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Medical Innovations – Kit Yamoyo and its value chain
11th Medical Innovations Summit 2015, Royal Society of Medicine 12-Se...
What is ColaLife and who are we?
ColaLife is a charity registered in the UK
Charity number: 1142516
• Two founding executi...
Rohit Ramchandani
Jane Berry
The other members of the ColaLife team
Our starting point
What we did next
1
Next moves
What we did What we learned
2 3
54
Medical Innovations – Kit Yamoyo and i...
Our starting point
What we did next
1
Next moves
What we did What we learned
Medical Innovations – Kit Yamoyo and its valu...
observation 1
Diarrhoea
17%
Malaria
12%
AIDS
3%
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
Cent...
the idea
Why not put ORS & Zinc Kit in Coca-Cola crates?
Our starting point
What we did next Next moves
What we did What we learned
Medical Innovations – Kit Yamoyo and its value ...
Jun 2010 | Gave up jobs to try and get a trial started
Jun 2010 | Gave up jobs to try and get a trial started
Our kitchen table
UK
Jun 2010 | Gave up jobs to try and get a trial started
Rohit on Skype
Canada
Our kitchen table
UK
Jun 2010 | Gave up jobs to try and get a trial started
Rohit on Skype
Canada
Harvard & UNICEF
on speaker phone
USA
Our kit...
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
impact Mothers in underserved rural
communities increase use of ORS and
Zinc in home treatment of diarrhoea
purpose
Target...
Dec 2011
COTZ trial timeline | 24 months
Our starting point
What we did next Next moves
What we did What we learned
Medical Innovations – Kit Yamoyo and its value ...
Early 2012 | Pre-trial focus group work
What we learnt
Litre sachets are too big
Measuring water was an issue
Willingness ...
Mar 2012 | Finalised the Kit Yamoyo design
Mar 2012 | Finalised the Kit Yamoyo design
Kit Yamoyo
• Attractive
Mar 2012 | Finalised the Kit Yamoyo design
Kit Yamoyo
• Attractive
• ORS sachets are 200ml
Mar 2012 | Finalised the Kit Yamoyo design
Kit Yamoyo
• Attractive
• ORS sachets are 200ml
• Packaging is also:
• A measur...
Mar 2012 | Finalised the Kit Yamoyo design
Kit Yamoyo
• Attractive
• ORS sachets are 200ml
• Packaging is also:
• A measur...
Mar 2012 | Finalised the Kit Yamoyo design
Kit Yamoyo
• Attractive
• ORS sachets are 200ml
• Packaging is also:
• A measur...
Awards | The Kit Yamoyo has won many global awards
0
Nobody sold
ORS or Zinc
in the
private
sector.
Sep 2012
Before we started
0
Nobody sold
ORS or Zinc
in the
private
sector.
<1%
of children
received the
correct
treatment
for diarrhoea
Sep 2012
Bef...
0
Nobody sold
ORS or Zinc
in the
private
sector.
<1%
of children
received the
correct
treatment
for diarrhoea
7.3km
Was th...
60%
Only 60% of
mothers
mixed ORS
correctly
when given
litre sachets.
0
Nobody sold
ORS or Zinc
in the
private
sector.
<1%...
60%
Only 60% of
mothers
mixed ORS
correctly
when given
litre sachets.
0
Nobody sold
ORS or Zinc
in the
private
sector.
<1%...
60%
Only 60% of
mothers
mixed ORS
correctly
when given
litre sachets.
0
Nobody sold
ORS or Zinc
in the
private
sector.
<1%...
60%
Only 60% of
mothers
mixed ORS
correctly
when given
litre sachets.
0
Nobody sold
ORS or Zinc
in the
private
sector.
<1%...
60%
Only 60% of
mothers
mixed ORS
correctly
when given
litre sachets.
0
Nobody sold
ORS or Zinc
in the
private
sector.
<1%...
60%
Only 60% of
mothers
mixed ORS
correctly
when given
litre sachets.
0
Nobody sold
ORS or Zinc
in the
private
sector.
<1%...
60%
Only 60% of
mothers
mixed ORS
correctly
when given
litre sachets.
0
Nobody sold
ORS or Zinc
in the
private
sector.
<1%...
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 pack...
Manufacture
Assembly
Distribution
Wholesale
K3.10
Retail
K3.70
Customer
K5.00
Market development - the Value Chain
Our starting point
What we did next Next moves
What we did What we learned
Medical Innovations – Kit Yamoyo and its value ...
