KYTS Briefing - Collaboration Partners' meeting 20-Oct-15, Lusaka, Zambia
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Progress update on the Kit Yamoyo scale-up in Zambia for the stakeholders who support public health in Zambia. The meeting was held at the CDC offices in Lusaka. For on-going updates please see: http://colalife.org/status
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KYTS Briefing - Collaboration Partners' meeting 20-Oct-15, Lusaka, Zambia
- 1. Kit Yamoyo Transition to Scale (KYTS) Cooperating Partners’ Meeting Lusaka, Zambia 20-Oct-15 Simon Berry CEO and co-founder simon@colalife.org colalife.org
- 2. Rohit Ramchandani Jane Berry The other members of the ColaLife team We have no commercial interest in anything I am going to describe to you
- 3. Our partners in Zambia – the trial
- 4. Our partners in Zambia – scale-up (so far)
- 10. Diarrhoea 19%of infectious disease deaths Malaria 15%of infectious disease deaths AIDS 4% Diarrhoea kills as many children than Malaria and AIDS combined Source: Liu et al (2015) Global, regional, and national causes of child mortality in 2000–13, with projections to inform post-2015 priorities: an updated systematic analysis. The Lancet.
- 11. In Zambia 46% of children are stunted (up to 70% in some areas)
- 12. observation 2
- 13. You can buy a Coca-Cola almost anywhere
- 14. Full shopsFull shops – empty clinics Remote rural retail shop, Kalomo District, Zambia Drug store room, Tiriri Health Centre, Katine, Uganda
- 15. the idea
- 16. Why not put ORS & Zinc Kit in Coca-Cola crates?
- 17. the action
- 18. Early 2012 | Pre-trial focus group work What we learnt Litre ORS sachets are too big Measuring water was an issue Willingness to pay Preferred branding
- 19. Mar 2012 | Finalised the Kit Yamoyo design
- 20. Mar 2012 | Finalised the Kit Yamoyo design Kit Yamoyo • Attractive
- 21. Mar 2012 | Finalised the Kit Yamoyo design Kit Yamoyo • Attractive • ORS sachets are 200ml
- 22. Mar 2012 | Finalised the Kit Yamoyo design Kit Yamoyo • Attractive • ORS sachets are 200ml • Packaging is also: • A measuring device for the water
- 23. Mar 2012 | Finalised the Kit Yamoyo design Kit Yamoyo • Attractive • ORS sachets are 200ml • Packaging is also: • A measuring device for the water • A mixing device
- 24. Mar 2012 | Finalised the Kit Yamoyo design Kit Yamoyo • Attractive • ORS sachets are 200ml • Packaging is also: • A measuring device for the water • A mixing device • A storage device (the soap tray is a lid) • A cup
- 25. Control districts Trial – Sep-12 to Sep-13 Intervention districts Trial districts
- 26. 60% Only 60% of mothers mixed ORS correctly when given litre sachets. 0 Nobody sold ORS or Zinc in the private sector. <1% of children received the correct treatment for diarrhoea 7.3km Was the average distance to ORS. Sep 2012 Before we started
- 27. 60% Only 60% of mothers mixed ORS correctly when given litre sachets. 0 Nobody sold ORS or Zinc in the private sector. <1% of children received the correct treatment for diarrhoea 7.3km Was the average distance to ORS. >26k kits sold into the two remote rural trial areas in 12 months. Aug 2013 After 12 months Sep 2012 Before we started
- 28. 60% Only 60% of mothers mixed ORS correctly when given litre sachets. 0 Nobody sold ORS or Zinc in the private sector. <1% of children received the correct treatment for diarrhoea 7.3km Was the average distance to ORS. >26k kits sold into the two remote rural trial areas in 12 months. 45% of children in trial areas received ORS/from Zinc. Up a baseline of <1%. Aug 2013 After 12 months Sep 2012 Before we started
- 29. 60% Only 60% of mothers mixed ORS correctly when given litre sachets. 0 Nobody sold ORS or Zinc in the private sector. <1% of children received the correct treatment for diarrhoea 7.3km Was the average distance to ORS. >26k kits sold into the two remote rural trial areas in 12 months. 45% of children in trial areas received ORS/from Zinc. Up a baseline of <1%. 2.4km The distance to ORS/Zinc in the trial areas was reduced by two-thirds from 7.3km to 2.4km. Aug 2013 After 12 months Sep 2012 Before we started
- 30. 60% Only 60% of mothers mixed ORS correctly when given litre sachets. 0 Nobody sold ORS or Zinc in the private sector. <1% of children received the correct treatment for diarrhoea 7.3km Was the average distance to ORS. >26k kits sold into the two remote rural trial areas in 12 months. 45% of children in trial areas received ORS/from Zinc. Up a baseline of <1%. 2.4km The distance to ORS/Zinc in the trial areas was reduced by two-thirds from 7.3km to 2.4km. 93% of Kit Yamoyo users mixed ORS correctly. Only 60% do when given 1 litre sachets. Aug 2013 After 12 months Sep 2012 Before we started
