TechNet Conference 2015 - Bangkok, Thailand

<p>On day 4 of the conference, I facilitated a roundtable discussion on what it takes to generate political will for supply chain improvements. At each table, participants shared their experiences generating political will and discussed in detail what it took to achieve meaningful change. Below are their observations, grouped into like categories:</p>
<p><strong>Seek global buy-in and funding for the issue</strong></p>
<p>Global buy-in and funding can be critical for implementing something in a country</p>
<p><strong>Collect local evidence and credible indicators of problem</strong></p>
<p>Create new evidence to “change the story” about the issue</p>
<p>Bring in different content experts to validate and contribute to the evidence so its not just one-sided</p>
<p><strong>Keep the momentum going (advocacy is a long process)</strong></p>
<p>Find ways to amplify the evidence and have many different people sharing it</p>
<p>This process takes a lot of time. To maintain the focus, share small milestones and “wins” along the way. Give frequent updates on progress.</p>
<p>Document government and partner commitments so you can hold them accountable later.</p>
<p><strong>Cultivate champions and key influencers--speak their language</strong></p>
<p>Transform leaders from forces of resistance to the heros—show them the difference they can make and give them credit</p>
<p>Map key influencers at MOH and understand who influences the influencers.</p>
<p>Learn what interests your key influencers, what their priorities are, what their background is, and what skills they have</p>
<p>Speak their language—translate your message into something they care about, consider their point of view</p>
<p>Be ready to educate and sensitize people to your issue and explain it in a way that makes sense to them.</p>
<p>Seek perspectives from ALL parties affected by an intervention (e.g., district managers, health workers, patients) to anticipate and address confusion and possible resistance.</p>
<p>Seek government ownership even if it takes longer</p>
<p>Cultivate 1:1 relationships. A lot of political support must be cultivated this way.</p>
<p><strong>Acceptable solutions</strong></p>
<p>Be clear and specific about the changes you want to see</p>
<p><strong>Be aware of context</strong></p>
<p>Understand the decision-making system, when are decisions made (e.g., what time of year are budgets decided), what committees and individuals are in charge of making decisions, who they report to and when they meet.</p>
<p>Target the right person and at the right time</p>
<p><strong>Partnerships</strong></p>
<p>Look for ways to lead in collaboration. Focus people on solving a problem together to get stronger buy-in and leadership.</p>
<p> </p>
<p>Please add to this thread to describe any insights that I did not capture, but you felt were important. </p>
<p>Also, if you have specific experience generating political will for supply chain changes (and many of you do), let's share these experiences more broadly. PATH is interested in gathering these stories in short case studies or interviews. Please respond to this post with a summary of your project and three key lessons you learned about generating political will for supply chain change. If we have a quorum of responses, we will follow up directly with a proposed standard format for case studies.</p>
<p>-Heidi Lasher</p>
<p>PATH iSCL advocacy project</p>

<p>TechNet 2015 Day 3 has  tackled Managing the System: Human Resources for Supply Chain Management and Data for Management. These two themes are closely linked. People are the sources of data, and people must also have the skills and capacity to use that data for management decisions. In well performing supply chains, the interdependence between people, processes, technology and infrastructure are essential, but people are at the center. They carry out the processes, they collect, enter, manage and analyze the data, they use and maintain the physical infrastructure and assets. On Day 1 we talked about optimizing process. Yesterday we explored cold chain infrastructure. So today we are looking at both human resources and data, and tomorrow we bring it all together.</p>
<p>Every presentation and session seemed to reinforce the need for skilled human resources operating immunization supply chains, and the need for data to make decisions, whether about supply replenishment, cold chain functionality, or human resource performance.</p>
<p>One presentation that really struck me was the vLMIS from Pakistan. In full disclosure, I was part of the initial strategy development for the vLMIS, but it has far exceeded my own expectations. But that's not my point here: Wasif presented a slide in which targets and consumption data were displayed across districts, indicating that in many cases, consumption far exceeded the targets used to forecast demand. Not only is this powerful evidence of the need to improve demand planning, it also helps assure us that using consumption data does not necessarily under-estimate demand required for 100% coverage, actually allows us to position adequate supplies to meet and exceed coverage targets.</p>

