Thoughts from the Last Mile Welcome to the VillageReach Blog

Tag Archives: Innovation

04.28 2015

For the last fifteen years, VillageReach has been working to help ensure all children have access to vaccines. I have had the opportunity to spend time in rural health facilities across sub-Saharan Africa, talk with hundreds of healthcare workers, and meet with numerous leaders of health ministries. Through our daily interactions with health workers and government partners, I’ve seen first-hand the challenges to achieving immunization equity, especially as new vaccines are being added to already strained systems.

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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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10.07 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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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  When that purchase becomes outdated, worn out or just doesn’t fit anymore, this process can be repeated.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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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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03.31 2014

By CLIFFORD KANONO
VillageReach Pharmacy Assistants Program Student– Class of 2015

IMG_2681My name is Clifford Kanono.  I am enrolled in VillageReach’s Pharmacy Assistant Training Programme. Previously, I worked as a Health Surveillance Assistant in the rural communities of Nkhata Bay District in the Northern part of Malawi. The health facility I worked in had to serve about 14,500 people in a year—a large number given the resources of the facility.  This, like most other health facilities in rural communities face many challenges, but one of the most problematic is the adverse effects of non-trained pharmacy personnel:

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07.19 2012

We recently sent out this latest update … here’s our news in case you missed it …

Malawi

  • update on our work to improve maternal and newborn health in Kwitanda
  • the latest on our Chipatala Cha Pa Foni (health center by phone) program, part of the Innovations for Maternal, Newborn and Child Health initiative
  • Mozambique

  • new update to our Mozambique Dedicated Logistics System (DLS) program
  • collaboration with the William Davidson Institute (University of Michigan) Supply chain & logistics study: new research to quantify the logistics challenges for a variety of medical commodities
  • Dr. Seth Berkley, President of the Global Alliance for Vaccines and Immunization (GAVI) visited the DLS program
  • Technology Initiatives

  • ODK Scan: update on our collaboration with the University of Washington’s Computer Science & Engineering to improve the quality of data collection
  • OpenLMIS: new website with updated details on activities and partners
  • Social Enterprise

  • VidaGas: our collaboration with the ghdLABs program at MIT, to evaluate the marketplace for our social enterprise in Mozambique
  • New Additions to Our Team

    Malawi:

  • George Chinkwita – Project Officer, Kwitanada Economic Development Initiative
  • Erin Larsen-Cooper – Program Associate
  • Mozambique:

  • Antonio Gaspar Tomboloco – Field Officer, Niassa Province
  • See here for details …

    Updated Financial Report

  • our recently posted 2011 independent financial audit
  • We welcome your questions and comments,

    Allen Wilcox
    President

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    05.25 2012

    Rapid Diagnostic Test (RDT) Data and Distribution Systems.

    As a partner in Mozambique’s health system, VillageReach is undertaking a study about the shortage of RDTs in the rural health centres. This is the second in a series of updates we expect to provide on the work – see the first post here. The study will conclude this fall.
    The study involves gathering and analyzing data that health workers collect as they provide testing services, and using that data to analyze consumption as it informs the test distribution. Data about the use of RDTs is critical to operating a well-functioning supply chain and ensuring that health centers have the right tests at the right time. This data allows planners in the health system to purchase the right quantity of tests and distribute them throughout the health system while minimizing wastage and expiry.
    Until now, the national health system in Mozambique has not distributed standardized forms for collecting this data. However, the lower levels in the government recognized the need and value of the data and implemented their own systems. In the first visit made by the study team in January this year, it was found that the data collected was of very poor quality, due to lack of standardized instruments or forms to use for recording data and a lack of training for the health workers. The forms used to collect the data were undergoing numerous changes, which complicates the process of data collection at the service delivery point.
    Tim2
    The system for distributing tests and collecting data about tests was designed with the following flow: the RDTs are amassed at a provincial medical store, redistributed to district storage facilities, and then transported to rural health centers. The image on the left represents the ideal.
    Last week we visited again and found that key improvements had taken place in the last four months.
    1. Systems and processes are in place to collect data about the use of tests. These are being used properly and routinely. This is no small feat in a country so vast and full of infrastructure challenges that can limit access to the health centers.
    2. The Logistics Management Information System is installed and in use at the district level. That is a major accomplishment, and one that will improve the distribution and supply of medicines throughout the country.
    But this visit revealed another fundamental observation. Despite improvements over the recording and availability of data about test consumption, there continues to be shortages and stock outs of tests in the health centers. Specifically, I observed situations where there were too few RDTs and a number of them had expired before being used. If the data is there to make the system work, then what is happening?
    For many cases, we discovered the question can be answered by the following factors:
    • A lack of vehicles for transport limits regular distribution of RDTs and medicines to health centers;
    • Where there are vehicles available for transport, there is often a lack of fuel;
    • Where there are vehicles and fuel, there is a chronic lack of allowances for personnel to carry out the distribution of medicines.
    These factors greatly influence the availability of RDTs at the health center level. With delays in distribution, RDTs may expire before they are used, ultimately reducing the quality of service at the health centers. Tim1
    All this ultimately results in poor distribution system of RDTs used in the province and a higher cost of distribution. In addition, the lack of regular distributions results in incomplete and inaccurate data about the health centers being reported back to administration levels within the health system. This image on the right represents what we see in reality.
    These factors, all too common occurrences for health systems with limited resources, highlight the importance of improving the quality and capacity of the underlying infrastructure the health centers depend on in order to support so many remote communities.

    Timóteo Eduardo Chaluco, Monitoring & Evaluation Officer

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    08.13 2009

    The Rockefeller Foundation and Results for Development Institute just released their report that offers a landscape view of successful global healthcare financing and delivery models involving the private sector.  VillageReach’s model is recognized as an innovative model in supply chain management.    While the identified models span a wide variety of services and strategies, it is exciting to see a growing embrace of the role of the private sector in improving public health.  When VillageReach began in 2001, it often felt like there was mutual distrust between the public health and development professionals and the private sector entrepreneurs.  Reports like this are a nice reminder of how much and how quickly things have changed.

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    Malawi healthcare worker