A key part of a strong and resilient health system is sustainable access and appropriate use of safe, effective, quality-assured, and affordable health commodities. Our teams work closely with national and sub-national health care providers, logisticians, policy- and decision-makers, communities, the private sector, and other donors and stakeholders to design and implement a mix of interventions for strengthening supply chain systems.
Our supply chain interventions have successfully improved the delivery of drugs and other commodities advanced in many countries in Africa, Latin America and the Caribbean, the Middle East, and Asia with:
Forecasting, supply planning, and information systems: URC has worked with key stakeholders to optimize forecasting and supply planning by building local ability to use modern methodologies, ranging from complex, statistics-based regression analysis of historical data and development of epidemiological profiles of the population to simple, consumption-based methods.
Procurement, distribution, and quality assurance of health commodities: URC has used digital technology to streamline procurement processes, connect people, and create more transparent and efficient solutions to supply chain challenges. This includes using GS1 barcode technology, mobile applications, and web-based forecasting tools. We have helped health facilities prepare for disease outbreaks by setting up emergency commodity order systems with national agencies. URC also has supported last-mile distribution of health commodities, such as COVID-19 vaccines, malaria drugs, and long-lasting insecticidal nets.
Human workforce development and institutional capacity building: Trainings – including e-learning for distance education – address all components of the logistics cycle, forecasting, procurement, warehousing, transportation, and distribution. URC also coaches and provides on-the-job training to personnel to analyze causes of performance or quality gaps, create and test improvements, and use data to determine the most effective changes.
Commodity quality assurance: In Uganda, URC analyzed the availability of essential medicines at service delivery points and involved district medicines management teams (DMMTs) to identify and respond to key challenges. One key bottleneck addressed are delays in placing accurate orders. Guided by its quality improvement methodology, URC supported the DMMTs to set up a two-way mechanism for providing guidance and mentoring to district focal persons and cold chain technicians on completing requests and orders. As a result, the order rate and timeliness for essential medicines improved from 40% to 90% in just one year, contributing to the reduced stockout for laboratories and HIV, TB, malaria, and family planning commodities.
Governance and leadership: Using the Usapang Dibdiban approach – a discussion with local government and key technical personnel regarding the local TB situation – the USAID TB Platforms Project in the Philippines supported local government unit (LGU) supply chain activities by developing stakeholder skills to advocate for the approval of increased budgets for TB elimination/recovery plans in their respective LGUs. TB Platforms held 11 Usapang Dibdiban sessions in 2020, which helped to more than double local allocations in support of TB related procurements from $55,000 to $114,600 in approximately one year. From 2021 to 2022, the project is conducting similar advocacies, resulting in TB budget increases to date of approximately $640,000.
Integrated quality of care training: URC and partners are training high-volume maternity units in East Central Uganda on an integrated quality of care approach, which recognizes the critical importance of quality medicines in addition to the correct clinical skills. For example, URC is working to ensure that oxytocin – which prevents postpartum hemorrhage, the number one cause of maternal mortality in low- to middle-income countries – is on hand and properly cold stored to the point of patient contact. The training is producing results: The number of women giving birth who received labor-inducing drugs in the third stage of labor or immediately after birth in the region increased from 108,680 in 2016 to 146,220 in 2021.
Information systems: In 2016, the Ministries of Health in Panama and Guatemala lacked a tool for reviewing supply chain data to support HIV/AIDS commodity procurement planning, decision making, and distribution to HIV/AIDS clinics. URC supported the development of low-cost, web-based logistics management information systems – including the design, testing, and scale-up of the applications nationwide in both countries. Today, these systems provide stock status in real time and – when necessary – trigger an immediate dispatch of commodities.