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Making sure essential drugs and services reach people who need it and when they need it is a challenge, especially in the eastern state of Bihar, India, where resources are limited.

The Government of India mandates that frontline health workers have supplies of zinc and oral rehydration salts (ORS) to manage simple childhood diarrhoea. Yet, irregular supplies of zinc and ORS adversely affect the caregivers’ access to this life-saving therapy, which not only can decrease the duration and severity of diarrhoea, but can reduce the chances of having other episodes in the next few months.

In the Dumrikatsari block of Sheohar District, Bihar, MI implemented an innovative supply chain pilot project, aiming to ensure frontline health workers get timely supplies of zinc and ORS. To do this, MI leveraged the Government of Bihar’s existing vaccine delivery system network, which involved both Courier Service Men (CSM), responsible for transporting vaccines to villages each week, and Cold Chain Handlers (CCH), the health workers responsible for storing and handling vaccines.

The CSMs were given a Supply Chain Replenishment Kit, alongwith the regular vaccines they carried, when they visited their assigned village health sub-center on a fixed Village Health and Nutrition Day (VHND) each week.

This kit had adequate quantities of zinc and ORS for distributing to each frontline health worker. On reaching the VHND site, the CSM recorded the zinc and ORS stocks available and the gap supply needed by each frontline health worker, and replenished the stock accordingly. At the end of the day, they returned to the government Primary Health Center and handed over the zinc and ORS stock status report to the CCH, allowing them to keep better track of overall stock and foresee any arising issues.

Thanks to this innovation in the supply chain, zinc and ORS utilization rates with frontline health workers can be better assessed and stocks can be replenished in real-time. This is just one example of how MI works in partnership with governments to provide low-cost solutions that have a major impact on significant health issues.

MI’s intervention to strengthen the Childhood Diarrhoea Management Program in Bihar is supported by the Children’s Investment Fund Foundation.