarcity of replacement parts. Together, these challenges lead to high failure rates for refrigerators, potentially damaging vaccines and adversely affecting immunization coverage. Providing a sustainable solution for improving CCE performance requires an understanding of the root causes of failure.

Project teams conducted small-scale studies to determine the root causes of CCE failure in selected locations in Uganda and Mozambique. The evaluations covered 59 failed refrigerators and freezers in Uganda and 27 refrigerators in Mozambique. In Uganda, the vast majority of failures were due to a cooling unit fault in one widely used refrigerator model. In Mozambique, 11 of the 27 problems were attributable to solar refrigerators with batteries that were unable to hold a charge, and another eight problems were associated with a need to adjust thermostat settings.

The studies showed that tracking and evaluation of equipment performance and failure can yield important, actionable information for a range of stakeholders, including local CCE technicians, the ministry of health, equipment manufacturers, and international partners such as the United Nations Children’s Fund, World Health Organization, and Gavi, the Vaccine Alliance. Collaborative efforts to systematically collect and communicate data on CCE performance and causes of failure will help to improve the efficiency and reach of immunization programs in low- and middle-income countries.

Improving iSC performance through outsourcing – Considerations for using third-party service providers to increase innovation, capacity and efficiency

Development partners and donors have encouraged and incentivized governments in developing countries to explore ways of working with third-party service suppliers to reduce costs and increase service delivery capacity. The distribution of vaccines and medicines has for a long time shown demand for outsourcing but public health systems have struggled to develop the expertise and capital assets necessary to manage such ventures.

Existing transport and logistics capacity within public health systems, in particular, is well documented as being insufficient to support existing, let alone future immunization needs. Today, a number of countries are contracting party logistics providers (3PLs) to supplement the in-house distribution operations of public health systems. This commentary reflects on recent, leading examples of outsourcing initiatives to address critical gaps in transport and logistics.

System redesign of the immunization supply chain: Experiences from Benin and Mozambique

Evidence suggests that immunization supply chains are becoming outdated and unable to deliver needed vaccines due to growing populations and new vaccine introductions. Redesigning a supply chain could result in meeting current demands.
The Ministries of Health in Benin in Mozambique recognized known barriers to the immunization supply chain and undertook a system redesign to address those barriers. Changes were made to introduce an informed push system while consolidating storage points, introducing transport loops, and increasing human resource capacity for distribution. Evaluations were completed in each country.

Evaluation in each country indicated improved performance of the supply chain. The Effective Vaccine Management (EVM) assessment in Benin documented notable improvements in the distribution criteria of the tool, increasing from 40% to 100% at the district level. In Mozambique, results showed reduced stockouts at health facility level from 79% at baseline to less than 1% at endline. Coverage rates of DTP3 also increased from 68.9% to 92.8%.

Benin and Mozambique are undertaking system redesign in order to respond to constraints identified in the vaccine supply chain. Results and learnings show improvements in supply chain performance and make a strong case for system redesign. These countries demonstrate the feasibility of system redesign for other countries considering how to address outdated supply chains.

The potential of next-generation supply chains to ease DRC’s “Casse-tête”

Looking at the challenges of vaccine delivery in the DRC today and why a new or “next-generation” immunization supply chain is needed, what it might look like, and its potential benefits.

News from the Last Mile

February 19, 2018
News from the Last Mile (February 2018)

VillageReach Newsletter from February 2018

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