Reaching the Last Mile at All Costs

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Date
April 25, 2022
Lead Paragraph/Summary

Malawi’s rural population makes up about 82 percent of the entire population. Reaching them with medicine can be a significant challenge as 72 percent of the country’s roads are unpaved and dirt roads making travel by road difficult and often dangerous. The country saw an average of 5,592 traffic fatalities per year from 2012 to 2019—roughly around four traffic fatalities for every 32 people—significantly higher than the global average. This especially becomes challenging during the rainy season.

The Global Health Supply Chain – Procurement and Supply Management (GHSC-PSM) project in Malawi promotes access to health commodities for people, including malaria commodities, even for those living in the most hard-to-reach areas. Since 2016, through PMI funding, GHSC-PSM and the ministry of health procure and deliver medicines, rapid test kits, bed nets, and other health commodities to prevent and treat malaria.

Last mile distribution, or where supplies leave the fulfillment center for clinics and health facilities across the country, is where the commodities enter Malawi’s toughest terrain. GHSC-PSM leverages local private transport companies familiar with the landscape to distribute malaria products to hard-to-reach areas. These companies use numerous transportation methods, such as boats, canoes, trucks, vans, motorbikes, tricycles, and community members, to transport essential medical supplies to places where standard vehicles are not accessible to ensure that every facility has these items in stock. 

The project’s interventions have greatly improved the availability of malaria commodities, especially in areas that would have been cut off due to a poor road network. As a result, data from the district health management information system shows that up to 99.6 percent of the suspected malaria cases in the public sector received a parasitological test, and 98.6 percent of the confirmed malaria cases received first-line antimalarial treatment.