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[DATE][SPEAKERS NAMES]
The 5th Global Health Supply Chain Summit
November 14 -16, 2012Kigali, Rwanda
NGO Social Responsibility Model for Commodity Delivery
Leah Hasselback
Lessons Learned from Expanding a Supply Chain Redesign in Mozambique
4
Project History
• 5-year supply chain redesign pilot project implemented in Cabo Delgado province (Dedicated Logistics System)
• Old: Collection-based, ad hoc approach
• New: Vendor managed inventory with level jumping
• Includes supportive supervision and information system
• Conducted impact evaluation in Cabo Delgado, using neighboring Niassa province as a comparison
Mozambique
Cabo Delgado
Niassa
Dedicated Logistics System Monthly Activities
DistrictStorage
ProvincialStore
Health Centers
1. Leave provincial level with:
- medical supplies- energy - equipment, parts - information
2. Site visit (in coordination with district level):- record & stock inventory- service equipment- supportive supervision- collect data
3. Return to provincial level office:- input data- analyze information- address problems- prepare for next trip
14%
28%
12%
46%
Niassa
18%
12%
9%
61%
Cabo Delgado
Transport
Personnel
Cold Chain
Vaccines & Supplies
Dedicated Logistics System ResultsThe Forest
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Indicator Baseline Result
Coverage Rates (DPT-Hep B3) 68% 95%
Vaccine stock outs 80% 1%
Cold chain functioning ~40% 96%
DPT1-3 Dropout Rate 12% 3.8%
Trust in the public health system
91% visited in last month despite:•47% of families living over two hours away; •85% of them having to walk to get there; and•most common reason for vaccination failure being “place of immunization too far.”
The Dedicated Logistics System (Cabo Delgado) is more cost-effective and efficient.
What do you do after a successful pilot?
A new approach to achieve impact, sustainability, & scale:
– Outsourcing activities In house operations with technical assistance
– External resources Mix of internal and external resources for funding and transportation
– NGO staff closely coordinating with government All government staff closely coordinating with the NGO
Challenges in the New ApproachThe Swamp
Note: In Niassa, 35% of irregularities were caused by transport.
Three Challenges in the In House Approach
• Funding– Funds allocated and available but no cash in hand– Not enough time in 1 month to carry out activities and
secure funding on time for the next month’s distributions– Interim solution: direct funding from VillageReach for some
costs• Transportation
– Vehicles not available because of lack of planning, management, maintenance
– Insufficient quantity of vehicles available– Interim solution: provision of some vehicles for
distribution• Human Resources
– Distributions interrupted as staff are called back for other activities
Rethinking Expansion Approaches
We know that we can be more efficient with a redesigned supply chain, but…
How do we combine the best of outsourcing and in house operations to achieve impact, sustainability, and scale?
Hybrid Approaches
Challenge Outsource In House
Funding Local fund agent Funds monitoringRequisitioningReporting
Transportation Outsource vehicle use Technician carries out distributionsManage performance of transport provider
Human Resources Applying private sector best practicesPerformance based payProfessionalization of the field coordinator
Government staff
Travel Tips
• In designing supply chains, start at the last mile– Build systems to work with the available capacity– The last mile of distribution is the first mile of
information
• Focus on building shared interest– Allows for bringing in new partners, such as the
private sector – Drives scale and sustainability
• Only travel uncovers the unexpected challenges!
www.villagereach.org
Leah HasselbackMozambique Country Director
[email protected]: +258 827324196
Av. 25 de Setembro, 1123-11º. EMaputo, MozambiqueTel: +258 21326446 Fax: +258 21326448
Thank You
