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The Challenge of Resource and Infrastructure in Effective Supply Chain

July 27, 2021

Introduction

One of the key principles for Digital Development is Understanding the Existing Ecosystem. This means digital innovations should consider the existing structure, ecosystem, and context before implementation to ensure relevance, sustainability, and avoidance of duplication of efforts. No matter how cutting edge or innovative a tool is, if it does not consider and account for the ecosystem, it is likely to fail and not scale. inSupply Health works at the forefront of adapting technical innovations to the local context by pinpointing these ecosystem challenges and co-designing practical solutions with users.

Background

inSupply Health utilized HCD techniques to identify user needs, barriers and desires for actionable remote temperature monitoring data in Kenya and Tanzania. In Kenya, the National Vaccines and Immunization Program (NVIP), in collaboration with inSupply Health, conducted Human-Centered Design (HCD) research to generate insights about Kenya’s current vaccine cold chain equipment (CCE) temperature monitoring data visibility, access, and use. In Tanzania, inSupply Health used HCD to enhance vaccine potency and complement the ongoing remote temperature monitoring (RTM) initiatives by identifying indicators and proposing visualizations to be implemented in existing information systems and discussed in various forums.

Figure 1: CCEOP (Cold Chain Equipment Optimization Platform); MoHCDGEC (The Ministry of Health, Community Development, Gender, Elders and Children); IVD (Immunization and Vaccines Development); JSI (JSI Research & Training Institute, Inc.)

The Challenges

One of the main themes that emerged via inSupply’s HCD workshops in both Kenya and Tanzania was infrastructure and resource-related challenges that reduce the effectiveness of CCE and RTM. Unreliable electricity supply in various parts of the country due to power outages interrupt the normal function of CCEs and data collection of temperature monitoring devices. Without electricity for prolonged periods, the fridges where vaccines are stored stop working and devices stop recording temperature data. Many health care workers identified solar energy-powered CCEs or backup generators as potential solutions.

Access to dashboards, where analyzed data is visualized, is another challenge. Most frontline health care workers pay out of pocket using their personal phones and data bundles to access CCE dashboards. Even when willing to use their personal data, access is still problematic because some devices, for example Huawei, are not compliant with the tool, meaning the tool cannot be downloaded or accessed on the device, or the device memory is full.

Another important barrier is transportation. Health care workers at subnational levels need transportation to be able to visit health facilities in order to translate challenges emerging from the data into solutions via support, supervision and on-the-job or refresher training. Without accessible transportation provision, challenges remain unresolved and health facilities often fail to use the CCEs and RTM devices to their full potential.

Conclusion

To maximize the potential effectiveness of CCE and RTM devices, these solutions must be designed or purchased with the user needs and local context, infrastructure, and health worker skills in mind. Gavi has already started working on addressing the power supply issue by providing solar fridges that come with a service bundle to some countries.

Full HCD report coming soon.

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