We were warned. People said to us: “Scale-up is completely different to running a trial. You’ve run a successful trial, do you really want to get involved in the scale-up?”
The truth is that we had no burning desire to get involved in scale-up. In fact our original strategy was to generate the evidence that our model works in one country (Zambia) and leave others to pick this up and implement the national scale-up and then move on to do the same in another country. However, towards the end of the trial in Zambia, we realised that our rock-solid evidence was likely to sit on shelves and gather dust. So we decided that we had to follow through with the scale-up. I’ve talked about our approach to scale-up and the funding challenges we faced doing this elsewhere.
With the funding now in place for scale-up in Lusaka, we realise our whole approach needs to change. It was our Distribution and Marketing Consultant, Ralf Siwiti (pictured above), who pointed this rather obvious fact out. The sort of change needed is fundamental and is best demonstrated with an example. During the trial we designed a desirable diarrhoea treatment kit (Kit Yamoyo), we put it into the distribution chain at a price that enabled everybody involved in getting it to remote rural communities to make a profit AND for it to arrive in these communities at a price people could afford. We then promoted it within these communities and waited to see it the existing private sector distribution channels got the product to these communities. They did. From a standing start and within a year we sold 26,000 kits to retailers serving these communities.
During the trial it was important that we did not interfere with the distribution as we wanted to prove that existing systems would do the job for the right product with the necessary community-level promotion. In this phase, if a retailer stocked out we simply recorded the fact, we did nothing to re-stock the retailer.
Without really thinking about it, we continued with this approach during the initial weeks of the Lusaka scale-up. Fieldworkers would visit retailers and record the fact that retailers were out of stock but did nothing to help them re-stock. It took Ralf (who wasn’t involved in the trial) to point out that this was ridiculous! We are in the scale-up phase now and fieldworkers need to carry stock when carrying out support visits so that there is an opportunity to sell to retailers that have little or no stock. The success of the scale-up will depend on as many care-givers as possible being aware of Kit Yamoyo and having experience using it and to achieve this retailers need stock. A retailer with no stock can’t sell. We need to transition from being “hands-off” to being “hands-on”!
This realisation is one thing, turning fieldworkers used to a ‘hands-off’ approach into sales people is quite another but we are making progress. On 18-Feb-16 we gathered all KZF field staff together with the top management for a review and re-orientation event where we looked at current practices and issues and got agreement that our approach needed to change. We agreed targets for:
- the number of face-to-face retailer visits to be carried out per month
- weekly sales
- stocking rates
We also agreed that fieldworkers should carry Kit Yamoyo with them when they visit retailers so that they have the potential to sell kits to retailers with little or no stock.
To back this up we upgraded the KYTS Dashboard to reflect these new key performance indicators and provide a mechanism for monitoring progress towards targets. This is the dashboard for the first full month since the event and although there is still a lot of room for improvement, this represents big change when compared with previous months. Click on the image to see it full-size on Flickr.
Click here to view full-size on Flickr
We publish are dashboards regularly here: http://colalife.org/dashboards
I am confident that we are now on the road to continuous improvement.