- 31. 60% Only 60% of mothers mixed ORS correctly when given litre sachets. 0 Nobody sold ORS or Zinc in the private sector. <1% of children received the correct treatment for diarrhoea 7.3km Was the average distance to ORS. >26k kits sold into the two remote rural trial areas in 12 months. 45% of children in trial areas received ORS/from Zinc. Up a baseline of <1%. 2.4km The distance to ORS/Zinc in the trial areas was reduced by two-thirds from 7.3km to 2.4km. 93% of Kit Yamoyo users mixed ORS correctly. Only 60% do when given 1 litre sachets. Aug 2013 After 12 months Sep 2012 Before we started
- 32. 4% Only 4% of kits went into Coca-Cola crates. Aug 2013 After 12 months
- 33. In Zambia, it’s the space in the market, not the space in the crates that is important. This means we can revisit the packaging to make it cheaper. Kit Yamoyo Washing Powder Eggs Biscuits Cola – but not Coca-Cola Bread
- 34. Manufacture Assembly Distribution Wholesale K3.10 Retail K3.70 Customer K5.00 Market development - the Value Chain
- 35. Awards | The Kit Yamoyo has won many global awards
- 36. Control districts Trial – Sep-12 to Sep-13 Transition – from Oct-13 Transition districts Intervention districts Progress towards national scale-up
- 37. 4Scale-up Kit Yamoyo formats: screw-top and flexi-pack
- 38. 4The flexi-pack retains the measuring functionality
- 39. 4The flexi-pack retains the measuring functionality
- 40. Scale-up Control districts Trial – Sep-12 to Sep-13 Transition – from Oct-13 Transition districts Intervention districts KYTS-ACE – from Feb-15 Progress towards national scale-up
- 41. 4The GRZ ORS/Zinc co-pack 452,000 kits to 11 of the SUN Districts
- 42. Scale-up Control districts KYTS-LUSAKA – from Oct-15 Trial – Sep-12 to Sep-13 Transition – from Oct-13 Transition districts Intervention districts KYTS-ACE – from Feb-15 Progress towards national scale-up
- 43. Scale-up Control districts KYTS-LUSAKA – from Oct-15 Trial – Sep-12 to Sep-13 Transition – from Oct-13 Transition districts Intervention districts KYTS-ACE – from Feb-15 Progress towards national scale-up
- 45. Campaigning for… 1. 200ml ORS sachets for home use 2. Co-packaging of ORS and Zinc 3. ORS and Zinc as over the counter medicines 4. People to understand that all our designs, learning and findings are theirs to take and use for FREE – we are NOT promoting a product – we are promoting a game-changing new approach to diarrhoea treatment in the home
- 46. Thank you to the ColaLife funders past and present Isenberg Family Charitable Foundation
- 47. Thank you to the ColaLife funders - current Isenberg Family Charitable Foundation
- 48. questions?
Hinweis der Redaktion
- [Presentation description: This presentation describes the progress of UK charity ColaLife from its initial concept to ‘piggyback’ simple medicines, at the ‘last mile’ of distribution in developing countries, through to the results and learning from the 2 year trial in Zambia, to scale-up plans to cover the whole of Zambia and spread designs and learning more widely.]
- I also want to recognise my colleagues. Jane works with me full-time when she hasn’t got Shingles which is the case at the moment. She is my partner in life and ColaLife. Rohit is based in Canada and works with us part-time. He is our public health adviser and it completing his Doctoral in Public Health at Johns Hopkins University.
- I also want to recognise my colleagues. Jane works with me full-time when she hasn’t got Shingles which is the case at the moment. She is my partner in life and ColaLife. Rohit is based in Canada and works with us part-time. He is our public health adviser and it completing his Doctoral in Public Health at Johns Hopkins University.
- I also want to recognise my colleagues. Jane works with me full-time when she hasn’t got Shingles which is the case at the moment. She is my partner in life and ColaLife. Rohit is based in Canada and works with us part-time. He is our public health adviser and it completing his Doctoral in Public Health at Johns Hopkins University.
- This is the first observation I mentioned
- Against this backdrop, 1 in 5 children didn’t make it to their 5th birthday.
- – 25 times higher than here in Europe.
- ColaLife wants to make this picture for developing countries look like…
- … this one.
- Just as shocking as this level of mortality is the fact that diarrhoea, an easily treated condition, is the second biggest killer. It was back in 1985 and still now. Dehydration from diarrhoea kills more children than Malaria and HIV/AIDS combined.
- Just as shocking as this level of mortality is the fact that diarrhoea, an easily treated condition, is the second biggest killer. It was back in 1985 and still now. Dehydration from diarrhoea kills more children than Malaria and HIV/AIDS combined.
- Against this backdrop of high mortality and the lack of essential medicines to treat diarrhoea, you can get a Coca-Cola (and other FMCGs) in most places,
- While community shops are well stocked with the things people want, the public sector struggles to keep public health centres stocked with essential medicines.
