GAVI Study – Outsourcing the Distribution Component of Vaccine and Medicine Supply Chains

Many government supply chains operate with limited transport capacity, which limits their ability to make last mile deliveries, and results in health workers collecting commodities from the next tier in the supply chain. Outsourcing is often used as a means to improve efficiencies, access new capabilities or access additional capacity, which has yielded successful results in some cases. Outsourcing is also an option when financing for an asset is not available which this is becoming an increasingly important issue now as donors are reluctant to pay for warehouses and trucks for Central Medical Stores (CMS).

This report focuses on how to outsource the physical distribution of vaccines and medical products to a private sector Logistics Service Provider (LSP) in sub-Saharan Africa. It analyses existing approaches to outsourcing, the challenges encountered and lessons learned. A number of outsourcing examples have been identified within the focus countries of Uganda, Zambia, Mozambique, Senegal, Nigeria, Ghana, Kenya, Tanzania and Malawi. These primarily focus on the distribution of ambient medical products, and incorporate many elements of vertical supply chains such as those part of the government operated CMS supply chain. There are just two examples of outsourced vaccine logistics that have been identified, a public private partnership in South Africa, and one in Nigeria.

The framework has been designed specifically to assist government operated CMS vaccine and medical supply chains in outsourcing distribution services. The report uses templates and documents to describe how to manage an outsourcing in a structured manner.  It also includes a practical toolkit to assist government operated CMS vaccine and medical supply chains in the outsourcing of distribution services. The Outsourcing Framework begins with a list of considerations for outsourcing and explains the process from creating a project plan and RFP, through contracting to implementation and business as usual.

Please click below to download the full report.

Transaid’s MSD for Ugandan Mothers Programme

As a partner in the MSD for Ugandan Mothers Programme, Transaid addressed the transport related constraints to accessing maternal health services through the design and implementation of an emergency transport scheme to improve access for pregnant women.

Transaid also implemented another access to health programme, MORE MAMaZ (click here) which aimed to increase the use of maternal and new-born health services among rural communities in Zambia. It built on the successes achieved by a predecessor programme, Mobilizing Access to Maternal Health Services in Zambia (MAMaZ), implemented between 2010-2013.

To read more about the MSD Uganda Mothers Programme, click below.

T21. The WHO Minimum Standards for the Cleaning and Decontamination of Vehicles

This tool is a set of guidelines developed by the World Health Organisation (WHO) and GOAL, which aim to provide an understanding of how to safely clean and decontaminate vehicles that have been used to transport people with Ebola. It was developed in 2015 and helps car washers to avoid Ebola infection of themselves, as well as Ebola infection from the patient to the next patients.

2014-2016- “Rural Transport Solutions for Maternal Health; the MORE MAMaZ Emergency Transport Scheme”

The MORE Mobilising Access to Maternal Health Services in Zambia (MORE MAMaZ) programme is an integrated programme that empowers rural communities to address the household and community-level barriers that prevent women and girls from accessing maternal and newborn health services. This programme builds on the successes achieved by a predecessor programme; Mobilising Access to Maternal Health Services in Zambia (MAMaZ), which was implemented between 2010 and 2013.

This technical case study outlines the emergency transport-related activities of the MORE MAMaZ programme. These activities aim to improve access to health services for communities in the five MORE MAMaZ districts.

2012-2015 “An Emergency Transport Scheme in Rural/Peri-Urban Uganda that Utilises Informal Transport Services

This technical case study outlines Transaid’s involvement in a 4 year programme called MSD for Ugandan Mothers (MUM). The MUM programme works with franchised, private health facilities, local businesses, and communities to expand women’s access to affordable, quality maternal healthcare. Transaid worked as part of the MUM programme to improve the understanding around the transport related constraints to women accessing maternal healthcare and to design and implement an intervention to improve access.

2015 – “Developing an East African Community Standardised Driver Training Curriculum and Instructor’s Manual for Drivers of Large Commercial Vehicles”

This technical case study outlines the background, methodology and conclusions of a six month programme that developed a standardised driver training curriculum and instructor’s manual for drivers of large commercial vehicles. The curriculum and instructor’s manual were developed for the East African Community and funded by TradeMark East Africa.

2015- “Evaluation des obstacles à l’accès aux soins de santé maternelle et conception d’un système de transport adapté au contexte des femmes enceintes.”

Evaluation des obstacles à l’accès aux soins de santé maternelle et conception d’un système de transport adapté au contexte des femmes enceintes.

Cette étude de cas technique présente le contexte, la méthodologie et les conclusions d’une assistance technique apportée à un projet au Kenya sur une période d’un mois. Les objectifs du projet étaient de renforcer les systèmes de santé de base et d’augmenter le taux de survie des mères et des nouveau-nés en permettant à des femmes enceintes de milieux défavorisés d’accéder à des services de santé abordables et de qualité.

Assessment and Development of a Motorcycle Taxi Rider Training Curriculum

Between December 2014 and April 2015, Transaid, working closely with key stakeholders in Tanzania, have developed an appropriate training curriculum for motorcycle taxi riders (for the full curriculum see annex A). This AFCAP-funded programme began by gathering and assessing any existing motorcycle training curricula to identify any gaps that need to be addressed. It was vital that the development of the training curriculum had strong support from the relevant training schools and regulatory authorities as well as feeding in valuable input from the motorcycle taxi riders themselves and addressing the needs of passengers. To ensure this key stakeholder input and support, SUMATRA and the Traffic Police (see Annex B for letter of support) were engaged from the very start and the project team conducted interviews with Driving Schools and regulatory authorities. Two stakeholder workshops were facilitated; one in Bagamoyo, which focused on gathering input from boda boda riders, owners and passengers for the curriculum and one in Dar es Salaam that focused on gaining feedback and input from the key regulatory authorities and ministries. This final report details the outcomes from these activities as well as presenting the final developed curriculum, proposed next steps and proposals for licensing, testing and training.