By: Modibo Dicko, Souleymane Koné, Ousmane Dia, Boubacar Dieng, Kuburua Iyabo Daradara, Onome Dibosa Osadolor, Ahmad Muhammad, Abdulrahman Kelani, Daniel Ali, Michelle Arnaud-Seidel
From 20 – 24 January 2020, a National Training of Trainers on Vaccine Management was organized in Lagos, Nigeria, by the National Primary Health Care Development Agency (NPHCDA) for 250 participants from National and State levels, incl. representatives of Technical and Financial Partner Agencies. The general objective was to impart participants with the knowledge necessary for vaccine management officers to properly carry out their responsibilities at all levels of the supply chain.
The training was organized as a Gemba Walk through vaccine management tasks at the various levels of the supply chain in Nigeria. To cope with the huge number of participants, the Gemba Walk was combined with the Carrousel method. The Gemba Walk takes management staff to the front lines to look for wastes and opportunities to propose improvements. The Carousel is a tool for knowledge transfer and collective work in the form of workshops also called stations. Participants are divided into groups that circulate from station to station in order to learn from and contribute to the discussions initiated by station facilitators.
As the Gemba Walk is planned in such a way as to enable participants to follow the vaccines on their path through the different levels (National, State, LGA and service) of the supply chain, the consultant and his WHO counter-part, Souleymane Kone, went through an exercise of identification of vaccine management tasks pertaining to each level. was then discussed with and approved by the Nigerian team composed of representatives of NPHCDA and their local partners, namely the GAVI consultant, UNICEF and WHO officers (video conference of 10 January 2020).
During the Gemba Walk, participants went through these tasks in order to able to implement or supervise them correctly. As there was no participant coming from LGA level to the training, the State and LGA stages were combined in a single State/LGA Stage. Therefore, there were only 3 stages: (i) National, (ii) State/LGA and (iii) Service. During the Gemba Walk, the focus was (a) strategic for the national stage, (b) managerial for the State/LGA stage and (c) operational for the service stage.
During the national stage (1 day), the Carousel comprised 4 stations dealing with (i) Planning, budgeting and resource mobilization, (ii) Knowledge management, (iii) Supply chain transformation and (iv) Governance.
During the State/LGA stage (1 day), the Carousel comprised 5 stations: (i) Generating evidence, (ii) Knowing SCM tools, (iii) Equipment management, (iv) Health care waste management, (v) Managing storage and distribution. This was followed by a 1.5-day practice on 3 management tools: the Stock Management Tool (SMT) for vaccines, the District Health Information System platform (DHIS2) for district programmatic activities and the Waste Management Tool (WMT) for planning health care waste management at district level. For this 3-station Carousel, each session lasted a half-day.
During the Service level stage (1 day), the Carousel comprised 5 stations dealing with (i) Knowing SCM tools, (ii) Knowing vaccine storage temperatures, (iii) Stock management operations (refrigerators, cold boxes, vaccine carriers and icepacks, freeze and fridge tags were brought in the room), (iv) Vaccination session planning and (v) Reminders about basics on vaccine management and injection safety (VVMs, MDVP, WHO-UNICEF Joint Statements, key vaccine management reference documents, etc.).
In all the Stations, sessions were held in a very interactive way; facilitators were requested to make just introductory presentations via PowerPoint. These presentations were followed by questioning, comments and discussion by the participants. Rapporteurs were selected for each group in order to capture the essence of those contributions. These reports are being synthetized by NPHCDA in the final report of the training.
This was the first time, a combination of Gemba Walk and Carousel method was used for training on EPI logistics in Africa. Apparently, the training seems to have met participants’ expectations as far as one can judge by their evaluations: indeed, they gave an overall score of 4.24 out of 5 to the course. At the end of this vaccine management training, participants were equipped with the necessary knowledge to correctly follow the course on Effective Vaccine Management, which was due to take place immediately after.
It remains now to draw all the lessons from this experience in order to prepare future training sessions with large number of participants. A full report of the training will be shared soon.