2014
Incorporating the learning
into a national scale-up plan
Control
Trial – 2012-13
Transition – from 2013
Transition
Intervention
Progress towards national coverage
ORS
Reduce number
of sachets to 4
NOTE: This will
also enhance
adherence
Zinc
Produce locally
Only include
blister pack
So...
ORS
Reduce number
of sachets to 4
NOTE: This will
also enhance
adherence
Zinc
Produce locally
Only include
blister pack
So...
4Learning – 200ml ORS sachets
ORS
Reduce number
of sachets to 4
NOTE: This will
also enhance
adherence
Zinc
Produce locally
Only include
blister pack
So...
ORS
Reduce number
of sachets to 4
NOTE: This will
also enhance
adherence
Zinc
Produce locally
Only include
blister pack
So...
Learning - designing for better zinc adherence
ORS
Reduce number
of sachets to 4
NOTE: This will
also enhance
adherence
Zinc
Produce locally
Design the
blister pack to
e...
ORS
Reduce number
of sachets to 4
NOTE: This will
also enhance
adherence
Zinc
Produce locally
Design the
blister pack to
e...
ORS
Reduce number
of sachets to 4
NOTE: This will
also enhance
adherence
Zinc
Produce locally
Design the
blister pack to
e...
ORS
Reduce number
of sachets to 4
NOTE: This will
also enhance
adherence
Zinc
Produce locally
Design the
blister pack to
e...
4Learning – leaflet
ORS
Reduce number
of sachets to 4
NOTE: This will
also enhance
adherence
Zinc
Produce locally
Design the
blister pack to
e...
ORS
Reduce number
of sachets to 4
NOTE: This will
also enhance
adherence
Zinc
Produce locally
Design the
blister pack to
e...
4Learning – packaging – the screw-top
4Learning – packaging – the screw-top
4Learning – packaging – the flexi-pack
2015
Implementing national
scale-up plans
Scale-up – from 2015
Control
Trial – 2012-13
Transition – from 2013
Transition
Intervention
KYTS-ACE
Progress towards nati...
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
What we did next Next moves
What we did What we learned
Medical Innovations – Kit Yamoyo and its value ...
Scale-up – from 2015
Control
KYTS-LUSAKA
Trial – 2012-13
Transition – from 2013
Transition
Intervention
KYTS-ACE
Progress ...
Sharing the learning – our global impact strategy
colalife.org/openaccess
Campaigning for…
1. 200ml ORS sachets for home use
2. Co-packaging of ORS and Zinc
3. ORS and Zinc as over the counter
med...
Chimtende, Katete
Like us on
Facebook
(please):
facebook.com/colal
ife
Thank you to the ColaLife funders
Isenberg Family
Charitable Foundation
To be continued…
colalife.org
simon@colalife.org
jane@colalife.org
rohit@colalife.org
The data contained in this presentation are unpublished and based
on preliminary analysis of data from the ColaLife Operat...
Royal Society of Medicine - Medical Innovations - Kit Yamoyo and its value chain
Royal Society of Medicine - Medical Innovations - Kit Yamoyo and its value chain
Royal Society of Medicine - Medical Innovations - Kit Yamoyo and its value chain
Royal Society of Medicine - Medical Innovations - Kit Yamoyo and its value chain
Royal Society of Medicine - Medical Innovations - Kit Yamoyo and its value chain
Royal Society of Medicine - Medical Innovations - Kit Yamoyo and its value chain
Royal Society of Medicine - Medical Innovations - Kit Yamoyo and its value chain
Royal Society of Medicine - Medical Innovations - Kit Yamoyo and its value chain
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Royal Society of Medicine - Medical Innovations - Kit Yamoyo and its value chain

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Presentation given by ColaLife's Simon Berry at the Royal Society of Medicine's 11th Medical Innovations Summit 2015 on 12-Sep-15.
This includes a brief history of ColaLife, the learning from the operational trial in Zambia and progress towards national scale-up.

