Registered attendees can visit the BREAKOUT SESSION page to access the recordings of each session and related materials https://chhs.gatech.edu/conference/2020/attendeeportal/breakouts/day1. For information on the submissions process, please visit the Call for Presentations page.
The Zambian Ministry of Health has taken strides in improving the health commodity supply chain, notable among which is the automation of most processes and procedures using the Electronic Logistics Management Information System (eLMIS). The onset of COVID-19 presented the challenge of meeting new demands to the supply with minimal disruption to routine health services during this volatile situation. This presentation analyses the resilience of the eLMIS, looking at supply chain performance before and during the COVID-19 pandemic and the degree to which the pandemic has affected the Zambian health supply chain.
To understand the impact of the pandemic on supply chains from the very top of the supply chain--sourcing supplies--to the very last mile--serving people in need, we have conducted stakeholder interviews globally, regionally, and nationally in multiple countries. Our goal was to better understand how supply chains will need to change to adapt to the new, dynamic world in which disasters are ever increasing, and the pandemic persists. We have concluded that we will likely see long-term structural changes across a number of key areas: markets, sourcing, technology, governance and risk management.
The German-Austrian research project NutriSafe develops technologies to increase the resilience of food supply chains by using innovative Distributed Ledger Technologies, aka Blockchain. Universities and research institutions, private companies, and public authorities form the research consortium. Two scenarios guide NutriSafe: The German consortium considers food supply and logistics with small and medium crises mainly on food safety while the Austrian consortium deals with more massive crises in food security with the need for intervention by public authorities. All results of NutriSafe are made available in the NutriSafe toolkit under an open-source license.NutriSafe´s Distributed Ledger Technologies facilitates transparency by sharing information across the supply chain and agile responses through an open architecture that allows us to add data and actors on-demand in crises. Digital and real-time tracking & tracing enable agile responses in food safety and are the basis for effective interventions in major food supply crises solutions.
NutriSafe´s results include Distributed Ledger Technologies for information sharing, (mobile) clients to connect to the distributed ledger infrastructure, services for the management of supply chains and food supply, simulations and serious games as means for analysis of security and resilience, considerations on information security and privacy, as well as business models for a resilient food supply chain: supply boxes, scanner check-outs, and secure elements are technologies for a fully digital supply chain with innovations for payments, information flows and food supply for more resilience in the food supply.
In this study, we examine the best strategies for using ships to supplement the fuel supply and help humanitarian organizations (e.g., FEMA and DLA) who must speed up the disaster response and recovery operations. This research is inspired by conversations with workers from FEMA who worked directly on the situation in Puerto Rico after Hurricane Maria, and the proposed network is designed based on FEMA’s long-term fuel distribution strategy.
To address the challenges associated with retaining trained and qualified health systems staff in Benin, the USAID Global Health Supply Chain-Technical Assistance Francophone Task Order (GHSC-TA Francophone TO) project, in collaboration with the Ministry of Health (MoH), launched the Young Logistician Professionals Program (YLPP) in 2018. YLPP recruits and trains young professionals to manage and monitor the health commodity supply chain at the community-level, which has resulted in the enhanced mitigation of stockouts and expiries while expanding youth capacity in supply chain logistics. To date, 30 YLPs have been recruited and trained in supply chain management best practices and deployed across Benin to assist with commodity management and reception of donated goods
Innovative health interventions can be costly and difficult to scale, however, the right model of implementation can enable optimal use of scarce resources. Ministries of Health (MoH) are powerful allies for cost-effective implementation of innovations, and their ownership is a strong indicator of interventions being sustained programmatically and financially. For this reason, Nexleaf Analytics collaborated with the Kenya National Vaccines and Immunization Program (NVIP) of the MoH, with support from Gavi to install Remote Temperature Monitoring (RTM) devices in 293 vaccine stores in Kenya. RTM monitors the temperature of the vaccine refrigerators in real-time to allow for data-informed actions by the MoH, which can improve cold chain management, reduce vaccine wastage, and ensure potent vaccines are administered to all children.
