Procuring medicines is not enough to make them available to the last mile. When functioning and fully funded public health supply chains are in place, the population, especially the most vulnerable, will receive the medicines when and where they need them.
When we first started this work (in Ethiopia) about seven years ago, when customers came to a warehouse in search of their medicines, the pharmacist had to run down to the warehouse to check if they had an item (it took too long to find the stock card). Now they can access the data the same way as my Walgreens pharmacist can. And they can look to see if the stock is available at any of the other warehouses (even if the nearest location might be a day away).
Like many Eastern European countries in the early 1990s, Romania had a history of low contraception use and a high rate of abortion. Starting in 1999, progress accelerated dramatically thanks to a number of critical and complementary interventions; a national health insurance scheme, the privatization of health providers, extensive policy change, training to enable more providers to offer family planning services, and a heavy focus on rural access.
We need to look at whether people have the right mix of incentives to avoid unhealthy lifestyle choices, and to access preventive health, such as vaccinating their children, using contraceptives for birth spacing or to avoid pregnancy, using condoms for disease prevention, and sleeping under bed nets in malarial zones. But just as importantly, we need to ensure that health care providers, both individual and institutional, have the right alignment of incentives to deliver high quality, affordable health services and pharmaceuticals.
Do we have anything to learn from the Cola supply chain? Certainly. Governments and others working to distribute health commodities can learn a lot from the private sector, which excels at finding innovative ways to reduce cost, improve efficiencies, plan effectively, create incentives, and motivate people.
Providing and maintaining continuous access to health products for the most difficult-to-reach populations necessitates the development of agile supply chains that rely on a multiplicity of partners and strategies to improve service delivery.
It’s been a couple hundred years since Dr. Snow plotted cholera deaths on a simple map; one of the earliest examples of data visualization and epidemiology. But using maps, geo-spatial data and geographic information system data is trendier than ever. Think: satellites, drones, smart phones. These powerful technologies offer billions of pixels worth of data that many industries have only just tapped into as a resource.
Since 2006, the USAID | DELIVER PROJECT, implemented by JSI, has worked in coordination with governments and international and local partners in over 72 countries to achieve universal access to family planning by strengthening health commodity supply chains and the policy environments that support them. In each country, we have had an impact. Over the life of the project, commodities shipped by the project have averted an estimated 79.4 million unwanted pregnancies, prevented more than 200,000 maternal deaths, and averted more than 1.2 million child deaths.
We work with clients and countries around the globe to deploy innovative user-centered logistics management information systems (LMIS) and other tools that help people make better decisions and take effective action. We have learned a lot from these experiences, such as: What makes a system implementation successful? Once data is available, how can it be used to make decisions and improve performance? What other HIS solutions and processes are linked to these digital LMIS? We will be sharing stories and lessons learned specifically from Zambia, Tanzania and Ethiopia through our Digital LMIS Innovations Blog Series.
I am passionate about the innovation that I represented at this forum, but it is very different to these innovations of “things”. Our proposal, partnering with Dimagi, is to replicate an approach JSI implemented and scaled with the Ministry of Health in Malawi and take those lessons to Kenya. While our approach does include innovative use of technology, a simple mHealth supply chain management tool for community health workers, this approach also includes IMPACT teams.