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Fixing weak links in vaccine chain

Millions of vials of vaccine shipped into Nigeria move from national drug stores to regions, to stores in states, further down to local government areas. They move through local immunisation officers down to vaccinators. The chain lengthens and broadens as vaccinators make their way across communities nationwide.

Example, it was immunisation morning in 2018 and teams of vaccinators were sent out across Delta State. Each local government area was assigned a six-member command centre that included a local immunisation officer, a coordinator of primary healthcare, a health educator, a disease surveillance officer and a malaria focal person. They were to ensure that all commodities and materials needed for vaccination were picked up and stored for use.

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The officials met early and picked up supplies for their teams: measles vaccine packed in iceboxes, syringes and needles, cotton wool and methylated spirit. The officers are the humans in a “supply chain” to get vaccines to millions of Nigerian children.

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The consensus is that the supply chain for immunisation in Nigeria is inadequate: the materials, activities, individuals, structures and the resources, is overwhelmed by an ever-increasing population.

However, interestingly, attention has turned to the supply chain and there is a bright focus on the leaders and managers of the chain.

Global courier firm, UPS, and Gavi (the Vaccine Alliance), have developed what they call Strategic Training Executive Programme (STEP), that is hoped will produce skilled and competent individuals to shore up the supply chain for immunisation in Nigeria.

The National Primary Health Care Development Agency (NPHCDA) requested Gavi to have STEP implemented in Nigeria.

A Deputy Director at NPHCDA, Chinenye Ekpemauzor, after STEP on “What leadership is all about”, said “I have gained useful insight on how to become more strategic, efficient and accountable for my actions in my organisation.”

The Africa Resource Centre for Supply Chain (ARC) advocated for the relevance of STEP to decision makers in immunisation.

Regional Director of ARC, Azuka Okeke, explained that STEP presented a unique opportunity for countries like Nigeria to develop supply chain leaders who would advance transformation in effective and efficient immunisation delivery.

Okeke said, “One of the key areas of focus of STEP in Nigeria is building strong leadership at national and state government levels that will drive ownership of health programmes beyond vaccine management.”

The Gavi-sponsored STEP is not restricted to Nigeria. It is based on an academic framework of professional competencies expected for supply chain managers. It combines traditional learning with on-the-job training to help supply chain leaders develop their “problem-solving skills and foster effective team-building approaches,” said Magloire Achidi, Supply-chain Consultant for Gavi.

The Vice President of Member Engagement at the International Federation of Pharmaceutical Wholesalers (IFPW) and one of the sponsors of GAVI STEP training, George Bray, said, “Leaders bring people together to tap their collective wisdom. When doing so, you must be prepared for differences of opinion and conflict. Becoming an effective negotiator can reveal new opportunities, sharpen your focus, satisfy your needs and improve your relationships.”

The Director of Public Health and Safety at UPS, Kevin Etter, said, “Leadership is getting the work done through people. A leader sets direction, motivates and builds an inspiring vision, as well as creates something new. Leaders inspire others, possess decision-making capabilities and should be focused on the vision to inspire others to the overall goal.”

A state Immunisation Officer in Niger State, Dr. Samuel Jiya, said, “One measure of one’s success is the degree to which one builds up others who work with that individual.

“Team effectiveness is achieved when there is a clear and compelling purpose, skills that are complementary and mutual accountability. Everybody in a team is important, and that is why we must sustain team relationship.”

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