Immunization programs require, among other components, a dependable and efficient supply chain system to deliver vaccines and related supplies. An indispensable part of this system is sufficient numbers of personnel with the knowledge and skills to perform essential supply chain functions. However, in Ghana, like in most resource-limited countries, these personnel are barely available. In this case study, we describe an ambitious strategy that was deployed overtime in Ghana, to create and rapidly expand supply chain management (SCM) competencies which immunization is also a component among health care workers during their formation, through pre-service training. Exposing pre-service students to key SCM concepts and competencies equipped them with urgently needed knowledge and skills that they need to perform these duties. The pre-service training program led to the rapid integration of SCM modules into the curriculum of health care workers in major schools of nursing and pharmacy in the country. We estimate that through this cascade style of training, over 14000 health workers were equipped with SCM skills over a 4 year period, without the need to remove them from their workstations for in-service training. The sustainability and cost-savings of the pre-service training model was also enhanced by utilizing local institutions to lead the customization and delivery of the SCM curriculum to a group of core trainers.
