ABSTRACT:
In Nigeria, fragmented public health supply chains and difficult terrain limit equitable access to essential medicines(1), particularly for zero dose children and hard to reach communities, slowing progress toward Universal Health Coverage. Drone technology can overcome distance, but its impact depends on subnational leaders who can integrate multimodal logistics, data systems, and public private partnerships into routine decision making. Traditional training rarely builds these leadership competencies, leaving a gap between technology deployment and health system transformation(2). STEP 2.0 Zipline was implemented by Empower School of Health with Zipline and partners, funded by Gavi. 22 supply chain officers, cold chain officers, chief pharmacists, and senior managers completed a 5-day in person workshop and 3-month workplace implementation phase(3). A dual coaching model paired each state team with Zipline coaches (drone operations and multimodal logistics) and private sector coaches. Participants implemented 22 “Your Transformation Challenges” on data integration between Zipline and state systems, last mile delivery in emergencies, real time data use for forecasting, PPP led drug revolving funds and reducing vaccine wastage through on demand resupply. Completion was 88% (22/25) with an overall satisfaction rating of 4.7/5 and an average 19% self-reported improvement across five leadership competency domains(2). Implementation generated system effects: in Kaduna, Zipline utilization increased from 35% to 45%, facilities served from 60 to 145, and order fill rates from 61.7% to 89%; in Cross River, integrating Zipline data with state systems helped reach large numbers of zero dose children and expand drone delivery to new communities. Participants cited experiential, workplace anchored learning, cross state peer exchange, and sustained coaching as critical. Subnational leadership development, combined with technical supply chain skills and public private collaboration, is pivotal for integrating drone enabled delivery in ways that advance equity, resilience, and sustainability, and offers a replicable framework for other health technology innovations.