Presentations

This presentation begins with a review of current educational offerings and research activity in supply chain management and related fields across major educational markets in Africa. This is followed by a summary of interviews with selected African companies regarding SCM talent and innovation needs. The presentation closes by exploring SCM as an emerging educational pathway and considering options for expanding research coverage to meet innovation needs

Our research analyses private-humanitarian supply chain partnerships and contract designs based on empirical data, collected by interviewing experts both from leading commercial companies and humanitarian organizations. First, we examine how the two sectors initiate partnerships and what the incentives for both sides are. Then, we classify the different types of contract designs and framework agreements applied in the different phases of disaster response.

While not looking to forecast the future, we aim to challenge and broaden assumptions about what comes next and how you participate in the coming changes.We are looking to stimulate thinking about global health supply chain design so that governments, global agencies, and private actors support relevant and timely investments. We can all help ensure that patients around the world achieve dramatically improved access to affordable healthcare – when, where, and how they want it. In this presentation, we will highlight trends we believe will impact your organization and consider the actions you can take to address them. We are at a time, when economic forces and the spread of technology are coming together in a way that at this is a time for being overly optimistic about healthcare supply chains in developing countries.

Nigeria is undergoing significant supply chain transformation across the country, with several major donors making investments in various initiatives in operation at both the federal and state levels. In Kaduna State, the Bill and Melinda Gates Foundation (BMGF), with the aid of its technical partner Pamela Steele Associates (PSA), is supporting the state with the Kaduna Public Health Supply Chain Transformation Project, which aims to transform the state’s public health supply chain. 

The Kaduna State health supply chain is beset by several problems, including the high cost of the supply chain, the low availability of essential medicines and commodities and, at the same time, the unacceptably high level of wastage, with the system continuously showing low levels of accountability and insufficient performance management. In addition, overstock in Central Medical Stores and understock in local health facilities suggest the state faces significant ‘last-mile’ distribution challenges. Fundamentally, the supply chain suffers due to a structure that is dependent on donor funding and that has resulted in nine separate supply chain programmes. Information processes are cumbersome as each programme separately collects a distinct set of data for its own supply chain. Also, each programme has a parallel distribution system despite their similar commodity flows. The state is seeking to align with the national policies and strategies of the Federal Ministry of Health’s National Products Supply Chain Management Programme for integration of the supply chain, through the National Supply Chan Integration Project (NSCIP).

The IMPACT Team approach is a feasible management tool for county supply chain managers to use data and a structured process to drive prioritization, decision-making and action planning around supply chain improvement. inSupply introduced the approach as a result of the devolution of health services in Kenya in 2013, which shifted responsibilities and budgetary authority to the counties and demanded stronger analytic and leadership capacity for supply chain management at the county level.

The IMPACT Team Network approach - a people- and data-centered system to build supply chain leaders and skills - along with a structured framework for routine data and analytics use to drive decision making and action planning around supply chain improvement. inSupply and the Ministry of Health selected the 10 focus counties for IMPACT Team implementation. To fill the gap in data visibility and analytics, inSupply identified existing logistics data for contraceptive and vaccine supply chains and worked with county leaders to create key performance indicators to drive the quality-improvement process. inSupply developed a user-friendly, excel-based, Indicator Tracking Tool with one dashboard for each supply chain per county.

This presentation focuses on how North Star Alliance, a nonprofit health services delivery organization, provides health services delivery for mobile populations along the transport corridor in Africa. North Star Alliance has adopted a containerized clinic model, operating a network of 38 Roadside Wellness Centres, to advance health services delivery in Africa. The organization's core model is premised upon principles of logistics and supply chain management.

This presentation focuses on two key issues pertaining to North Star’s operations: i) strategies for partnership and alliance-building along distinct stages of the health care delivery supply chain, and ii) challenges and trade-offs for a non-profit in coordinating and managing partnerships with diverse actors along the health care delivery supply chain.

The presentation will also discuss the complexities a non-profit health services delivery organization confronts as it strives to mobilize resources in an increasingly competitive global health funding environment where each nongovernmental organization attempts to persuade prospective partners that its project is more valuable than those of another nongovernmental organizations. Throughout the presentation, a focus will be on how North Star manages trade-offs that emerge for a nonprofit, as it simultaneously strives to achieve goals of scale, sustainability and health equity.

In resource-limited settings, medical commodity supply chains for public health care systems face a myriad of challenges, including incomplete data about consumption and stock levels. There is growing interest and uptake in these settings of electronic logistics management information systems (LMIS), largely focused on warehousing and distribution. This has provided improved visibility of data and more efficient supply chain management. However, access to data about stock movements at the health facility level remains as a gap in these systems. Clinton Health Access Initiative partnered with ThoughtWorks, Inc to develop a mobile solution appropriate for use with Android tablets at the health facility level by the Mozambican Ministry of Health (MoH).

