Last Mile Distribution: CHAI Lessons learned through interventions in Kenya, Uganda and Lao PDR

This document describes CHAI's work on last-mile distribution in Kenya, Lao PDR and Uganda between 2019 and 2022 and highlights key learnings that can be used by those implementing (EPI supply chain specialists, logistics partners) or supporting the implementation (core and expanded implementing partners) of similar interventions. For a national immunization program to be effective, it is essential to ensure the continuous and uninterrupted availability of vaccines up to the point of vaccination. Countries (especially LMICs) continue to face vaccine stock-outs at national, district, and health facility levels, affecting immunization services. Distribution systems in the lower tiers of the supply chain and at the last mile are often ineffective or nonexistent. As a result, they cannot ensure vaccine delivery to health facilities on time, in full, and in the right state for use. The document aims to  provide insight into the three key gaps observed by CHAI that affect the last mile delivery- (procedural, structural, and transportation) and why these gaps persist before describing the detailed efforts and outcomes of these interventions across the three countries and synthesising the lessons.