Data to Action: A Mixed-Methods Study of Data Use Teams, Improved Availability of Contraceptives in Guinea, Indonesia, Kenya, and Myanmar.

Information Mobilized for Performance Analysis and Continuous Transformation (IMPACT) Teams routinely bring together data, people, processes, and technology, under the leadership of governments, to institute a change in culture that leads to sustained improvements in supply chain processes and outcomes. This mixed methods study examined whether IMPACT Teams were effective in improving reproductive health supply chain outcomes in Guinea, Indonesia, Kenya, and Myanmar and identified enablers and barriers to IMPACT Team success and sustainability in Indonesia and Kenya.The study design employed a pre-post intervention comparison panel design with a nonrandomized matched comparison group to examine the IMPACT Teams' effect on 2 supply chain outcomes: stocked according to plan and stock-outs. Additional key informant interviews conducted in Kenya and Indonesia explored enablers and barriers to IMPACT Team success and sustainability.For nearly all products across the 4 countries, an increase in products being stocked according to plan and a reduction in stock-outs can be attributed to the IMPACT Team intervention, demonstrating that IMPACT teams are an effective approach for improving contraceptive supply chain inventory management and availability. However, our findings do not demonstrate a clear causal pathway as theorized in our theory of change, namely that government leadership leads to the installation of a data use culture, which in turn leads to improved product availability. In both Indonesia and Kenya, though product availability improved, there was a lack of leadership and culture change. This suggests that improved product availability does not depend on establishing a data use culture or government leadership, but rather, that a data use culture-rather than product availability-is the outcome of interest for sustained change, and that understanding motivations and incentives for leadership participation may be more important for scaling, institutionalizing, and sustaining gains in supply chain outcomes.

Using Data to Keep Vaccines Cold in Kenya: Remote Temperature Monitoring with Data Review Teams for Vaccine Management.

BACKGROUND: Global vaccination coverage rates have remained around 85% for the past several years. Increasing immunization coverage rates requires an effective cold chain to maintain vaccine potency. Remote temperature monitoring (RTM) technology for vaccine refrigerators has shown promise for improving the ability of supply systems to maintain optimal temperature conditions to ensure potent vaccines reach the end users. METHODS: A pilot study of RTM technology and data use teams was implemented in 36 study sites in Kenya. Data were collected at baseline and endline points over a 3-month baseline and 7-month implementation period. Data included 44 qualitative interviews, process logs, meeting minutes from data use team meetings, and quantitative temperature and power data from the RTM devices. RESULTS: The ability of cold chain equipment to maintain World Health Organization-recommended temperatures in study sites improved markedly between the baseline and implementation periods, resulting in an improvement in total time spent in the correct range from 83.9% in the baseline period to 90.9% in the intervention period and an improvement in time spent in the too cold range from 6.5% to 1.5%. Friedman tests revealed that differences in time spent in the correct range and time spent in the too cold range during the course of the study were statistically significant (P<.001 and P=.04, respectively). Qualitative and quantitative data suggest that this improvement was due to a combination of improved responsiveness to temperature excursions at the facility level, resulting from SMS alarms for temperature excursion periods, and improved ability at the management level to recognize and address recurring problems. CONCLUSION: The combination of using RTM technology with a structured data review process by a management team is a promising approach for improving cold chain outcomes. Future research examining the added value of each of the technological and behavioral components separately is needed.