Published in: Healthcare
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Royal Society of Medicine - Medical Innovations - Kit Yamoyo and its value chain

  1. 1. Medical Innovations – Kit Yamoyo and its value chain 11th Medical Innovations Summit 2015, Royal Society of Medicine 12-Sep-15 #medinnov @colalife Simon Berry
  2. 2. What is ColaLife and who are we? ColaLife is a charity registered in the UK Charity 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
  3. 3. Rohit Ramchandani Jane Berry The other members of the ColaLife team
  4. 4. Our starting point What we did next 1 Next moves What we did What we learned 2 3 54 Medical Innovations – Kit Yamoyo and its value chain 11th Medical Innovations Summit 2015, Royal Society of Medicine 12-Sep-15
  5. 5. Our starting point What we did next 1 Next moves What we did What we learned Medical Innovations – Kit Yamoyo and its value chain 11th Medical Innovations Summit 2015, Royal Society of Medicine 12-Sep-15 2 3 54
  6. 6. observation 1
  7. 7. Diarrhoea 17% Malaria 12% AIDS 3% Diarrhoea kills more children than Malaria and AIDS combined
  8. 8. In Zambia 46% of children are stunted (up to 70% in some areas)
  9. 9. observation 2
  10. 10. Full shopsFull shops – empty clinics Remote rural retail shop, Kalomo District, Zambia Drug store room, Tiriri Health Centre, Katine, Uganda
  11. 11. the idea
  12. 12. Why not put ORS & Zinc Kit in Coca-Cola crates?
  13. 13. Our starting point What we did next Next moves What we did What we learned Medical Innovations – Kit Yamoyo and its value chain 11th Medical Innovations Summit 2015, Royal Society of Medicine 12-Sep-15 2 3 54 1
  14. 14. Jun 2010 | Gave up jobs to try and get a trial started
  15. 15. Jun 2010 | Gave up jobs to try and get a trial started Our kitchen table UK
  16. 16. Jun 2010 | Gave up jobs to try and get a trial started Rohit on Skype Canada Our kitchen table UK
  17. 17. Jun 2010 | Gave up jobs to try and get a trial started Rohit on Skype Canada Harvard & UNICEF on speaker phone USA Our kitchen table UK
  18. 18. Sep 2010 | Cycle ride across France raised £6,000
  19. 19. Oct 2010 | First of three consultation trips to Zambia
  20. 20. Jun 2011 | Partnership and trial plan in place
  21. 21. impact Mothers in underserved rural communities increase use of ORS and Zinc in home treatment of diarrhoea purpose Target 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
  22. 22. Dec 2011 COTZ trial timeline | 24 months
  23. 23. Our starting point What we did next Next moves What we did What we learned Medical Innovations – Kit Yamoyo and its value chain 11th Medical Innovations Summit 2015, Royal Society of Medicine 12-Sep-15 2 3 54 1
  24. 24. 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
  25. 25. Mar 2012 | Finalised the Kit Yamoyo design
  26. 26. Mar 2012 | Finalised the Kit Yamoyo design Kit Yamoyo • Attractive
  27. 27. Mar 2012 | Finalised the Kit Yamoyo design Kit Yamoyo • Attractive • ORS sachets are 200ml
  28. 28. Mar 2012 | Finalised the Kit Yamoyo design Kit Yamoyo • Attractive • ORS sachets are 200ml • Packaging is also: • A measuring device for the water
  29. 29. 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
  30. 30. 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
  31. 31. Awards | The Kit Yamoyo has won many global awards
  32. 32. 0 Nobody sold ORS or Zinc in the private sector. Sep 2012 Before we started
  33. 33. 0 Nobody sold ORS or Zinc in the private sector. <1% of children received the correct treatment for diarrhoea Sep 2012 Before we started
  34. 34. 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
  35. 35. 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
  36. 36. 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
  37. 37. 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
  38. 38. 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
  39. 39. 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
  40. 40. 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
  41. 41. 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
  42. 42. 4% Only 4% of kits went into Coca-Cola crates. Aug 2013 After 12 months
  43. 43. 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
  44. 44. Manufacture Assembly Distribution Wholesale K3.10 Retail K3.70 Customer K5.00 Market development - the Value Chain
  45. 45. Our starting point What we did next Next moves What we did What we learned Medical Innovations – Kit Yamoyo and its value chain 11th Medical Innovations Summit 2015, Royal Society of Medicine 12-Sep-15 2 3 54 1
  46. 46. 2014 Incorporating the learning into a national scale-up plan
  47. 47. Control Trial – 2012-13 Transition – from 2013 Transition Intervention Progress towards national coverage