In this presentation, we will share Kenya’s experience and best practices from the rollout of the RTM technology across the country. In this implementation, the MoH managers were in charge of the logistical planning, including training, installations and follow-up with all the sub-county managers across Kenya. Nexleaf along with CHAI, UNICEF and WHO provided minimal support, limited to facilitation and general coordination.
This presentation will cover lessons learned, both successes and challenges, to act as a blueprint for all other countries who want to scale technology across the whole country with minimal partner support. The numerous lessons and best-practices can be used to further strengthen other similar initiatives, where upfront and ongoing efforts are required from the MoH for the long-term success of the project.
Presentation covers challenges involved in building Sustainable & Resilient Cold Chain, needed for delivering Covid-19 vaccine ensuring, its safety as well as Potency….
The views are there, towards making the strategic planning, in consideration to development of cold chain action plan, rationale distribution system with sustainable delivery mechanism.
In addition to this, presentation covers use of novel cold chain technologies in cold chain emphasizing energy saving measures/environmentally friendly solutions…
Since 2013, the UN Migration Agency (IOM) started an enhanced vaccination program, ensuring that refugees arrive in their countries of resettlement protected against vaccine-preventable diseases (VPD). The project became an integral part of IOM resettlement activities with more than 400,000 refugees vaccinated and 95% coverage of measles vaccine achieved. The vaccination program, implemented in close partnership with the Centers for Disease Control and Prevention, has allowed IOM to protect refugee health, provide uninterrupted resettlement and avoid importation of diseases from countries affected by outbreaks of VPDs.
To enhance quality of the vaccination program, IOM partnered with Nexleaf, a non-profit technology company leading an innovative approach to cold chain system enhancements worldwide. Vaccine refrigeration equipment frequently fail in remote locations, exposing vaccines to potential damage that may result in diminished potency and reduced effectiveness. Nexleaf has designed a remote temperature monitoring solution that continuously monitors the vaccine cold chain, and sends alarms to the health personnel and managers. These efforts can reduce freezing excursions by up to 93%.
IOM’s partnership with Nexleaf has resulted in strengthening IOM cold chain monitoring capacities in over 30 countries with staff trained, equipment installed and global monitoring systems configured. We hope to develop this partnership to cover more IOM and partner operations, while also exploring joint collaboration with Ministries of Health. In this session IOM and Nexleaf will share best practices and lessons learned for strengthening cold chain systems in multinational settings to protect the vaccine potency and ensure quality of refugee health services worldwide.
What information about your organization would you want to monitor, analyze, and share? Digital dashboards allow us to monitor key performance indicators (KPIs) and other important metrics in the interest of improving our work and making better decisions. If set up well, they can also allow us to easily generate reports without all the hours and days of prep work. In this session we will present how to set up a dynamic digital dashboard using Google Sheets and Google Data Studio, both of which are free and easy to use.
Association for Supply Chain Management (ASCM), through its’ Global Health Supply Chain Initiative in Africa has adopted, multiple approaches to improving public health supply chain agility. One approach is the strategic investment in a robust, technology-driven supply chain assessment tool; the Global Health Supply Chain Maturity Model Assessment Tool, a tool designed to identify potential performance problems in a supply chain. Other approaches include improving public health supply chain staff technical capabilities through Leadership Forums, Certifications and Transformation Learning Programs (TLP).
The authors will describe a foundational disease model to project infectious diseases across a network. They will outline example results on the impact of operational or policy decisions such as the wearing of mask, distancing policies, voluntary quarantining, or others.
In this research, we present the first results of the Health Emergency Response in Interconnected Systems (HERoS) research project funded by the EU H2020 (101003606). By analyzing primary data (interviews) and secondary data (reports) of the end-users of HERoS and of other members of medical supply chains, we have identified disruptions and their associated gaps caused by consumer behaviour, capacity limitations and legislation.
The conventional wisdom suggests that donors support charities with lower overhead cost ratios. Yet, these metrics may discourage necessary investments in organizational and operational infrastructure. Our empirical study shows that donors are willing to accept higher overhead costs of HOs that demonstrate greater degrees of accountability.