<p>This conference comes around every 18 months or so, and when it does invaluable conections are made, experiences shared and supply chain insights gained. But the conference lasts for less than a week. How to maintain the momentum and continue to support strengthening immunization supply chain and logistics systems when the conference ends on Friday?</p>
<p>One answer is this website. We have established a variety of tools to support this network of immunizations professionals. Most importantly the forum, but also in other areas that may be less familiar to you. For example, the Reviews area, where members can submit reviews of PQS-prequalified products, and read the reviews of others members. Take a look if you haven't already:</p>
<p><a href="/en/reviews">http://www.technet-21.org/en/reviews</a></p>;
<p>We are also planing to release a new area of the website entitled the TechNet Reosurce Library, which we will be demoing to those who are interested as part of the TechNet Clinic.</p>
<p>So we already have some online tools to take forward the conversations that have been taking place this week. But surely more can be done. <strong>How else can TechNet-21.org support you and your immunization projects? I am particularly interested in hearing your thoughts on this.</strong></p>
<p>One area I want to highlight is the "groups" feature (in which anyone reading this is already participating), where special-interest groups can come together in a dedicated space for more focused discussions around a particular topic or organization. We already have a group for this conference (private, i.e. your request to join has to be approved), as well as the IPAC group (private also) and Imunization Information Systems (completely public, i.e. all you have to do is click Join). Are you interested in having such a space to support a collaboration on a particular topic? Do you need a resource library (public or private) as part of this? If so, please let me know. If I'm not at the TechNet Clinic just drop me a line and we can discuss in more detail.</p>

<p>It is not so much of a clinic as a hangout! The TechNet clinic, which will be located in the London room of Conrad Hotel, is your go to place if you want to learn more about the TechNet website and the fourm. If you are new to the network and would like to <strong>register</strong> and subscribe to the free weekly digest, please visit us. We will help you register. As for registered members, you may be facing <strong>problems</strong> logging in, posting on the fourm, accessing a document, or even using the search tool. We will troubleshoot your problems for you. Some of you may have <strong>suggestions</strong> as to how we could improve the look and feel of the website and forum and make it more user-friendly; your suggestions are most welcome!</p>
<p>Drop by even if it is just to say hi.</p>
<p><strong>Please note the 'clinic' will be open during the lunch and coffee breaks.</strong></p>

<p>Uttar Pradesh is the most populous state in India, with significantly low immunization coverage, and relatively few primary healthcare centers, each covering a wide geographic and demographic area. A single cold-chain point at the last mile may service up to 250,000, with full immunization coverage as low as 28%.  Cold chain handlers have lacked capacity to effectively record data or manage inventory, previously being done in non-standard ways. Timely visibility into inventory at the last-mile was nonexistent, making it difficult to manage the supply chain and ensure availability.  To address these challenges, the Immunization Technical Support Unit (ITSU), a unit of the Ministry of Health & Family Welfare of India, deployed a novel model covering two districts using a mobile phone based supply chain software called Logistimo.  This included digital data entry using a mobile application along with standardized procedures for data recording and management.  The simple and highly usable application can run on any feature phone to encourage and collect quality data in low resource environments. Using this system,  stellar reporting rates above 90% were achieved, and a vaccine availability of above 99%.  In this discussion, we will share our experiences of deploying such a system and learning from it.</p>
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<p>See you on <strong>Thursday, May 14, 13:00-14:00</strong> at <strong>Ballroom Foyer</strong>.</p>

<p>Dear TechNet Colleagues,</p>
<p> </p>
<p>ColdTrace is a low-cost wireless system that monitors the temperature and power of cold storage units at health facilities and regional stores that have vaccines and other temperature-sensitive medications. When the temperature becomes too hot or too cold, ColdTrace sends SMS alerts to clinic workers and managers to warn them about the danger to the vaccines and other medications.</p>
<p> </p>
<p>The analytics reported on a web dashboard are customizable and cover information on fridge uptime, performance by fridge model, fridge holdover time, and power availability. These analytics can be aggregated across district/province and displayed over time.</p>
<p>During the session, the following will be demonstrated: <br />1) ColdTrace device with SMS alerts and dashboard<br />2) Visualizations and reports, and actions taken by clinics staff, managers and technicians</p>
<p><br /><strong>In this session we highly encourage and welcome country representatives to share their valuable feedback on the current challenges around cold chain management and fridge failures to better inform future technologies and efforts around cold chain strengthening.</strong></p>
<p><br />We hope to explore and discuss the following questions during our session. We encourage all the participants to start an online discussion here before the conference to share their unique feedback and experience from working in different countries.</p>
<p> </p>
<p><em>Discussion Questions: </em></p>
<p>1) What are the most common causes of fridge failure, and how can we improve our understanding/knowledge based on this topic to strengthen cold chain systems? Some causes include equipment and installation, power, and processes. How are they particularly different in your region or area?</p>
<p>2) What information/infrastructure do maintenance technicians need to improve fridge uptime in facilities?</p>
<p>3) Can timely data on temperature excursions and power outage lead to prompt actions by the health facility staff and the technician? </p>
<p>4) How can data contribute to timely diagnosis and solving fridge problems and how can systems contribute to verifying that actions have been taken and problems have been solved?</p>
<p>5) Can analytics on fridge performance play a role in informing decision making around fridge model procurement and strengthening maintenance systems (e.g. ordering necessary spare parts, providing tools, transportation, etc.)</p>
<p> </p>
<p>Thank you all and I look forward to our discussions on this board and at the conference!</p>
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Addressing_Fridge_Failures.pptx (136kb)