What we've learnt from Coca-Cola | Taking ColaLife to scale in Zambia

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The final keynote presentation at the IHI/BMJ Quality & Safety in Healthcare Conference. Paris, 11-Apr-14

Text of What we've learnt from Coca-Cola | Taking ColaLife to scale in Zambia

  • ColaLife | What we've learnt from Coca-Cola. Taking ColaLife to scale in Zambia. 11-Apr-14
  • What is ColaLife and who am I? ColaLife is a charity registered in the UK Charity number: 1142516 No paid employees Five voluntary trustees Focus on saving childrens lives Independent Our only project is in Zambia Looking for global impact through Disruptive innovation Generating robust evidence Sharing findings and learning No commercial interest 2009 2010 2011 2012 20131985
  • The other members of the ColaLife team 2009 2010 2011 2012 20131985 Rohit Ramchandani Jane Berry
  • 1985 | Our starting point Coca-Cola seems to get everywhere in developing countries, yet life-saving medicines don't. Why?
  • Coca-Cola seems to get everywhere in developing countries, yet life-saving medicines don't. Why? Coca-Cola seems to get everywhere in developing countries, yet life-saving medicines don't. Why? 1985 | Our starting point
  • Child mortality in less developed countries is unacceptably high. In 1985 1 in 5 children didnt make it to their 5th birthday (now its 1 in 8). 1985 | The ColaLife idea was born
  • The public sector struggles to maintain reliable supplies of drugs to health facilities. Child mortality in less developed countries is unacceptably high. 1 in 8 children dont make it to their 5th birthday. 1985 | The ColaLife idea was born
  • The public sector struggles to maintain reliable supplies of drugs to health facilities. Child mortality in less developed countries is unacceptably high. 1 in 8 children dont make it to their 5th birthday. Yet you can get a Coca-Cola in the most remote, rural villages. 1985 | The ColaLife idea was born
  • The public sector struggles to maintain reliable supplies of drugs to health facilities. Child mortality in less developed countries is unacceptably high. 1 in 8 children dont make it to their 5th birthday. Yet you can a Coca-Cola in most remote, rural villages. Why dont we put medicines in Coca-Cola crates? 1985 | The ColaLife idea was born
  • 1985 | The ColaLife idea was born
  • Why not put ORS & Zinc Kit in Coca-Cola crates?
  • 1985 | No technology to enable sharing of the idea
  • May 2008 | Gordon Browns Business Call to Action
  • May 2008 | Set-up Facebook Group
  • and with international good practice (WHO/UNICEF, 2009) also including Lancet 2013 series on nutrition/diarrhoea Apr-13 Strengthened distribution systems and new delivery strategies Diarrhoea treatment kits for all new mothers combining ORS and Zinc Market-based solutions are often the most effective way to deliver key diarrhoea control commodities We know what to do but access and availability are barriers
  • 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 kitchen table UK
  • Sep 2010 | Cycle ride across France raised 6,000
  • Oct 2010 | First of three trips to Zambia
  • Jun 2011 | Partnership and trial plan in place
  • Nov 2011 | COTZ Funders in place
  • Dec 2011 | COTZ gets underway
  • Dec 2011 The trial timeline
  • impac t 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
  • 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
  • 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:
  • Mar 2012 | Finalised the Kit Yamoyo design Kit Yamoyo Attractive ORS sachets are 200ml Packaging is also: A measuring device for the water
  • 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
  • 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)
  • 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
  • The COTZ trial Research Design & Methodology Quasi-experimental, pre-test, post test design Baseline, midline and endline surveys Target groups: Care-givers of under-5 children and private community retailers Four Districts two intervention districts and two comparator districts Sample sizes: 625 HH per district 40 retailers per district
  • The COTZ trial Distribution infrastructure and value chain Pharmanova MSL Coca-Cola wholesalers Standard Sales (2) Isusyas Approximately 85 retailers across Katete and Kalomo Manufacture & Assembly Lusaka to District District to Retailers Mothers & Care-givers
  • >26k kits sold into the two remote rural trial areas in 12 months.
  • >26k kits sold into the two remote rural trial areas in 12 months. 45%of children in trial areas received ORS/Zinc. Up from a baseline of