The number of individuals are facing food security increases, and the role of food assistance is helping to meet these needs becomes more apparent each year. The United States Agency for International Development (USAID) Office of Food for Peace (FFP) responses to developmental and emergency purposes by providing millions metric tons of food assistance. This donated food assistance reached hundreds of millions of people. We developed an economic optimization model to identify the most suitable warehouse locations among all potential candidate locations to improve FFP's global food aid by considering developmental and emergency purposes.
Multi-month dispensing (MMD) allows HIV/AIDS patients to receive several months of antiretroviral (ARV) supply at once, improving adherence and reducing cost to facilities and patients. Because of these benefits, many countries started scaling up MMD for ARVs in 2019 with support from the USAID Global Health Supply Chain Program-Procurement and Supply Management (GHSC-PSM) project. COVID-19 has imposed a need to accelerate MMD to reduce clinic visits and minimize exposure. Since dispensing decisions have profound effects on the supply chain, GHSC-PSM is supporting MMD scale-up in multiple countries and advising clinical partners on the challenges of an abrupt MMD scale-up. This includes managing multiple bottle sizes and an artificial "seasonal" demand pattern that could result in stockouts and high fluctuations in patient visits between months. Implementing MMD requires careful planning and policy development.
GHSC-PSM has supported government stakeholders, clinical partners and donors by providing MMD resources that allow countries to make data-driven decisions and manage supply chain constraints. The GHSC-PSM-developed Multi-Month Simulation (MuMS) tool for scenario planning facilitates data-driven conversations with local and international stakeholders on the feasibility of rolling out MMD for 3-6 months. The tool uses existing data and makes broad assumptions to model the potential effects of increasing the quantity given to each patient on current and future stock status.
Resources like MuMS and other rapid scenario planning tools can improve communication and decision-making between supply chain and clinical stakeholders to ensure commodity availability during COVID-19. In coming months, GHSC-PSM will continue to share and improve the tool.
In commercial operations, transportation services are regularly outsourced to well established third-party logistics providers, which enables a greater optimization of operation. In-spite of a near constant humanitarian funding crunch, thus far humanitarian logisticians have been hesitant to transfer the outsourcing approach to their in-country logistics. To provide quantitative evidence for an ongoing debate, this study develops an agent-based simulation of the in-country humanitarian logistics market. It quantifies the impact of humanitarian common transportation services, which results in more than 20% cost savings and time savings greater than 5% in an example scenario.
IMPACT teams have been implemented across 17 counties in Kenya and 10 countries globally. To enhance uptake, ownership and institutionalize the approach, inSupply Health deployed a dual strategy of human centered design to co-create solutions and adaptive learning for continuous improvement. Based on insights from both processes identifying capacity building in effective data use as a motivator and a gap, inSupply created 7 IT role profiles and related virtual learning packages covering technical, leadership and behavioral competencies required to run effective ITs. ITs have adopted virtual meetings and learning to enhancing their competencies and performance in providing essential health services.
In February 2019, Ghana Health Services (GHS) partnered with Zipline - a healthcare supply chain optimization company providing on demand delivery via Zips (drones) - and launched its first distribution center in Omenako, Greater Accra. In March 2020, the Ministry of Health announced the use of Zipline in supporting COVID response through:
Ensuring continuity of vaccine campaigns during a pandemic
Rapid allocation of PPE through pull based systems
Supplementing COVID-19 sample transport logistics to free up vehicles for patient transport
This presentation dives into Zipline and Ghana’s partnership to create a more flexible supply chain system and how they were able to mitigate the effects of supply chain shocks to Ghana’s healthcare system.
