Reimagining the Last Step of the Cold Chain in Africa
JSI leads six-country collaboration to maximize performance of the clinic fridge
In an unprecedented gathering, JSI recently convened maintenance technicians, data analysts, and supply chain managers from six countries in Nairobi to tackle a mutual challenge: how to anticipate and streamline maintenance of the health clinic refrigerator in remote clinics in Africa. Working together, attendees identified potential technology-enabled solutions to manage this critical last stop in the cold chain.
At first, a simple refrigerator may not appear to be the lynchpin of a global medical supply chain. But for remote or underserved regions in Africa and other continents, this humble appliance is the bedrock of families’ access to the medications and vaccines they need to lead healthy lives.
Why? A slew of life-saving vaccines and medicines must be stored at 2–8°C to maintain quality and potency. These include routine vaccines to protect children from debilitating diseases such as measles-mumps-rubella, polio (IPV and OPV — Oral), cholera, BCG (TB), diphtheria-tetanus-pertussis, rotavirus, and HPV. They also include medicines like oxytocin, which prevents postpartum hemorrhaging, and insulin, among others.
But when a clinic’s hard-working fridge is down for a parts replacement, and maintenance technicians must travel long distances to assess the malfunction, order the part, and then return to install it, that process stresses the health care system and delays patient care. Health workers often spend precious hours traveling to a neighboring clinic for medications while families are left waiting and may become less inclined to return.
To solve cold chain breakdowns in the supply chain, JSI experts and partners came together to define and resolve the pain points.
In collaboration with New Horizons, PATH, VillageReach, CHAI, eHealth Africa, and MOMENTUM Routine Immunization Transformation and Equity, JSI gathered cross-national teams to map out cold chain systems processes, identify challenges, resolve issues, and share experiences. The event, designed for the men and women who fix cold chain equipment and understand the inner workings of the needed equipment, provided them with shared insights and solutions.
The group’s collective effort built on their findings at the TechNet conference in 2023 and on a JSI-led study focused on fridge maintenance technicians, nurses, logisticians, and other stakeholders in Kenya, Niger, and Tanzania. The conference surfaced ideas for digital access to predictive data analytics, real-time peer-to-peer support, and online training. For example, insights such as what caused a breakdown — a cut in electricity, the need to change a solar panel or replace a compressor?
To develop solutions to what are sometimes complex and hidden issues, JSI sought technicians’ perspective for the creation of a diagnostic toolkit on cold chain equipment. Participants shared groundbreaking programs already in place to optimize repair routes, order spare parts, and provide remote guidance for basic maintenance.
The National Primary Health Care Development Agency in Nigeria demonstrated use of easy-to-access apps (Varo app and PogoDV) to extract and use data from FridgeTags for temperature monitoring.
After observing how this approach could be adopted in Tanzania, the Tanzanian Ministry of Health’s Immunization and Vaccine Development Program identified what is potentially useful for them and can be incorporated into their remote monitoring and overall cold chain system.
This was the first opportunity many technicians had to collaborate with peers from other nations, delving into the intricate details of cold chain equipment maintenance and repair. Their ideas became bridges, connecting individuals and institutions and fostering a spirit of shared discovery and collective ingenuity.
Properly maintained cold chain equipment allows for the correct storage of vaccines and medicines. Our collective responsibility is to strengthen the systems that allow a maintenance technician to do their job.
JSI will continue to create opportunities for groundbreaking ideas to transcend borders, spark inspiration, and unite us all in the pursuit of progress for a resilient and reliable cold chain.
