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Supply Chains for CCM: Preliminary Baseline Results & SC Intervention Areas
SC4CCM Project Goal ,[object Object],[object Object]
Project Objectives ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SC4CCM Theory of Change
GOAL LEVEL OBJECTIVES Sick children receive appropriate treatment for common childhood illnesses Main Country Level Objective: CHWs have usable and quality medicines available when needed for appropriate treatment of common childhood illnesses Precondition 1 : Necessary, usable, quality CCM products are available at  CHW resupply point/s Precondition 2:   CHWs,  or person responsible for CHW resupply, know how, where, what, when and how much of each product to requisition or resupply and act as needed Precondition 3:   CHWs  have adequate storage: correct conditions, security and adequate space. Precondition 4:  Goods are routinely transported between resupply points and  CHWs Precondition 5:   CHWs  are motivated to perform their roles in the CCM product supply chain  SC4CCM Core Indicators Derived from  the main country level objective and immediate preconditions
Analysis of Product Availability Results by Precondition Malawi, Ethiopia & Rwanda
Country Contexts ,[object Object],[object Object],[object Object],[object Object]
Main Country Level Objective: CHWs have usable and quality medicines available when needed for appropriate treatment of common childhood illnesses
Product Availability among CHWs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Product availability at the resupply point appears to be strongly linked to product availability at the CHW, but is not the only predictor PRECONDITION 1:  Necessary, usable, quality CCM products are available at CHW resupply point/s
Product Availability at the Resupply Point & CHW Malawi Ethiopia Rwanda
RP fully stocked CHWs stocked out or not fully stocked RP not fully stocked CHWs have stock Malawi
[object Object],[object Object],[object Object],[object Object],[object Object],PRECONDITION 2:  CHWs, or person responsible for CHW resupply, know how, where, what, when and how much of each product to requisition or resupply and act as needed
[object Object],[object Object],[object Object],PRECONDITION 3:  CHWs have adequate storage: correct conditions, security and adequate space Storage did not appear to be a strong driver of product availability
[object Object],[object Object],[object Object],PRECONDITION 4:  Goods are routinely transported between resupply points and CHWs Transport is a challenge for CHWs ,[object Object],CHWs reported lack of motivation to travel to collect supplies as no compensation for time/travel
[object Object],PRECONDITION 5:  CHWs are motivated to perform their roles in the CCM supply chain Malawi -  84%  HSAs reported receiving a supervisory visit in last  3 months Ethiopia -   81%  HEWs reported receiving a supervisory visit in  last month Rwanda -  59%  CHWs reported receiving a supervisory visit in the  last month 2% of HEWs identified supervision as a motivating factor
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],PRECONDITION 5:  CHWs are motivated to perform their roles in the CCM supply chain
Main Country Level Objective: CHWs have usable and quality medicines available when needed for appropriate treatment of common childhood illnesses Precondition 1 : Necessary, usable, quality CCM products are available at  CHW resupply point/s Precondition 4:  Goods are routinely transported between resupply points and  CHWs Preliminary Conclusions Most significant drivers of product availability at CHW level Precondition 2:   CHWs,  or person responsible for CHW resupply, know how, where, what, when and how much of each product to requisition or resupply and act as needed Precondition 5:   CHWs  are motivated to perform their roles in the CCM product supply chain  Training appears to be necessary but not sufficient to significantly improve product availability CHWs receive frequent supervision in all countries, but content can be improved to target SC problems; motivation for SC tasks was not high 13. CHWs routinely collect and report timely, accurate logistics data
General Hypothesis Guiding Selection of Interventions ,[object Object]
Malawi Proposed Intervention  Strategies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Ethiopia Proposed Intervention  Strategies GROUP A: “Ready Lessons” for SC knowledge and skills GROUP B: Collaborative SC problem solving. “Finding local solutions together!” GROUP C: Supply chain segmentation for improved transportation. “No product left behind!”
Ethiopia Interventions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Supply Chain Performance
Standardize Resupply Procedures SMS System:  Data-Driven Advance-Orders, Simplified Engaging  CHWs to Prioritize  SC Activities Rwanda Proposed Intervention Strategy
Thank You! Sarah Andersson, sandersson@jsi.com sc4ccm.jsi.com

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CCM Supply Chains Baseline & Intervention Areas

  • 1. Supply Chains for CCM: Preliminary Baseline Results & SC Intervention Areas
  • 2.
  • 3.
  • 5. GOAL LEVEL OBJECTIVES Sick children receive appropriate treatment for common childhood illnesses Main Country Level Objective: CHWs have usable and quality medicines available when needed for appropriate treatment of common childhood illnesses Precondition 1 : Necessary, usable, quality CCM products are available at CHW resupply point/s Precondition 2: CHWs, or person responsible for CHW resupply, know how, where, what, when and how much of each product to requisition or resupply and act as needed Precondition 3: CHWs have adequate storage: correct conditions, security and adequate space. Precondition 4: Goods are routinely transported between resupply points and CHWs Precondition 5: CHWs are motivated to perform their roles in the CCM product supply chain SC4CCM Core Indicators Derived from the main country level objective and immediate preconditions
  • 6. Analysis of Product Availability Results by Precondition Malawi, Ethiopia & Rwanda
  • 7.
  • 8. Main Country Level Objective: CHWs have usable and quality medicines available when needed for appropriate treatment of common childhood illnesses
  • 9.
  • 10. Product availability at the resupply point appears to be strongly linked to product availability at the CHW, but is not the only predictor PRECONDITION 1: Necessary, usable, quality CCM products are available at CHW resupply point/s
  • 11. Product Availability at the Resupply Point & CHW Malawi Ethiopia Rwanda
  • 12. RP fully stocked CHWs stocked out or not fully stocked RP not fully stocked CHWs have stock Malawi
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18. Main Country Level Objective: CHWs have usable and quality medicines available when needed for appropriate treatment of common childhood illnesses Precondition 1 : Necessary, usable, quality CCM products are available at CHW resupply point/s Precondition 4: Goods are routinely transported between resupply points and CHWs Preliminary Conclusions Most significant drivers of product availability at CHW level Precondition 2: CHWs, or person responsible for CHW resupply, know how, where, what, when and how much of each product to requisition or resupply and act as needed Precondition 5: CHWs are motivated to perform their roles in the CCM product supply chain Training appears to be necessary but not sufficient to significantly improve product availability CHWs receive frequent supervision in all countries, but content can be improved to target SC problems; motivation for SC tasks was not high 13. CHWs routinely collect and report timely, accurate logistics data
  • 19.
  • 20.
  • 21. Ethiopia Proposed Intervention Strategies GROUP A: “Ready Lessons” for SC knowledge and skills GROUP B: Collaborative SC problem solving. “Finding local solutions together!” GROUP C: Supply chain segmentation for improved transportation. “No product left behind!”
  • 22.
  • 23. Standardize Resupply Procedures SMS System: Data-Driven Advance-Orders, Simplified Engaging CHWs to Prioritize SC Activities Rwanda Proposed Intervention Strategy
  • 24. Thank You! Sarah Andersson, sandersson@jsi.com sc4ccm.jsi.com

Editor's Notes

  1. Check if Amanda understand the subtle difference between 3 and 8
  2. Different responses in motivation
  3. Different responses in motivation
  4. Yasmin - I have left this as is – it is different to the two pager because of MOH sensitivities – so I’ve left it until we come to common wording