Royal Society of Medicine - Medical Innovations - Kit Yamoyo and its value chain

transcript

Medical Innovations – Kit Yamoyo and its value chain

11th Medical Innovations Summit 2015, Royal Society of Medicine 12-Sep-15

#medinnov@colalife

Simon Berry

What is ColaLife and who are we?

ColaLife is a charity registered in the UKCharity number: 1142516

• Two founding executives• Five voluntary trustees• Focus on saving children’s lives• Independent• Our only project is in Zambia• Looking for global impact through

• Disruptive innovation• Generating robust evidence• Sharing findings and learning

• No personal commercial interest

Rohit Ramchandani

Jane Berry

The other members of the ColaLife team

Our starting point

What we did next

Next moves

What we did What we learned

Our starting point

What we did next

Next moves

observation 1

Diarrhoea

Malaria

Diarrhoea kills more children than Malaria and AIDS combined

In Zambia 46% of children are stunted (up to 70% in some areas)

observation 2

Full shopsFull shops – empty clinics

Remote rural retail shop, Kalomo District, Zambia

Drug store room, Tiriri Health Centre, Katine, Uganda

the idea

Why not put ORS & Zinc Kit in Coca-Cola crates?

Our starting point

What we did next Next moves

Jun 2010 | Gave up jobs to try and get a trial started

Our kitchen tableUK

Rohit on SkypeCanada

Our kitchen tableUK

Rohit on SkypeCanada

Harvard & UNICEF on speaker phoneUSA

Our kitchen tableUK

Sep 2010 | Cycle ride across France raised £6,000

Oct 2010 | First of three consultation trips to Zambia

Jun 2011 | Partnership and trial plan in place

impactMothers in underserved rural communities increase use of ORS and Zinc in home treatment of diarrhoea

purposeTarget communities in two under-served rural districts have improved access to ORS and Zinc

outputs

Profit-driven supply chains improve availability of ADKs (anti-diarrhoea kits) in targeted communities in two underserved rural districts

Mothers/care-givers demonstrate awareness of ADKs and the benefits of the contents (ORS, Zinc and Soap)

access = ADK in the hand of an aware mother/care-giver

Availability = ADK in stock in retail outlets at community level

Generating robust evidence - the COTZ results framework

Dec 2011

COTZ trial timeline | 24 months

Our starting point

Early 2012 | Pre-trial focus group work

What we learnt

Litre sachets are too big

Measuring water was an issue

Willingness to pay

Preferred branding

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

the water

• A mixing device

• A storage device (the

soap tray is a lid)

• A cup

Awards | The Kit Yamoyo has won many global awards

0Nobody sold ORS or Zinc in the private sector.

Sep 2012

Before we started

<1%of children received the correct treatment for diarrhoea

Sep 2012

Before we started

7.3kmWas the average distance to ORS.

Sep 2012

Before we started

60%Only 60% of mothers mixed ORS correctly when given litre sachets.

Sep 2012

Before we started

Sep 2012

Before we started

>26kkits sold into the two remote rural trial areas in 12 months.

Aug 2013

After 12 months

Sep 2012

Before we started

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

2.4kmThe 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

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

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

4%Only 4% of kits went into Coca-Cola crates.

Aug 2013

After 12 months

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

Biscuits

Cola – but not Coca-Cola

Manufacture

Assembly

Distribution

WholesaleK3.10

RetailK3.70

CustomerK5.00

Market development - the Value Chain

Our starting point

2014Incorporating the learning

into a national scale-up plan

Control

Trial – 2012-13

Transition – from 2013

Transition

Intervention

Progress towards national coverage

Reduce number of sachets to 4

NOTE: This will also enhance adherence

Produce locally

Only include blister pack

Produce locally

Leaflet Packaging

Removeconstraint of fitting in Coca-Cola crate

Produce locally

Produce re-fill option

Learning – product design

Produce locally

Leaflet Packaging

Produce locally

Learning – product design

4Learning – 200ml ORS sachets

Produce locally

Leaflet Packaging

Produce locally

4Learning – reduce number of ORS sachets to 4

Produce locally

Leaflet Packaging

Produce locally

4Learning – zinc

Learning - designing for better zinc adherence

Produce locally

Design the blister pack to enhance adherence to the 10-day regime

Blister pack needs no box

Produce locally

Leaflet Packaging

Produce locally

4Learning – zinc packaging design

Produce locally

Leaflet Packaging

Produce locally

4Learning – soap

Produce locally

Produce locally(still to be achieved)

Leaflet Packaging

Produce locally

4Learning – soap

Produce locally

lister pack needs no box

Produce locally

Leaflet Packaging

Produce locally

4Learning – leaflet

Produce locally

Leaflet

Simplify –single fold.Same leaflet for all formats

Packaging

4Learning – packaging

Produce locally

Leaflet

Simplify –single fold.Same leaflet for all formats

Packaging

Removeconstraint of fitting in Coca-Cola crate. Only 4% of retailers used this option

Produce locally

42014 | Incorporating the learning into the scale-up

4Learning – packaging – the screw-top

4Learning – packaging – the flexi-pack

2015Implementing national

scale-up plans

Scale-up – from 2015

Control

Trial – 2012-13

Transition

Intervention

KYTS-ACE

452,000

Product - new public sector format

Promotion – aspirational product

Promotion – frontline and face to face

Para-skilling shop-keepers to advise customers

Our starting point

Scale-up – from 2015

Control

KYTS-LUSAKA

Trial – 2012-13

Transition

Intervention

KYTS-ACE

Sharing the learning – our global impact strategy

colalife.org/openaccess

Campaigning for…

1. 200ml ORS sachets for home use2. Co-packaging of ORS and Zinc3. ORS and Zinc as over the counter

medicines4. 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 promoting a game-changing new approach to diarrhoea treatment in the home

Chimtende, Katete

Like us on Facebook (please):

facebook.com/colalife

Thank you to the ColaLife funders

Isenberg Family Charitable Foundation

To be continued…

colalife.org

simon@colalife.orgjane@colalife.orgrohit@colalife.org

The data contained in this presentation are unpublished and based on preliminary analysis of data from the ColaLife Operational Trial in Zambia (COTZ). Final calculations may vary and will be published in peer reviewed literature in due course.

In the interim, the following citation may be used: Ramchandani, R. et al. (forthcoming). ColaLife Operational Trial Zambia (COTZ) Evaluation. Johns Hopkins Bloomberg School of Public Health, Baltimore.

Related correspondence should be sent to Rohit Ramchandani (roramcha@jhsph.edu) and copied to Simon Berry (simon@colalife.org).

A note on the data contained within this presentation

Royal Society of Medicine - Medical Innovations - Kit Yamoyo and its value chain

Healthcare