A key element in fighting infectious diseases is to detect and control outbreaks as early as possible. One of the most rigorous control strategies is to perform exhaustive population screening, in which villages or populations at risk are visited and screened by a mobile team. Since budget available to maintain this costly approach tends to decrease when prevalence decreases, a key challenge is to minimize the risk of re-emergence by increasing the effectiveness of available mobile teams. This risk is of particular relevance in the context of Human African Trypanosomiasis (HAT), also called Sleeping Sickness, a disease that causes substantial suffering in the DRC and surrounding countries.

One way to improve effectiveness of mobile screening teams is to optimize their planning. This encompasses deciding which villages to visit and with what time interval to visit them so as to minimize the expected burden of disease. This talk discusses how we, based on close cooperation with local partners, mapped the relationship between HAT prevalence and planning decisions, and how this led to the development of simple and effective guidelines for planning decisions. We shall discuss how our research is impacting practice and how it provides input to the debate on elimination strategies.

Since 1990, significant improvements in child health have been made. The under-five mortality rate has decreased by 49%, from 90 deaths per 1,000 live births in 1990 to 46 per 1,000 in 2013. However progress is hindered in many low- and middle-income countries by weak health systems and poor access to life-saving medical equipment commonly found in neonatal intensive care units (NICUs). The presentation outlines UNICEF Supply’s role in procurement of Essential Medical Equipment and the considerations for product selection, installation, training, after sales service and maintenance of complex capital equipment associated with the NICU environment. Access to these technologies requires a foundation of basic infrastructure including availability of medical gasses and clean, reliable electricity.  Proper selection of fit-for-purpose and high value-for-money equipment is essential. This requires ensuring products meet minimum specifications and manufacturers have the proper certifications demonstrating a robust quality management system. Clinical training, installation, and after sales service are also essential to ensuring the equipment is safe and effective. Finally, health technology management requires a cadre of well-trained clinical engineers who are knowledgeable and skilled at preventative and corrective maintenance and who maintain a robust spare parts supply to support this maintenance.

The presentation outlines UNICEF Supply’s role in procurement of Essential Medical Equipment and the considerations for product selection, installation, training, after sales service and maintenance of complex capital equipment associated with the NICU environment.

Rapidly evolving infectious disease epidemics, such as the 2014 West Africa Ebola outbreak, pose significant health threats and present challenges to the global health community due to their heterogeneous geographic spread. Policy makers must allocate limited intervention resources quickly and often in anticipation of where the outbreak is moving next. We develop a two-stage model for optimizing when and where to assign Ebola treatment units (or other interventions) across geographic regions during the outbreak's early phases.The first stage uses a Susceptible-Infectious-Removed (SIR) transmission model to forecast the occurrence of new cases at the region level, capturing connectivity among regions.

The second stage compares two approaches to efficiently allocate resources across affected regions: (i) a greedy heuristic prioritizing regions based on their basic reproductive number, R0, which delivers good results when Ebola case data are limited, and (ii) an approximate dynamic programming (ADP) algorithm coupled with the underlying calibrated epidemic model, which finds a better solution when more nuanced data are available. Although we illustrate our model’s utility for the 2014 Ebola epidemic, which has fortunately abated, the general methodology could be applied to other emerging outbreaks—such as the ongoing Zika virus epidemic—and other interventions (e.g., vaccination, mosquito control, community education).

Indonesia’s National Population and Family Planning Board (BKKBN) in partnership with the “My Choice” Program is strengthening the supply chain for family planning, to improve consistent access to a choice of contraceptives at health facilities across three provinces in Indonesia .  Over the past decade, Indonesia’s contraceptive prevalance rate has remained stagnant in part due to inconsistent access to contraceptives, especially long acting contraceptives, at service delivery points. Although stock outs have often been a hot conversation topic, these discussions have focused on non-achievement of service targets and have not precipitated larger discussions on the overall supply chain system. 

Over the last two years, BKKBN and the ‘My Choice’ program have worked in three provinces to address the supply chain challenges through a holistic systems strengthening approach. The work is guided by three core themes – organization, collaboration and information -with an aim to making systems more efficient and sustainable. First, we have built organizational capacity through piloting redesigned standard processes and modern training tools such as video tutorials and mobile apps for supervision. In addition, we have created multi-level collaboration through quality improvement techniques and the use of whatsapp groups. Lastly, we have improved data visibility, quality and use by equipping stakeholders with tools to maintain accurate logisitic records and reports and created an inventory management and monitoring tool that facilitates easy decision making in particular guiding the distribution of stock to maintain adequate stock levels and monitor the overall strength of the the supply chain. 

