The document discusses Zambia's Essential Medicines Logistics Improvement Program (EMLIP) Hybrid model. EMLIP uses a hybrid push-pull system to distribute essential medicines from central medical stores to health centers and hospitals. It was launched in 2009 across 27 districts to address challenges of volatile currency and reduced health budgets. By 2016, the program reported a 98% reporting rate, 96% stock availability, and reduced antimalarial stockouts to 3%. The document recommends continuing the EMLIP rollout, strengthening the electronic logistics management information system, protecting investments in the supply system, and setting aside minimum health budget amounts to hedge against currency fluctuations.

1. ZAMBIA ESSENTIAL
MEDICINES LOGISTICS
IMPROVEMENT PROGRAM
(EMLIP HYBRID)
Alexis Anderson
Bryan Kirk
Priya Konduru Subramani Raju
Samantha Straitz
in partnership with Chimuka Hampango & Derrick Nyimbili

2. Objective
Background
EMLIP
Challenge
Economy
Volatile Currency
Procurement
Recommendations

3. EMLIP Medical Stores
Limited (MSL)
District Community
Medical Office
(DCMO)
MSL Hub
Provincial Health
Office (PHO)
Hub Staging Post
Health Centers
& Community
Health Workers
Hospitals Levels
1,2,3
LMU
LMIS Reporting & Ordering Health Center Kits Top-Up Commodities, Emergency Feedback Reports
Launched June 2009 in 27
districts
Essential medicines, family
planning products, malaria
commodities
Hybrid Push-Pull System
Forced Ordering Maximum-
Minimum Inventory Control
System

4. Exports  from $10.22 billion (2014) to $6.32 billion (2015)
Kwacha  from US $6,829 per tonne (2014) to US $5,160 per tonne (2015)
GDP  from 6.7% (2013) to 4.3% (2015)
Challenge Volatile
Currency
Reduced
Health Budget

5. Health budget allocation  from 11.3% in 2013 to 8.3% in 2016
• 2013: 11.3%
• 2014: 9.9%
• 2015: 9.6%
• 2016: 8.3%
Challenge Volatile
Currency
Reduced
Health Budget

6. Recommendations
Continue
EMLIP
Rollout
Strengthen
eLMIS
Continue scale-up and implementation to the remaining
districts in Zambia, including transitioning to the Electronic
Logistics Management System (eLMIS)
Ministry of Health set aside a minimum amount of money for
essential medicine drug procurement
Protect
Investment

7. Recommendations
Continue
EMLIP
Rollout
Strengthen
eLMIS
Protect
Investment
- Hybrid system enhances commodity security
- Drugs available on as-needed basis
-  commodity waste
-  stock data reporting
- Antimalarial stockouts reported at
all levels of health care system
- Poor logistical and supply systems;
limited commodity procurement
2009
- 98% reporting rate and 96% antimalarial
facility level stock availability
- Health facility stockouts of ACT  to 3%
2016

8. Recommendations
Continue
EMLIP
Rollout
Strengthen
eLMIS
Protect
Investment
Increase data reporting
speed, ease & accuracy
Improve data quality
Reduce stockouts
Improve health
outcomes
Generate Cost
Savings

9. Recommendations
Continue
EMLIP
Rollout
Strengthen
eLMIS
Protect
Investment
Ministry of Health set aside
minimum amount of money
Hedge against budget fluctuations