Mozambique

National Expansion of the Dedicated Logistics System

Mozambique

Since 2010, VillageReach has supported the Mozambique Ministry of Health in a large-scale program covering four provinces addressing a population of approximately 13 million. VillageReach’s Dedicated Logistics System (DLS) program features a dedicated, integrated, distribution system, whereby a small number of specialized workers visit each health center monthly to delivery vaccines and supplies, repair equipment, facilitate an information system to collect and report data, and provide supportive supervision.

This reassignment of tasks to create a systematic distribution process, the related information management system, and an active and ongoing recurrent training and supervision program are the core innovations of the DLS.
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Key objectives of the program are to:

  • Improve health in Mozambique by sustaining high vaccination coverage rates and low vaccination dropout rates.
  • Improve the community’s knowledge of, trust in, and use of health services.
  • Increase the cost-effectiveness and cost-efficiency of the logistics systems for vaccines, Rapid Diagnostic Tests (RDTs), and other related commodities in Mozambique.
  • Reduce stock outs and wastage of vaccines, RDTs, and other related commodities in all health centers where the system is implemented.
  • Reduce interruptions in service delivery due to stock shortages, health worker absence and lack of health worker time.

On the strength of realizing significant improvements in the distribution of vaccines, the program has more recently integrated commodities such as Rapid Diagnostic Tests (RDTs) for HIV/AIDS, malaria, and syphilis into the system, working with partners such as Elizabeth Glaser Pediatric AIDS Foundation (EGPAF).

The DLS program was developed as a result of an earlier demonstration project operating in northern Mozambique from 2002-2007. VillageReach released the results of an independent impact evaluation of the project and conducted a complementary study of the costs of the VillageReach designed logistics system with the system used in a control province. Following is a summary of those evaluations:

  • Vaccine coverage rates increased from 68.9% to 95.4% for children age 24-35 months.
  • Monthly incidence of stock outs in rural health centers decreased from 80% to 1%.
  • Up-time of the cold chain increased from approximately 40% before the project to 96% over a year after the conclusion of the project.
  • An average of 95% of health centers were visited each month by the dedicated logistics system staff with an average interval of 31 days in between visits, despite extremely difficult road conditions and harsh rainy seasons.
  • The VillageReach model was 17% more cost-effective compared to the vaccine distribution program of the control province.

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