In our oral presentation we will describe the methodology, intervention design, midterm impact results (conducted in February 2017), and lessons learned. The presentation will highlight the successes and lessons learned in the efforts to strengthen supply chains within and across the various decentralized system levels and provide others working in this field with some innovative, locally produced solutions for improving supply chain performance.  

The Minimum Initial Service Package (MISP) for Reproductive Health is a set of life‐saving commodities and activities to be implemented at the onset of every humanitarian crisis. The MISP includes planning for comprehensive reproductive health services integrated into the primary health program, including the provision of RH equipment and supplies. The kits are designed to respond to three month’s need for supplies and can be ordered directly through the UNFPA AccessRH procurement service.

Although abortion is legal in several humanitarian host countries, particularly in cases of rape, and many donors and governments have recommended that abortion services be available where they are legal, the only MISP kit available to practitioner organizations is for the management of complications of an unsafe abortion (kit 8). This kit includes MVA and misoprostol but does not provide guidance for using these technologies for induced abortion, nor do the kits include mifepristone, the gold standard WHO-recommended medication for induced abortion. While the Interagency Field Manual for Reproductive Health in humanitarian settings mentions the need to provide safe induced abortion when it is legal, there is currently no way to access mifepristone or technical assistance to enable humanitarian practitioner organizations to build skills or access commodities they might need to provide this service.  

A number of humanitarian practitioner advisors on the Inter-agency Sub-Working Group on Safe Abortion have recommended the creation of a new abortion kit in a new parallel privately marketed system.  The group has suggested the development of a new kit based on the MISP system for distribution to humanitarian agencies, including MVA, misoprostol alone, or mifepristone and misoprostol for induced abortion.  This presentation describes the results of preliminary interviews and examines options for the development, distribution, awareness-raising, evaluation, pre-positioning, and feasibility of the new kit exploring the potential for positioning the kit within the UNFPA system and outside, examining partners and distributors based on preliminary recommendations.

Lack of consistent logistic and product electronic data exchange standards have lead UNFPA to face unreliable manual data entry and incomplete data while interfacing with its global suppliers. GS1 standards have been long recognised in the health supply chain to streamline product identification, data capture and track and trace event sharing. UNFPA has been working with national governments and key suppliers to successfully test shipment data (ASN/Despatch Advice) electronic data exchange and will continue to expand this to cover all critical commodities in the coming years. Having recognised the importance of reliable supply chain data for product identity, capture & share through barcode identification, logistic track and trace, stock-out management, inventory management and planning.

The direct benefits of this data exchange, besides facilitating internal data analysis and significantly reducing time consuming manual work efforts, will be that national government warehouse management systems and health management systems will continuously have up-to-date electronic shipping data information originating from the suppliers, provided through UNFPA’s IT system. The system of utilizing standardized GS1 data - and master data shared by suppliers via the procurement entity and routed through a single data warehouse all the way to recipient country governments’ electronic logistics systems - could then be further expanded for NGOs, UN agencies and other humanitarian agencies to reduce (or avoid) data source siloes by each donor entity. 

The presentation will start out by featuring a short background section on UNFPA and its procurement position as the largest public sector procurer in the world of reproductive health commodities. It will then describe one of UNFPA’s standard humanitarian interventions which is the provision of reproductive health kits that contain life-saving medicines, supplies including contraceptives and medical equipment to address the immediate sexual and reproductive health needs of a community in crisis. This section will also display numbers of kits dispatched, the cost involved and number of pregnancies and death prevented by these interventions. Lastly, this section will describe how eligible clients, i.e. governments, NGOs and other UN agencies can acquire these kits from UNFPA.

The second part of the presentation will provide an overview of collaborative engagements in the procurement and supply chain area and in particular discuss UNFPA’s collaboration with WFP in the freight and logistics area, with other UN and non-UN entities including the Global Fund and the private sector. The WFP collaboration strives at uniting UNFPA’s procurement expertise in reproductive health commodities with WFP’s logistics expertise to create mutually benefiting economies of scale by leveraging key strengths and capacities of both organizations. The collaboration with other UN agencies, non-UN entities and the private sector focus on achieving better value for money by sharing data and/or tools and standardize processes and/or guidelines and thereby optimize use of resources.

Lastly, the collaboration between the Global Fund (GF) and UNFPA was established to provide access to quality assured, competitively priced RH commodities for GF principal Recipients by channelling all requests for lubrication, male- and female condoms to UNFPA for procurement. Due to the increase in UNFPA’s procurement volume of these commodities, this collaboration has the further benefit of allowing UNFPA to better shape supplier markets for the benefits of all parties.