As part of its efforts to increase the availability of medicines in Senegal, in 2012, the Ministry of Health (MoH) worked with its development partners to create an Informed Push Model to facilitate the effective delivery of family planning products to the last mile. In 2016, the MoH launched Yeksi Naa to extend last-mile distribution beyond family planning products. The project focused on using third-party logistics to manage the delivery of health products from the district level to service delivery points (health centres and posts). During its initial phase, the project was hugely successful and significantly contributed to reducing stock-outs and improving the availability of medicines at the last mile. In 2017, the model was extended to deliver 118 products in 9 of the 14 regions of Senegal. However, during the scaling phase, some limitations were experienced. The programme was paused for these challenges to be assessed and addressed before the approach was applied more extensively.
Following a request from the MoH and its partners, between 2019 and 2020, the Africa Resource Centre (ARC) appointed a team of experts to evaluate Yeksi Naa’s operating model. The National Health Development Plan and the evaluation of Yeksi Naa revealed several gaps in the programme management, including:
Based on the assessment and building on its expertise in supply chain, ARC is supporting the MoH through developing a strategic advisory project to strengthen the public health supply chain and address the challenges identified through the evaluation, allowing Yeksi Naa to be relaunched effectively across the country in due course.
The five workstreams include:
The primary goal of the supply chain planning is to create a consolidated entity within the MoH that will support supply chain planning and integrate the efforts of different planning systems. The supply chain planning assessment will provide detailed insight into current planning practices and recommend an operating model for public health supply chain planning. The planning entity will also provide input for the design and layout of public health supply chain governance in the country.
The inventory management assessment will explore inventory management practices for health products at each level of the health pyramid. This work will inform best approaches and quick wins to improve the inventory management indicators, and help in developing updated inventory management policies to optimize service and cash flow throughout the public health supply chain.
This workstream aims to identify the challenges between district and central-level communications. In order to achieve this, the information systems and associated technologies across Senegal’s public health supply chain will be mapped.
ARC has been tasked with coming up with the optimal method for medicine delivery. This includes assessing the best scenarios to deliver drugs at the last mile at the lowest cost; leveraging private sector expertise for distribution; and developing a system to pay private sector providers timeously.
This workstream seeks to assess and understand where there are funding gaps in the supply chain system. This will facilitate smoother payment processes to third-party logistics partners, which are an essential component of effective last mile delivery.
ARC’s support to ministries of health focuses on strengthening six supply chain elements. The Yeksi Naa engagement strengthened five of these six areas: strategy, governance, improvement roadmap, solutions proposals, and budgets and investment cases.
Key elements: strategy and budgets and investment cases
All five workstreams will inform a consolidated and comprehensive strategy to guide public health supply chain across the country. In addition, ARC will support the MoH by:
IMPACT: Financing structures will support the design and implementation of innovative practices to improve supply chain outcomes in the country.
Key elements: governance and improvement roadmap
ARC’s contributions to this work will lead to:
IMPACT: The capacity of the MoH will be increased and supply chain management will be increasingly effective and efficient.
Key element: solutions proposals
In implementing all five workstreams, ARC will broker in consultants who can build the capacities of MoH staff to ensure knowledge transfer and sustainability.
IMPACT: Private sector knowledge and expertise will be applied to strengthening the systems within the public health supply chain.