VDD

Preventing childhood diseases through Vaccine Direct Delivery

By Adamu Lawan

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The Challenge
In Northern Nigeria, vaccines are often unavailable at health facilities due to irregular deliveries. There are no systems in place to track inventory and movement of commodities between facilities and state cold stores. This has led to substantial stock outs of vaccines at last- mile health facilities and consequently, the inability of children under the age of one to access routine immunization services.

eHealth Africa’s solution
In 2013, eHealth Africa developed a logistics platform, LoMIS, to transport vaccines and dry goods from the state cold store to health facilities at the ward level that are equipped with cold chain storage facilities. The project was launched in Kano in 2014 and in Bauchi and Sokoto in 2015.
Following its success in the pilot LGAs of Bauchi State this year, the implementation of Vaccine Direct Delivery was scaled up to include an additional 148 health facilities in the northern clusters of Bauchi State.

The Impact

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Getting Vaccinations on Time

By Hawa Kombian

One of the primary challenges facing routine immunization (RI) in northern Nigeria is a poor vaccine supply chain system which causes consistently high stock out levels. High stock out levels occur when vaccines are not delivered on time and are exacerbated by limited cold chain equipment (CCE) to keep the vaccinations viable. High stock out levels cause low RI coverage because there are fewer vaccines available when needed.

eHealth Africa (eHA) was engaged as a third-party logistics (3PL) supplier to provide a solution for this problem and the Vaccine Direct Delivery (VDD) program was the clear answer to streamline vaccine and dry goods delivery supply chain to CCE equipped health facilities. VDD works by:

One of the terrain challenges encountered by eHA's officers

One of the terrain challenges encountered by eHA's officers

  • Leveraging eHA’s geographic and information systems (GIS) capabilities to optimize delivery routes (including rugged terrain as pictured), reduce cost and maximize efficiency.

  • Collecting, analyzing and reporting data to provide custom delivery workflow support through a near real-time electronic data collection application - Logistics Management Information Systems (LoMIS) for stock level summaries via an integrated reporting dashboard.

VDD is a proven and effective model which enhances the efficiency and quality of Nigeria’s vaccine supply chain network. In collaboration with partners, VDD is implemented by eHA across some of Nigeria’s northern states specifically, Kano, Bauchi, and Sokoto. The program has had a proven and large-scale effect across northern Nigeria. The project has succeeded in improving both access and availability of healthcare for underserved populations, by enhancing the local vaccine supply chain network. It ensures that key and priority antigens are available, as evidenced by the low stock out rates, and are a major contributor to improved RI, especially for children's health. 

 

eHealth Africa Launches Vaccine Direct Service in Sokoto State

By Daniel Ojabo

In partnership with the Sokoto State government, eHealth Africa (eHA) just launched a vaccine delivery and immunization campaign to address supply related gaps in Sokoto State, Nigeria.

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Recently concluded phase of the Vaccine Direct Delivery (VDD) campaign in Kano State saw over 7 million doses of antigens delivered and 4.6 million children immunized. Building on this success, eHA will be engaging Sokoto State as a third party logistics partner to optimize the timely delivery of vaccines and routine immunization supplies across all 23 Local Government Areas (LGAs) in the state.

According to the VDD Project Manager Adamu Lawan, “eHA is contracted to deliver vaccines to health facilities at the wards across all 23 LGAs in the state.”

VDD will be implemented to support demand creation activities and address supply related factors on routine immunization uptake. It will provide a reliable vaccine delivery service for state Primary Health Care (PHCs) facilities in the state, allowing them to run monthly Immunization Plus Days (IPDs) in addition to regular vaccination clinics for children under five.

“eHA is contracted to deliver vaccines to health facilities at the wards across all 23 LGAs in the state.

- Adamu Lawan, Project Manager

The project, which kicked off on 13th December of 2016, is expected to run for 12 months and work with over 80 (PHCs) in Sokoto State. Health facilities will be clustered by Wards/LGAs in order to examine the effect of demand creation against improved supply over a 6-month period.