- This brings me to the idea…
- Coca-Cola get everywhere so if we put medicines in the crates that would get everywhere too.
- This brings me to the idea…
- This was perhaps our most important activity in the whole trial – talking to mothers about diarrhoea treatment in the home. We learned four key things: Litre sachets are too big Measuring water is problem We also got an indication of how much they might pay for an anti-diarrhoea kit And how they’d like it branded
- This is the resulting product – Kit Yamoyo – is:
- • attractive – aspirational even
- • it contains 200ml sachets of ORS
- • the packaging acts as a measure for the water
- • it’s also a mixing device for the ORS
- • and can be used as a cup
- Thanks to DfID funding we will start scale-up where most people live - over 2 million of Zambia’s 13 million people live here. As the final step to national scale-up we will seek support to develop the market in the Copperbelt (green circle) where another 2 milllion live.
- So it’s no wonder that diarrhoea holds its position as the 2nd biggest killer of under 5 children.
- So what happened during our 12-month trial? • From a standing start we sold 26,000 kits to retailers serving the trial communities
- So what happened during our 12-month trial? • We increased treatment rates from <1% to 45%
- So what happened during our 12-month trial? • We reduced the distance mothers had to travel to access treatment – shops are a lot closer to people’s homes that clinics
- So what happened during our 12-month trial? • And through the design of the kit we increased correct measurement of the ORS from 60% to 93%. When using Kit Yamoyo, 93% of mothers got the mixing right
- Before and after…
- But here’s the shock: • Only 4% of the 26,000 kits sold travelled to the village in Coca-Cola crates
- In practice, this is what happened. It wasn’t the space in the crates that was important, it was the space in the market. We had designed and marketed an aspirational product (just like Coke) which people wanted and which retailers could make a profit bring to the communities and selling (just like Coke).
- We design and product TOGETHER WITH its value chain.
- The Kit Yamoyo has captured people’s imagination and won many global health, design and innovation awards. In Sep-13 it was featured at the UN General Assembly as a breakthrough innovation in Child Health. In Mar-14 it was show-cased by PATH and PSI in their Best Buys for Global Health initiative.
- Thanks to DfID funding we will start scale-up where most people live - over 2 million of Zambia’s 13 million people live here. As the final step to national scale-up we will seek support to develop the market in the Copperbelt (green circle) where another 2 milllion live.
- Because the kit no longer needs to fit in Coca-Cola crates we can move to cheaper packaging options. In the scale-up we will be using two new packaging formats: • a screw-top • a flexible pack
- Because the kit no longer needs to fit in Coca-Cola crates we can move to cheaper packaging options. In the scale-up we will be using two new packaging formats: • a screw-top • a flexible pack
- Because the kit no longer needs to fit in Coca-Cola crates we can move to cheaper packaging options. In the scale-up we will be using two new packaging formats: • a screw-top • a flexible pack
- Thanks to DfID funding we will start scale-up where most people live - over 2 million of Zambia’s 13 million people live here. As the final step to national scale-up we will seek support to develop the market in the Copperbelt (green circle) where another 2 milllion live.
- Because the kit no longer needs to fit in Coca-Cola crates we can move to cheaper packaging options. In the scale-up we will be using two new packaging formats: • a screw-top • a flexible pack
- Thanks to DfID funding we will start scale-up where most people live - over 2 million of Zambia’s 13 million people live here. As the final step to national scale-up we will seek support to develop the market in the Copperbelt (green circle) where another 2 milllion live.
- Thanks to DfID funding we will start scale-up where most people live - over 2 million of Zambia’s 13 million people live here. As the final step to national scale-up we will seek support to develop the market in the Copperbelt (green circle) where another 2 milllion live.
- And at the same time we are campaigning for: The production of 200ml ORS sachets for treatment of diarrhoea in the home – we don’t care who produces them – we just want them to be produced and available on the market. The co-packaging of ORS and Zinc to improve the likelihood that they are dispensed together ORS and Zinc to be classified as over the counter medicines. They are in many places but not everywhere. This classification will mean that the all pervasive FMCG distribution channels will be open to co-packaged ORS and Zinc People to understand that ColaLife is not selling anything! We want to give all our designs, learning and findings away for others to exploit for free. We are not selling a product or ideas, we are promoting a game-changing approach to diarrhoea treatment in the home
- It was the early commitment of funds to the ColaLife idea that leveraged all the other support for the trial and subsequent to the trial additional funders have come on-board. Notably Ceniarth and the Isenberg Family Charitable Foundation have provided ‘catalytic’ funding and we have always enjoyed support from individual supporters.
- It was the early commitment of funds to the ColaLife idea that leveraged all the other support for the trial and subsequent to the trial additional funders have come on-board. Notably Ceniarth and the Isenberg Family Charitable Foundation have provided ‘catalytic’ funding and we have always enjoyed support from individual supporters.