  48. 48. ORS Reduce number of sachets to 4 NOTE: This will also enhance adherence Zinc Produce locally Only include blister pack Soap Produce locally Leaflet Packaging Remove constraint of fitting in Coca- Cola crate Produce locally Produce re-fill option Learning – product design
  49. 49. ORS Reduce number of sachets to 4 NOTE: This will also enhance adherence Zinc Produce locally Only include blister pack Soap Produce locally Leaflet Packaging Remove constraint of fitting in Coca- Cola crate Produce locally Produce re-fill option Learning – product design
  50. 50. 4Learning – 200ml ORS sachets
  51. 51. ORS Reduce number of sachets to 4 NOTE: This will also enhance adherence Zinc Produce locally Only include blister pack Soap Produce locally Leaflet Packaging Remove constraint of fitting in Coca- Cola crate Produce locally Produce re-fill option 4Learning – reduce number of ORS sachets to 4
  52. 52. ORS Reduce number of sachets to 4 NOTE: This will also enhance adherence Zinc Produce locally Only include blister pack Soap Produce locally Leaflet Packaging Remove constraint of fitting in Coca- Cola crate Produce locally Produce re-fill option 4Learning – zinc
  53. 53. Learning - designing for better zinc adherence
  54. 54. ORS Reduce number of sachets to 4 NOTE: This will also enhance adherence Zinc Produce locally Design the blister pack to enhance adherence to the 10-day regime Blister pack needs no box Soap Produce locally Leaflet Packaging Remove constraint of fitting in Coca- Cola crate Produce locally Produce re-fill option 4Learning – zinc packaging design
  55. 55. ORS Reduce number of sachets to 4 NOTE: This will also enhance adherence Zinc Produce locally Design the blister pack to enhance adherence to the 10-day regime Blister pack needs no box Soap Produce locally Leaflet Packaging Remove constraint of fitting in Coca- Cola crate Produce locally Produce re-fill option 4Learning – soap
  56. 56. ORS Reduce number of sachets to 4 NOTE: This will also enhance adherence Zinc Produce locally Design the blister pack to enhance adherence to the 10-day regime Blister pack needs no box Soap Produce locally (still to be achieved) Leaflet Packaging Remove constraint of fitting in Coca- Cola crate Produce locally Produce re-fill option 4Learning – soap
  57. 57. ORS Reduce number of sachets to 4 NOTE: This will also enhance adherence Zinc Produce locally Design the blister pack to enhance adherence to the 10-day regime lister pack needs no box Soap Produce locally Leaflet Packaging Remove constraint of fitting in Coca- Cola crate Produce locally Produce re-fill option 4Learning – leaflet
  58. 58. 4Learning – leaflet
  59. 59. ORS Reduce number of sachets to 4 NOTE: This will also enhance adherence Zinc Produce locally Design the blister pack to enhance adherence to the 10-day regime Blister pack needs no box Soap Produce locally Leaflet Simplify – single fold. Same leaflet for all formats Packaging 4Learning – packaging
  60. 60. ORS Reduce number of sachets to 4 NOTE: This will also enhance adherence Zinc Produce locally Design the blister pack to enhance adherence to the 10-day regime Blister pack needs no box Soap Produce locally Leaflet Simplify – single fold. Same leaflet for all formats Packaging Remove constraint of fitting in Coca- Cola crate. Only 4% of retailers used this option Produce locally Produce re-fill option 42014 | Incorporating the learning into the scale-up
  61. 61. 4Learning – packaging – the screw-top
  62. 62. 4Learning – packaging – the screw-top
  63. 63. 4Learning – packaging – the flexi-pack
  64. 64. 2015 Implementing national scale-up plans
  65. 65. Scale-up – from 2015 Control Trial – 2012-13 Transition – from 2013 Transition Intervention KYTS-ACE Progress towards national coverage
  66. 66. 452,000 Product - new public sector format
  67. 67. Promotion – aspirational product
  68. 68. Promotion – frontline and face to face
  69. 69. Para-skilling shop-keepers to advise customers
  70. 70. Our starting point What we did next Next moves What we did What we learned Medical Innovations – Kit Yamoyo and its value chain 11th Medical Innovations Summit 2015, Royal Society of Medicine 12-Sep-15 2 3 54 1
  71. 71. Scale-up – from 2015 Control KYTS-LUSAKA Trial – 2012-13 Transition – from 2013 Transition Intervention KYTS-ACE Progress towards national coverage
  72. 72. Sharing the learning – our global impact strategy colalife.org/openaccess
  73. 73. 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 promoting a game-changing new approach to diarrhoea treatment in the home
  74. 74. Chimtende, Katete Like us on Facebook (please): facebook.com/colal ife
  75. 75. Thank you to the ColaLife funders Isenberg Family Charitable Foundation
  76. 76. To be continued… colalife.org simon@colalife.org jane@colalife.org rohit@colalife.org
  77. 77. 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

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