“Part of the mandate is also to help collect sharp and other wastes from the health facilities we make deliveries to, and deliver back to the cold stores,” Lawan added.

Several immunization programs across all 36 Nigerian states have seen a steady increase in vaccination coverage over the past decade. According to a 2014 report by the National Population Commission (NPC) of Nigeria and ICF Macro, full vaccination coverage of children aged 12-23 months was highest in Imo State (62.4%) and lowest in Sokoto State (1.4%).

The project will monitor and inform eHA, the Sokoto State government, and other stakeholders on the effect of improved vaccine delivery on childhood routine immunization in Sokoto State. The results of these research activities are expected to present an overall picture of the extent to which improving vaccine supply chain affects routine immunization coverage in Sokoto.

eHA will engage the state government through Routine Immunization officers who will track demand creation activities in their health facilities. Current routine immunization coverage information in Sokoto will also be documented using a desk review and analysis of District Health Information System (DHIS2) data. This research will be used to create a benchmark for evaluating the expected outcome of improving vaccine supply chain and delivery in Sokoto.

A Strong Partnership: Kano State and eHealth Africa

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The Kano State Primary Health Care Management Board renovation project provides the right facilities for staff to deliver crucial primary health care interventions across Kano State.

eHealth Africa (eHA) is finalizing a project with the Executive Secretary (ES) of the Kano State Primary Health Care Management Board (KSPHCMB), Dr. Muhammed Nasir Mahmoud, to renovate and upgrade the KSPHCMB’s Offices in Kano, Nigeria.

eHA worked for one month with the KSPHCMB to renovate the building and outside areas. Internet, solar panels, electricity and other facilities were added to provide a better work environment for the Executive Secretary and over 50 staff working for the KSPHCMB. “I believe if one has a conducive environment to work in with the right equipment, tools, and facilities, there should be no reason for people not to work effectively,” said Dr. Mahmoud.

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Dr. Mahmoud, has been in the role for over six months, and has seen a real difference in how stakeholders and visitors now see the board’s work through the building’s renovations. He manages the day to day activities of the KSPHCMB, and also oversees the activities of 1,143 Healthcare Facilities in 44 Local Government Areas of Kano State.

“When I came, the place had a lot of issues and was dilapidated,” said Dr. Mahmoud. “The renovations have built up KSPHCMB’s portfolio and general standing in the community. People come here everyday now, and are always impressed with the changes they see, which makes me proud to head this organisation.”

"Today’s world is a technological world, and without technology people will continue to be disadvantaged. I believe the innovations of eHA will continue to benefit us and other sectors in Kano." - Dr. Muhammed Nasir Mahmoud

The renovation project is one component of the joint work and long term partnership between  eHA and the KSPHCMB to improve primary health care in Kano State. Kano State has many challenges in health care delivery because of security issues and physical challenges in reaching remote locations. This results in the most vulnerable segments of society falling severely ill with preventable and treatable diseases including malaria, tapeworms, ulcers and diarrhea.

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Collaboration projects between eHA and KSPHCMB include the management and coordination of immunizations across the state, a health communication system (Kano Connect), management of Emergency Operation Centers, Geographic Information Systems (GIS) tracking, and the implementation of Health Camps linked to monthly Immunization Plus Day (IPD) campaigns. Another collaboration is Vaccine Direct Delivery, which takes vaccines from KSPHCMB cold stores and directly delivers them to rural health facilities.

“I have been partnering with eHealth Africa for many years,” said Dr. Mahmoud,”and we are currently working on signing a MoU to strengthen communication within the primary health care system. I know there are many areas where we will continue to partner with eHA, and I hope we will continue to explore these other areas. Today’s world is a technological world, and without technology people will continue to be disadvantaged. I believe the innovations of eHA will continue to benefit us and other sectors in Kano.”