Bill & Melinda Gates Foundation

When RED Meets RED: How Coca-Cola and the Health System in Ghana are Learning From One Another

September 23, 2013

Two-way learning with a focus on operational challenges and developing partnerships to bring the commercial and public sectors and civil society together can generate long term benefits.

I recently completed a four day visit to the bustling and busy city of Accra in the company of the Accenture Development Partners (ADP) team implementing the Last Mile Project with Coca Cola, and Ghana Health Services (GHS).

I participated in a workshop and series of meetings at GHS and Coca-Cola and I was particularly impressed by Livingston, a biomedical engineer from the Volta Region GHS engineering team who told me about the lessons he had learned from the pilot project he had just completed with Coca-Cola and ADP to introduce preventive maintenance in five Districts. “The District managers are very happy that we fixed and cleaned their vaccine fridges. When they work we can reach more children with immunizations.”

Coca-Cola is one of the most powerful and universal commercial brands. In even the most remote regions of the globe, Coke signs adorn village shops and markets. Take a look at any Coke advertisement; it projects their product by association with key human aspirations of happiness and health for family and friends.

Coca-Cola is also synonymous with best in class supply chains and commercial business practices that ensure they are meeting client needs. One of their operational approaches is to ensure “RED compliance” – that they achieve the "Right Execution Daily" with their standard operating procedures which is very pervasively displayed in their offices in the form of performance metrics by area and individual staff member.

This client centered operational approach is something Ghana Health Services (GHS) can learn from. Coincidentally, GHS also has an operational approach called “RED”, that Coca-Cola can also learn from. In this case GHS is seeking to “Reach Every District” including those in the North of the country and in remote island areas in Volta Region where poor infrastructure, weak local economies  and geographic challenges actually mean that Coke is yet to reach every village.

This recognition that there is an opportunity for two way learning between the public and private sector is the focus of a new project we are working on with Coke and GHS. This approach builds upon a number of earlier discussions with Coca-Cola and work done by Professor Prashant Yadav of the University of Michigan. In an article published in the Stanford Social Innovation Review. He concluded that while there is much to be borrowed from Coca Cola’s supply chain, there is much that is impossible to replicate. He found that a major difference between the Coca-Cola value chain and the public health supply chain is that there is no financial value added to incentivize performance. Another key lesson is that the more specific the operational ask, the easier it is to translate from Coca-Cola to GHS. By drilling down and focusing on specific functions in Coca-Cola’s supply chain operations, we have been able to find real synergies with similar operations managed by GHS.

After some initial work in 2012, the Gates Foundation partnered with Accenture Development Partnerships (ADP) to translate Coca-Cola best practices to the GHS. ADP’s role stemmed from the recognition that while Coca-Cola has some of the best supply chain systems, replicated with commercial business partners, their business does not usually involve sharing with the public sector. Their staff has experience, tools and benchmarking data suited to their own operational needs but needed ADP to help translate these to practices suited to GHS and the very different “business model” they operate.

One example is preventive maintenance of the cold chain equipment like refrigerators. Coca-Cola has 15,600 fridges in Ghana that are 99.3% operational thanks to their rigorous preventive maintenance schedule carried out by a dedicated team of 26 trained technicians supplemented by contractors. These technicians are equipped with tools, a repair vehicle, a stock of spare parts and clear performance targets and standard operating procedures. Performance is managed and measured against key performance indicators and validated by  supervisors and sales reps who also provide early warning of equipment problems when they visit retail outlets.


These fundamental components were broken down and translated by the ADP team into a set of requirements for GHS to achieve effective preventive maintenance. A pilot was conducted in five districts in the Ghana’s Volta Region over five weeks that enabled the servicing of 57 pieces of equipment, in 50 different facilities. Coca Cola provided in-country expertise in delivering a national maintenance model, providing access to their processes, tools and staff as well as setting up several meetings with GHS to share their experiences. A Coca-Cola Engineer named Maxwell accompanied Livingston on a visit to three clinics and two Coca-Cola outlets in the Volta Region, where they worked to service both vaccine fridges and Coca-Cola coolers, sharing knowledge and skills.Feedback from the pilot districts  has been very positive as hitherto around 20% of the GHS equipment was  non-functional and long delays were experienced with service calls. This worked uncovered that GHS engineers are not solely assigned to work on the Expanded Program of Immunization (EPI) in Ghana and are often diverted to service other equipment. The lack of a stock of spare parts and dedicated transport also can mean that routine preventive maintenance is not conducted and service requests to fix broken equipment are either not fulfilled or not fulfilled.

Dr. K.O. head of the EPI program stressed the importance of effective cold chain management. “We have good coverage rates in Ghana including in the North but recently we had a measles outbreak because vaccine potency was compromised when the cold chain failed, we then had to organize a special campaign and this cost us additional resources. ”

Coca-Cola Regional Director of Public Affairs and Communications for Equatorial Africa Ama Bawuah reaffirmed her support for continuing to help the GHS. “We see our relationship as a key part of us giving back to the community that we rely on for business. A healthier Ghana is a more prosperous Ghana and has more potential for us as a market. We also see how GHS reach the toughest parts of the country and can learn from that as well. At Coca-Cola we talk about the “golden triangle” as the intersection between business the public sector and civil society and that when these three are working together effectively the best results can be achieved.  We are committed through the Last Mile Project to continue to invest to work with the Gates Foundation, Global Fund and USAID to find further ways to share and learn from GHS.” Whether it is the Golden Triangle or Red meets Red, partners are finding smarter ways of ensuring rural Ghanaian villages can get both their life-saving  vaccines for their children and Coca-Cola. 

Interested in learning more? Watch Melinda Gates' TED talk, What Nonprofits can Learn from Coca-Cola.

 
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