The pulse of public healthcare supply chain in Africa changing the paradigm. Presented during the 37th annual SAPICS conference and exhibition at Sun City, South Africa, from May 31 to June 2.

1. The Pulse of Public Healthcare
Supply Chain in Africa
Changing the paradigm of
decision making in the public health supply chain

2. Agenda
Introduction1
Context2
Before3
Execution4
Results5

3. Terminology
• eLMIS: Electronic Logistics Management System

4. In Context

5. Introduction to Rwanda

6. Population (2011) 11 Million 52 Million
Area 26,338 km2 1,221,037 km2
Population Density 419.8/km2 42.4/km2
GDP Per Capita $ 698 $ 6,354
Introduction to Rwanda

7. Some Numbers?
Health Spend Per Capita (2013) $ 71 $ 593

8. Before

9. How Things Used to Work…
• Paper based
• Timeous

10. Objectives
Design, build, and implementation of a computerized logistics management information system that will
provide health commodity logistics data and order processing functionalities

11. Rwanda Ministry of Health Electronic Logistics
Management Information System (eLMIS)
Project Overview
• Ministry of Health supply chain covers 4 in-country
warehouses, 40 district pharmacies & regional hospitals, and
approximately 900 local health clinics and dispensing
facilities
• Supply chain-wide consumption (manual system updates
from dispensing locations, similar to POS);
• Annual and semi-annual quantification
(budgeting/forecasting, very light by commercial standards);
• Supply chain-wide inventory management (due-ins, due-
outs, in stocks, on order, etc.);
• Light warehouse management (receipts, put away, pick list
generation, shipments);
• Serialized item and lot tracking;
• Supply chain-wide order management;
• Supply chain-wide shipment visibility, with event notifications;
• Reporting and dashboards (incl. inventory control by program);
• Integration with their existing WMS (Sage), ERP (Sage) and HMIS
(hospital MIS).
KEY FACTS
• 11.78 million
population served
• 500+ Local health clinics
and dispensing facilities
• 40+ Distribution centers
and warehouses
• Approx. 3000 SKUs

12. Rwanda Ministry of Health Electronic Logistics
Management Information System (eLMIS)
Business Results
• Improved patient service levels
• Reduced costs
• Replaces previous paper-based and manual-driven system
• Increased operational efficiencies
• Improved in-stocks at district pharmacies and health clinics
• Reduced wastages
• Reduced total system cost to deploy, maintain and support
Rwanda Leveraging One
Network’s Cloud Platform to:
• Improve the provisioning, inventory
control, and distribution of critical HIV/AIDS
medicines and other pharmaceutical
products to patients across Rwanda
• Enable better patient service levels from
central supply facilities to hospitals, local
clinics and other dispensing locations

14. Rwanda Health Distribution
LogisticsManagementOffice
(LMO)
Private
Sector
MPPD
(DC)
District
Pharmacies
Referral
Hospitals
Health
Centres
National Blood
Transfusion Centres
National Reference
Laboratory
Regional Blood
Transfusion Centres
Health
Community
Coordinator
MOH SystemsMPPD WMS
Health Posts
District
Hospitals
Community Health Worker
eLMIS

15. Execution

16. Project Overview
Documentation
Project Charter
Project Management Plan
Project Work Breakdown Structure
Budget and Financial Plans
Communication Plan
Risk Management Plan
Readiness Assessment Plan
Change Management Plan
Training Plan
Testing Plan
Implementation Plan
Critical Success Factors:
• GOR Leadership
• AGILE Implementation
• Early Champion Identification
• USAID/GF Partnership
• Stakeholder Buy In
• Risk Management
Status:
 System Implemented in 30 District
Pharmacies, 43 District Hospitals, 2
Referral Hospitals, 527 Health
Centres, LMO and MPPD
 Usability
 Purchase Order Management -
98% of all facilities use eLMIS
to create, collaborate and
manage purchase orders
 Consumption - 80% of all
health facilities record daily
consumption in the eLMIS
 Transportation - 55% of orders
have been delivered
leveraging the transportation
function in eLMIS
 Impact
 Reduction in both LOE and
Cycle Time
 Value Chain Visibility
 Real Time Consumption Data

17. Implementation Framework
Rwanda eLMIS
Implementation
Framework
Top management support, Cross
functional project team with IT skills,
Business process reengineering,
Quality function deployment,
Concurrent engineering, Life cycle
approach, Project management,
Required financial support,
Performance measures and metrics
Top management participation, Long-term
business plan, Agility and cost, Strategic
partnerships, Integrated systems
Fitness for Business process, Change
Readiness, Internet connectivity, IT
investment, ERP, Software
and hardware availability, Systems
Integration, IT skills, Training and
Education in IT, IT evaluation

18. Solution Architecture
Inputs MPDD WMS Private SectorBUFMAR
eLMIS Platform
Processes&Workflow
Forecasting
& Netting
Order
Management Transportation
Supply
Planning &
Allocation
Load
Building
Appointment
Scheduling
Consumption
Data
Distribution
/Logistics
Transactions
Compliance
Permissions
& Security
Reporting
Alerts and
Notifications
Business Rules
and Policies
Operational
Data Store
Outputs
Informatio
n and
Commoditi
es
Visibility GOR/MOH
Donor Partners
MPDD
District
Pharmacies
Referral
Hospital
Health Centers
LMO
BUFMAR

19. Implementation Timeline
2012
2013
2013
2011
2012
2014
User Acceptance Testing
Conducted User
Acceptance Testing
.
Procurement
Developed RFP
Proof of Concept Demonstration
System Procurement
Contract Negotiation
Determine Contract Deliverables
SOW Development
Contract Award
Business Case Analysis
Developed Problem Statement
Identified project boundaries
Defined Expected Benefits and
Improvements
Defined project goals and objectives
Defined Solution Scope
Conducted Analysis of Alternatives
Detailed project constraints assumptions
Determined Acquisition Approach
Incremental Implementation
1st Implementation - DP and LMO
2nd Implementation - District Hospitals
3rd Implementation - Health Centers
Project Initiation
Conducted Stakeholder
Identification
Selected system champions
Developed implementation blue
print
Performed Risk Identification
Developed Project Management
Plan
Developed Project Charter
Identified solution constraints
and dependencies
Conducted readiness
assessment and skills analysis
Training of Trainers
Conducted Training of Trainers
Training conducted through a
combination of training videos,
printed handouts and “hands on”
instruction to provide the
participants with an opportunity to
practice the use of the eLMIS
.

20. Results

21. Impact on work performance
Purchase Order
Management
Inventory Management
Warehouse
Management
Supply Planning
Supply Chain and
Logistics Reporting
Greater Extent 70% 52% 74% 21% 49%
Some Extent 28% 44% 24% 34% 44%
Not all 44% 5%
0%
10%
20%
30%
40%
50%
60%
70%
80%
%

22. Impact on LOE
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Is the effort required to process an
order reduced?
Is the effort required to manage
inventory reduced
%
Is the effort required to process an order reduced? Is the effort required to manage inventory reduced
Yes 89% 84%
Not at all 9% 15%
Level of Effort Required to Process Orders/Manage
Inventory

23. Acknowledgments
* Some logos designed by

24. CLOSING
Questions
COMPANY 37
www.resolvesp.com
tlambiotte@resolvesp.com
47 Landmarks Ave, Samrand
0861 RESOLVE
resolvesp
@resolve_sp