South Africa

KwaZulu Natal province has the highest burden of disease associated with underdevelopment and poverty in South Africa, and has the highest mortality rate in the country. It also ranks first in HIV prevalence and tuberculosis infection. The high prevalence of these diseases results in a heavily burdened primary health system, strained health workers, and overall decreased quality in the services delivered to this rural population.

In 2009, VillageReach engaged in an assessment of the last mile logistics system in Umkhanyakude in KwaZulu Natal province. The primary purpose of the assessment was to design a last mile logistics system that would strengthen the existing HIV/AIDS supply chain and health information system, as well as management of rural health facilities necessary to support the achievement of KwaZulu Natal’s strategic goals to reduce new infections by 50% and expand access to appropriate treatment, care, and support to 80% of people diagnosed with HIV/AIDS. VillageReach’s assessment in Umkhanyakude identified a relatively secure and transparent supply chain in KwaZulu Natal province, with the majority of barriers isolated to the management of resources at the last mile.

The assessment found that the cost-efficiency and effectiveness of the last-mile health system in KwaZulu Natal system could be greatly improved through a combination of information systems management and health worker support interventions. As a result of the assessment work, VillageReach provided technical recommendations to streamline data collection and supportive supervision techniques to improve health sector performance at the service delivery level.