The Democratic Republic of Congo relies on donor support to cover pharmaceutical needs as minimal data and an unreliable logistics management information system (LMIS) negatively impacts supply chain managers' decision making abilities. Although the country's district health information system (DHIS-2) implementation captures patient data and indicators, it does not capture all commodity data and transactions. In 2018, USAID’s Global Health Supply Chain-Technical Assistance (GHSC-TA) Francophone TO project supported the Ministry of Health in the acquisition of InfoMED, a comprehensive LMIS for commodity management which captures patient data and triangulates it with data on drug availability. By ensuring interoperability with DHIS-2, InfoMED builds on previous investments and supports commodity availability, especially during emergencies like COVID-19.
JSI through the My Choice project collaborated with Indonesia’s National Population and Family Planning Board (BKKBN) to develop a suite of digital tools that integrate the family planning (FP) supply chain across multi-level stakeholders, standardizing processes and increasing visibility and transparency in operations. JSI has developed an Android application called Stokku (‘My Stock’) to digitize warehouse management processes and has transformed Indonesia’s FP supply chain from a rigid paper based system to a dynamic digital system that has improved responsiveness and efficiency. The presentation will describe the application, its features, and how the implementation has built the skills of warehouse managers, strengthened compliance of supply chain policies and improved overall supply chain performance.
To meet the rising global needs, the humanitarian community has signed off on making a strategic change toward more localisation – which commonly refers to the inclusion and empowerment of national and local actors in humanitarian assistance. To enhance understanding of the phenomenon, we have conducted an exploratory study on localisation of logistics preparedness capacities and obstacles to its implementation. We particularly focused on the perspective of the international humanitarian organisation (IHO) community as they are expected to implement the localisation strategy. Particularly, we find that it is not clear what is meant by localisation with confusion between strengthening external actors and internal national/local offices.
Mobile healthcare units are being used for delivery of many health services, particularly in remote areas. Managing these units brings many challenges that have been studied extensively in commercial logistics, including capacity management, mode selection, planning, routing, task allocation, and incentive alignment. For several contextual and cultural reasons, however, insights and tools from commercial logistics are not trivially transferable, which induces a need for dedicated research. This talks will report on some of the key insights obtained during more than 3 years of research on management of mobile healthcare units in collaboration with a large NGO.
Many low- to middle-income countries lack a professionalized supply chain occupational category, formed either via formal education or through the civil service structure. This professionalization is critical to embedding a workforce with specific supply chain competencies in the health system. Without trained professionals to manage health supply chains, drugs and supplies do not reach the patients who need them. The People that Deliver (PtD) Supply Chain Management (SCM) Professionalization Framework is a systematic approach to workforce development, where all practitioners are able to find a career path for growth and development, allowing supply chain professionals to lead and operationalize public healthcare supply chains and achieve country and organizational objectives.
The USAID Office of Foreign Disasters (OFDA) pre-positions stock of non-food items in anticipation of global disaster response requirements. This session shows how an optimization model was used to develop metrics that assess the effectiveness of its global stock portfolio in addressing future disaster scenarios. Interesting aspects of the analysis with OFDA included exploration of options developing a predictive disaster portfolio, insights on how agency preparedness targets affect the level of stock consolidation, and consideration of how the optimization model can inform a robust structured planning process based on concepts used in the private sector.
Material convergence, also known as unsolicited in-kind donations, poses significant challenges during disasters. This paper is the first to map the feedback processes influencing the overall dynamics and to offer a comprehensive analysis of how multiple policies affect the system based on system dynamics. Our analyses show that the unintended consequences of some policies trump their intended rationality, leading to undesirable outcomes. Four policies perform consistently better regardless of disaster characteristics (dispersion and forecastability) or the loci of decisions: admission control, donor education, pre-positioning, and quantity of human resources.
Supply chain management is essential for cold chain medicines, however, developing countries like Nigeria face challenges in managing cold chain medicines. Hence, this study examined the quality of practice of supply chain management of cold chain products in line the World Health Organization’s Regulatory and Quality Management Compliance Requirements. Findings showed poor performance in quality management and regulatory compliance hence, there is a need to channel resources towards developing guideline documents, infrastructure, and training to ensure efficient supply chain management of cold chain medicines.
