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Informed Design: Supply Chain Costing for Policy Decision Making

Informed Design: Supply Chain Costing for Policy Decision Making. Cost-Effectiveness of Vaccine Supply Chains in Mozambique USAID | DELIVER PROJECT Critical Issues Series Washington DC, July 30, 2012 Leah Hasselback. Why do supply chain costing?.

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Informed Design: Supply Chain Costing for Policy Decision Making

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  1. Informed Design: Supply Chain Costing for Policy Decision Making Cost-Effectiveness of Vaccine Supply Chains in Mozambique USAID | DELIVER PROJECT Critical Issues Series Washington DC, July 30, 2012 Leah Hasselback

  2. Why do supply chain costing? • Costs of getting commodities to health facilities is often overlooked or unknown • Knowledge of operating costs and cost drivers should be used to make decisions about: • Supply chain design • Implementation • Performance • Advocate for funding supply chain • Align pricing policies with actual costs • Improve efficiency and effectiveness of the supply chain

  3. Project History • 5-year supply chain redesign pilot project implemented in Cabo Delgado province (Dedicated Logistics System) • Old: Collection-based, ad hoc system • New: Delivery-based, vendor managed inventory with level skipping • Included supportive supervision and information system • Conducted impact evaluation in Cabo Delgado, using neighboring Niassa province as a comparison Mozambique Cabo Delgado Niassa Nampula

  4. Impressive results…but at what cost? • 91% visited in last monthdespite : • 47% of families living over two hours away; • 85% of them having to walk to get there ; and • most common reason for vaccination failure being “place of immunization too far.”

  5. CostStudy • Objective • Compare the costs of vaccine logistics in the pilot province and a control province. • Challenges • Haphazard nature of supply chain in Niassa. • Wide variety of activities, participants, frequency, and costs. • Lack of cost records. • Sufficient recall. • Methodology • Excel-based cost model • Transport, personnel, cold chain, vaccine & supplies • Immunization portion only • Niassa as comparison province • Niassa 10% random sample using PPS • 10 health centers in 8 districts • Surveys at health centers, districts, and province & national transport & maintenance staff • Total 42 surveys

  6. Description of Logistics System Assessed Mozambique • Cabo Delgado • Project system • Active logistic delivery system • Vaccines reliably delivered to health facilities each month • Niassa • Mixed & inconsistent • Collection & distribution • Varies by location & month

  7. Cabo Delgado: Dedicated Logistics System 1. Leave with: - medical supplies - propane - equipment, parts - knowledge Provincial Store • 4. Field coordinator office • input data • analyze information • prepare for next trip • training District Storage • 2. Site visit: • - record & stock inventory • - service equipment • - collect data • - supportive supervision Health Centers • 3. Return with: • - data Outreach Teams

  8. Niassa: Old System

  9. Results

  10. Results: Breakdown of Costs Conclusion: The Dedicated Logistics System (Cabo Delgado) is more cost-effective and efficient, which leads to government savings.

  11. Using the Results • Results were used to advocate for expanding the Dedicated Logistics System to other provinces, building on 15 months of advocacy with impact results. • 3 months later expansion approved by the Minister of Health. • Today 4 of Mozambique’s 10 provinces implement the Dedicated Logistics System, which now extends to over 445 health centers.

  12. Thank You www.villagereach.org Leah Hasselback Mozambique Country Director leah@villagereach.org Tel: +258 827324196 Av. 25 de Setembro, 1123-11º. E Maputo, Mozambique Tel: +258 21326446 Fax: +258 21326448

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