This session will introduce the participants to how supply chains for delivering malaria interventions are organized in malaria endemic countries, and what are the main barriers that prevent scale-up and wide coverage of interventions. It will also provide an overview of the role of effective supply chains in malaria elimination and eradication.
- To introduce the supply chains for malaria interventions.
- To understand why supply chains matter in the overall strategy for elimination and eradication.
The session will introduce a framework for analyzing access to health technologies, and its application to new malaria interventions.
- To introduce the Frost/Reich framework on access to health technologies.
- To apply that framework to new malaria interventions.
Achieving high coverage rates of malaria interventions often requires more than functioning supply chains to bring products or services to communities. It also requires active demand on the patient/consumer side. Demand-side drivers include willingness-to-pay, beliefs about the benefits and costs of the product/service, alternative options for care and prevention, and product quality and consumer-friendliness among others. We will discuss the role of these demand side drivers in uptake and use of key malaria products such as bed nets, ACTs and RDTs and will review several field experiments examining these issues.
- To understand key drivers of demand for malaria products.
- To gain knowledge of recent evidence on demand for malaria products.
- To understand the ways demand side factors can influence malaria policy.
Community health workers (CHWs) can play an integral role in increasing the availability of health care across the developing world. Studies have shown, for example, that CHWs are capable of providing safe, high-quality, integrated management of malaria diagnosis and treatment. While CHWs are a promising delivery channel for products and services that will lead to the eradication of malaria, question remain about how to recruit, retain and optimally compensate CHWs. Prof Ashraf discusses an innovative program in Zambia and preliminary findings from research on recruitment and compensation, including the use of social recognition to improve the performance of CHWs once deployed to the field.
The discussion will then return to the demand side of high-quality care to explore the potential for other innovative product delivery channels to encourage use of health products and services.
- To understand the unique role of a CHW in developing country health systems as an innovative delivery channel for lifesaving health services (including malaria prevention and treatment).
- To think “outside-the-box” about other innovative delivery systems that solve both demand-side and supply-side challenges.
- To understand the various approaches to recruitment and compensation for community-based health workers – volunteer, base pay/salaried, pay-for-performance, and private sector/social enterprise/social marketing (including margins on products and services) scenarios – and analyze their relative effectiveness.
This session will use an interactive team game that mimics a supply chain for malaria drugs in a malaria endemic country. Playing the game exposes the participants to the nature of challenges in running a supply chain for malaria interventions.
- To understand the problems associated with operating a supply chain for malaria interventions.
Comments regarding lessons from previous day.
This session will introduce the participants to the structure, physical and information flows in a government run supply chain for malaria medicines. Using a case study it will critically evaluate what structure works best under a given context and why.
- To understand the role of physical and information flows in the supply chain for malaria interventions.
- To understand how many tiers would be best suited for such supply chains and what factors to take into account while making that decision.
- To understand the value of “point-of-use” information in operating supply chains for malaria interventions.
Malaria elimination and eradication programs can attain their objectives only if medicines, vaccines and other products are developed, manufactured, and made available when and where they are needed. This session provides an overview of the challenges in global demand forecasting for malaria related products. It also highlights how poor forecasting can lead to supply shortages, higher prices and poor intervention coverage. The session also highlights how the uncertainties from poor demand forecasts create risks across the supply chain and how these risks can be mitigated or better shared between the different stakeholders.
- To understand the need of demand forecasting on malaria programs and the overall strategy for malaria elimination and eradication.
- To understand methods for better forecasting.
- To understand the risks that result from poor forecasts and how to mitigate/share them.
The session will analyze a case study on efforts to improve both access and quality of medicines in Tanzania.
- To discuss the Accredited Drug Dispensing Outlet initiative in Tanzania.
- To discuss how that approach might be applied to new malaria interventions.
Using the example of IRS in Uganda tho session will introduce the participants to the costs and benefits of decentralized operations for malaria interventions.
- To understand the cost and benefits of decentralized operations for delivery of malaria interventions.
- To understand methods for operational planning of interventions.
Retail sector drug shops and pharmacies are a common source of malaria treatment, especially for communities with poor access to the public health system. Distribution of RDTs through tho sector offers tremendous promise for increasing the accessibility of malaria diagnosis, but poses several unique challenges. We will discuss supply side and demand side factors to consider in expanding diagnosis through the retail sector and new evidence on the topic.
- To understand the key contributors to current low rates of malaria diagnosis.
- To understand the potential challenges and opportunities of introducing diagnosis through the retail sector.
- To gain knowledge of current evidence – and evidence-gaps – on the role of the retail sector in malaria treatment and diagnosis.
The session will discuss the political economy of supply chains and distribution of health technologies, and introduce a method for applied political analysis.
- To introduce the political economy of supply chains and distribution, with particular attention to new malaria interventions.
- To understand a method for applied political analysis.