SUPPLY CHAIN
Challenge
Childhood vaccination, a necessary
and thankfully common event in the industrialized world, is often an
unaffordable and unavailable luxury in the developing world, where a
child is ten times more likely to die from a vaccine-preventable
disease than their peers in industrialized countries. Often times, the
problem is as basic as the inability to move life-saving vaccines from
urban centers to the rural areas- home to roughly half of the
population of Mozambique, and 70% of the population of the Cabo
Delgado province. It is here, where infrastructure such as roads and
reliable energy are never guaranteed, and the cost of delivering
medical supplies can reach five times the cost of supplying urban
clinics. This process of moving the appropriate amount of necessary
vaccines and supplies relies on a series of steps, each entirely
dependent on the one before it, forming a complex supply chain that
can be derailed at any one of its links.
The success of any immunization program depends on the cold chain to
keep vaccines at the proper temperature. It is essential to maintain an unbroken cold chain for
vaccines from the point of manufacture until they are used.
Procurement
The purpose of the procurement
process is to make sure that the clinics have the resources needed to
meet the needs unique to the community they serve. This, in turn,
requires identifying the sources of those goods and services and the
way in which they will be acquired.
Transport
Transport is the means by which
supplies reach the places where they are needed. A strategy must be
developed to ensure the safe physical delivery of the supplies,
including providing refrigeration for vaccines and the consideration
of alternative plans in order to keep the supply chain uninterrupted
in the event of difficult scenarios, such as washed-out roads or
bridges.
Storage
The purpose of storage is to protect the needed supplies in an
organized, systematic fashion until they can be delivered to clinics
and individuals. It must also take into account reserve supplies, or
stockpiles, for future or unforeseen emergency needs.
Distribution
The chief goal of the supply chain is
delivering aid to people in need of medical care while considering
existing needs in a way that is fair and controlled to prevent abuse
or waste.
It is important to realize that each
of the above steps are closely linked, and that the failure of any of
the links will directly affect the ability to provide necessary care
to a community in need. For example, if an appropriate amount of
vaccines are acquired but the appropriate storage has not been
provided, the work invested in the procurement has been lost, the
vaccines are wasted, and the necessary care has not been provided.
Alternatively, if the vaccines are procured and stored correctly, but
the effort to transport them to rural areas fails, then the success up
to that point will have ultimately resulted in failure. One missing
link is all that is needed for the chain to break, and the communities
to continue without their basic needs met.
Source: World
Health Organization, PATH
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Solution
VillageReach is setting new standards in supply chain logistics for
the regular delivery of vaccines and other medical supplies to clinics
in rural areas of
Mozambique. Based on data collected from each clinic, VillageReach
works with the Ministry of Health
to procure appropriate amounts of medical supplies as to prevent
shortages and overstock waste. The materials are then transported to
the Ministry of Health regional warehouse, a location conveniently
shared with VillageReach's provincial office, where necessary storage
space and refrigeration can keep the materials secure and in good
condition.
Under the previous system of
distribution, clinic workers in need of vaccines and other medical
supplies were required to travel many miles, often on foot, to a
provincial or district warehouse to obtain supplies that were not
always available. Today, in Cabo Delgado, health workers at 90 rural
clinics receive monthly deliveries from one of VillageReach's three
delivery trucks, specially outfitted to navigate the difficult terrain
of rarely maintained roads and sustain the
cold chain necessary for the safe transport of vaccines. As the
VillageReach drivers leave from the provincial warehouse for two-week
excursions, they bring with them the necessary
vaccines, medical
supplies, and energy needed by each clinic
to serve their communities. In addition, the VillageReach staff bring
their knowledge of refrigerator maintenance and spare parts needed to
ensure continued cold storage at each clinic. In the event that an
urgent need arises between deliveries, VillageReach has outfitted many
communities with bicycles or motorcycles to ease the burden of
traveling to the warehouse.
The VillageReach supply chain
provides communities in Cabo Delgado safe syringes and medical kits
for common illnesses and five different vaccines allowing for
childhood immunization against tuberculosis, diphtheria, pertussis
(whooping cough), tetanus, hepatitis B, polio and measles.
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