The Intersection of Public Health Supply Chain Research and Policy

Session Chair: Dr. Frankline Keter, Africa Resource Center (ARC)

Paper 1: The Role of the Private Sector in Resolving Current Challenges in Public Health Supply Chains in Enugu State, Nigeria: Implications for post-Covid-19 Policy and Operational Improvements

Patrick Oseloka Ezepue 1; Henry Uro-Chukwu 2

  1. Department of Mathematics and Computer Science, Coal City University, Enugu, Nigeria
  2. Departments of Biomedical Sciences and Chemical Sciences, Coal City University, Enugu, Nigeria

This Study was Funded by Africa Resource Center (ARC), South Africa


There is a dearth of studies in Nigeria on state-wide public health supply chain management which use innovative mixed-method research design and analytics to address challenges in the supply of medicines and devices, thereby improving the policymaking and operational practices during and post Covid-19 pandemic. This paper helps to close this gap with a focus on the role of the private sector in resolving current challenges in public health supply chains in Enugu State, Nigeria, and improving supply chain management policies and operations during and post-Covid pandemic. The paper situates the said role of the private in an ambience of supports provided by the formal and informal sectors like government hospitals, pharmacies, and staff in key units and therapeutic areas, especially supply chain and procurement staff (for the formal sector), towns and professional communities (for the informal sector), among other entities. The novelty in the research consists in using an integrative Research Methods Canvas which promotes theoretical rigour in the research, integration of knowledge, applications, and teaching (RIAT) elements of the project, to design and implement the proposal and mixed methodology, facilitate insight development for improvement interventions, and post-research education of concerned resource persons for same, during and post-Covid-19 pandemic.

Paper 2: Assessing Challenges in Last Mile Distribution of Family Planning Commodities and the Effects on Product Availability and Accessibility in Kano, Nigeria

Maxwell Adibe O1; Chukwu Otuto Amarauche 1

Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka 

This Study was Funded by Africa Resource Center (ARC), South Africa


Maternal mortality rates especially in developing countries like Nigeria continue to remain at an unacceptably high level. Nigeria is responsible for about 20% of all global maternal deaths with a Nigerian woman having a 1 in 18 lifetime risk of dying because of pregnancy or childbirth. To reduce the incidence of maternal mortality, evidence-based strategies have been proposed, including family planning (FP) which is the only strategy that reduces the proportion of high-risk pregnancies and births as well as reducing exposure to the risk of maternal mortality. Despite these benefits, there is still a significantly high unmet need for contraception and family planning services. The contraceptive use is only 16% in Nigeria, and further lower in certain regions of the country such as in the north, with as low as 4.9%. In order to close the gap between contraceptive use and the proportion of people who express a desire to use them, the Nigerian government has implemented several policies and plans. However, there are still challenges including stock outs and last mile distribution challenges pointing to supply chain gaps.

This study was based on 287 facilities spread across Kano state and 2528 end users of FP services. Briefly, only 16% of the facilities had all the basic infrastructure requirements assessed with the majority of the facilities (88.85%) with less than 5 staff working on logistics and supply chain management of health commodities. Majority of the facilities (60.28%) picked up family planning commodities, however, only 9.76% had a pickup vehicle. The study also revealed some level of negative and stigmatizing attitudes towards use of FP services.

This research study highlights factors affecting policy decision-making regarding last mile distribution of family planning commodities in Kano state, northern Nigeria. It also provides evidence-based recommendations on how to tackle supply chain, religious and socio-cultural barriers to the uptake and use of FP services and commodities.

Paper 3: Lean thinking in Medical Supply Chains: Applicability and Success Factors

Severine Kessy, Gladness Salema and Yusta Simwita The Business School, University of Dar es Salaam, Tanzania

This Study was Funded by Africa Resource Center (ARC), South Africa


Globally, public healthcare facilities are being forced to increase their supply chains efficiency by adopting concepts and methodologies commonly used in manufacturing industries. This study examined the lean thinking in medicines supply chains by considering its applications and success factors in the entire process of the medical supply chain. It was guided by four objectives focusing on determining the drivers of and wastes associated with the medical commodities supply chain in the public and private health facilities. The study further compares existing lean tools and practices and examines their application in the medical commodities supply chain processes. The contextual factors (challenges and success factors), which are critical for effective lean application in the medical commodities supply chains, both at the health facility level and suppliers were also examined in this study. The study was purely qualitative, which was conducted in four regions of Tanzania using a case study approach. Specifically, key informants were medical officers in charge, procurement officers or pharmacists of the health facilities. Also the managers of the Medical Store Department, prime vendors and suppliers of private health facilities were interviewed to get additional information for each stage and processes of supply chain. In order to extract utility from the collected data, a value stream mapping approach was used to analyse the collected data.

The findings revealed that the main driver for waste associated with medicines and laboratory commodities supply chain in the public and private health facilities were demand management, supplier development, and institutional framework and governance. Other drivers were supply chain capabilities, incentives and culture. This paper will highlight details of the study.