With the world’s pharmaceutical companies—and universities and research organizations—all working to protect people against the COVID-19 pandemic, it is likely that there will be multiple COVID-19 vaccines that will reach domestic and international markets. But the development of the vaccines is only the first step in protecting people. Supplying and delivering any new vaccine into a country—and to the population—involve complex processes. This session will review six key lessons learned from previous new vaccine introductions that bring together the supply chain and program perspectives.
The introduction of new technical innovations in the public health sector has resulted in many siloed and unadopted solutions, such as online dashboards, due to a lack of advocacy around building the capacity of the countries to manage their own data systems. We see education and advocacy around this topic as very crucial for the whole sector. This is to ensure that countries know their rights and make their own decisions when it comes to data management. Nexleaf Analytics will hold a session to inform audiences about different aspects of data management and ownership.
The health care system in Nigeria is still largely dependent on paper based documentation which leads to loss of data and sometimes long periods of generating reports. Hence, Integrating technology into the day-to-day activities around the health system supply chain provides end-to-end visibility. Software applications like LoMIS, use of mobile technology and IoT smart devices for deliveries to provide near real-time data. The LoMIS applications have been able to reduce reporting time, provide visibility from State/LGA cold stores to CCE health facilities as well as provide electronic proof of delivery confirmation which totally eliminates long paper trails.
In the constantly evolving humanitarian sector, many International Humanitarian Organizations are currently seeking for interoperability in response to the sector’s urge for professionalization and ERP implementations, inter-NGO collaboration, and private sector partnerships. Since standardization is the necessary premise to interoperability, the Frontline Humanitarian Logistics initiative was created to reduce the time and cost involved in implementing IT solutions within humanitarian supply chains and encourage interoperability of systems across the sector. A common Humanitarian Logistics Process Framework (HLPF) was developed based on the extensive analysis of logistics processes of 7 INGOs, refined through a three-round Delphi study with 15 experts of INGOs, and validated by 19 INGOs. The proposed HLPF constitutes a reference model for inter-NGO collaboration through data exchange and process alignment, improves communication and allows data and software interoperability between private sector solutions and humanitarian needs.
The Partnership for Supply Chain Management, like many other organizations, felt the effects of COVID-19 restrictions in the form of production delays, transportation shortages, price inflations, and unexpected market behaviour. In our presentation we will provide more details about how we were impacted, and we will present some of the solutions we came up with to ensure the service continuity of our HIV, malaria and TB procurement work. While executing our regular work, we also started shipping COVID-19 diagnostics; and from this we gathered valuable lessons about the potential of fast-tracking processes for quicker service delivery. In closing, we will briefly recap some of the best practices that can help create resilient, sustainable and efficient supply chains going forward.
Following a decade of work by the Government of Pakistan in collaboration with its international and in-country partners, the national Logistics Management Information System (LMIS) has flourished to become a well-managed yet comprehensive database for informed health decision-making. The maturity of Pakistan’s LMIS allowed for rapid response and allocation of critical health commodities when faced with the global pandemic, COVID-19. Using advanced business intelligence and machine learning tools, data from across the country could be aggregated and analyzed quickly to ensure emergency supplies could be provided to citizens when and where they were needed. With support from the USAID Global Health Supply Chain Program-Procurement and Supply Management project, Pakistan has enhanced visibility and resilience across its supply chain, and is primed for self-reliance.
Project Last Mile (PLM) is a public-private partnership that leverages expertise from The Coca-Cola Company to strengthen health systems in Africa. In Nigeria, PLM worked with Lagos State Primary Health Care Board (PHCB) and the National Primary Health Care Development Agency (NPHCDA) to evaluate an outsourced CCE maintenance model leveraging the Nigerian Bottling Company's (NBC) local CCE service provider, Frigoglass. Over the 6-month pilot in Lagos, 134 non-functional units were repaired (94% of total non-functional units) with preventative maintenance provided for 359 CCE. Going forward, there are several learnings from Project Last Mile’s Lagos State maintenance pilot that can be applied for both outsourced or in-house maintenance models and help inform future CCE procurement and advocacy for continued allocation of resources for effective CCE maintenance.