Providing goods and services to support healthcare programmes around the world is a central pillar of DPSA’s work. From procuring pharmaceuticals, medical equipment and drug-testing services to managing complex logistics, we sustain vital healthcare programmes by delivering supplies and providing expertise quickly and efficiently to those in need.
We integrate procurement planning and supply chain management with programme design from the outset. This means not only understanding ‘what’ is needed, but ‘why’ and ‘how’, so that we can deliver the optimal product, service or solution. In this round-up of our recent healthcare work on behalf of the UK Government’s Department for International Development (DFID) in Africa, we show how we put this approach into practice.
These case studies showcase our experience of handling complex, multi-faceted supply chains; our specialist expertise in pharmaceuticals, medical equipment, energy, educational materials and procurement oversight; the benefits of having a single point of contact; and our ability to source goods from local and international suppliers.
Together, they demonstrate why ‘doing procurement differently’ can support positive healthcare outcomes and help aid to go further.
Targeted technical assistance can deliver significant cost savings
We were asked to support the Maternal, Newborn and Child Health Programme (MNCH2) across six states of northern Nigeria. This programme required a significant procurement of pharmaceuticals, medical equipment and consumables. On examining the requirements for goods and equipment provided by each state for the years 2017–18 and 2018–19, we anticipated that the client would be unlikely to be able to procure everything requested within the budget available.
Experience has shown us that clients’ specifications are often developed based on the goods and equipment they have bought before, as they do not have the resources to fully explore what is available. However, our access to the global marketplace and experience of handling complex procurements means we can consider a wider range of options.
Therefore, with the approval of the client, we undertook an exercise to investigate how things could be done differently. We examined more than 700 individual line items and identified 20 areas where alternatives could be provided without compromising quality. For example, we recommended clinical-quality microscopes rather than research-grade ones, which would meet the programme’s needs but were less expensive.
Among the requested pharmaceutical items, we identified where drugs could be obtained from sources other than MNCH2-funded facilities – such as anti-malarial drugs supplied nationwide by Nigeria’s National Malaria Control Programme. This meant we could remove those items from the procurement list and free up funding. In total, we were able to identify cost efficiencies of £10 million.
Creating an effective supply chain by working collaboratively
Strong partnerships proved essential when we were asked to deliver 1,500 tonnes of pharmaceutical and medical supplies to health facilities across Sierra Leone, under the country’s Free Health Care Initiative (FHCI). Ensuring the supply chain ran smoothly called for close collaboration across all the involved parties.
UNICEF was in charge of procurement, and the Clinton Health Access Initiative was assisting Sierra Leone’s Ministry of Health’s Directorate of Drugs and Medical Supplies with the project. Working with our partners, DPSA managed the physical distribution, fulfilled post-delivery governance and assurance procedures, and coordinated the supply chain.
The Government of Sierra Leone’s goal was to eventually take full ownership of FHCI, and it was establishing a new National Medical Supply Agency with this objective in mind. Ahead of the handover, we helped to train national staff, identify ways in which supply-chain processes could be improved, and develop robust accounting and reverse-logistics procedures for management of the supply chain in future.
Providing an end-to-end logistics solution for multiple delivery locations
Effective logistics management was critical to our work with the Free Health Care Initiative in Sierra Leone. One thousand five hundred tonnes of pharmaceutical and medical supplies, split into three batches of 500 tonnes each, had to be delivered to 1,244 locations across the country’s 14 districts. The destinations ranged from urban facilities to basic buildings in rural communities. The supplies were all delivered to a warehouse in the capital, Freetown, and we worked with our partners to design a plan for onward distribution to all locations. This included separating the supplies – 173 different commodity types – into specific consignments for each facility.
Each consignment was first taken by truck to a central point in each district, either a District Medical Store or a hospital. Local ‘last-mile distributors’ completed the final part of the distribution to the individual health facilities. These were specialists with expertise in handling logistics within their discrete, often remote, areas. Managing the physical challenges of terrain, infrastructure and weather conditions meant being resourceful and so various means were used: trucks, 4x4s, boats, motorcycles. Some goods were even carried on foot.
Providing an end-to-end solution, with items packaged and labelled in advance for each final destination, ensured supplies were ready for use straight away when they arrived. This approach also minimised the potential for mistakes and wastage, and it helped to inform the reverse-logistics process for returning unused goods.
Understanding programme goals supports capacity-building
Malawi’s National Drug Quality Control Laboratory was unable to conduct the number and range of pharmaceutical tests required for the quantity of drugs entering the country. In response, DPSA was asked to support the team by procuring quality-control services for testing drugs from facilities outside of the country. When we asked the client about the overall programme goals, we discovered the Laboratory had begun building a new facility and had ambitious plans to become certified by the International Organization for Standardization.
After reviewing the Laboratory’s plans, we recommended using 70% of the available funds to procure outsourced services, and reallocating 30% of the money to buying equipment for the new laboratory. This would benefit the country in two ways: the outsourced services would enable it to test drugs without delay, while helping to equip the new facility would assist Malawi to build capacity and conduct more of its own testing in future.
A single point of contact simplifies the procurement process for clients
Our country managers act as a single point of contact for our clients, coordinating sourcing, procurement and delivery from beginning to end. This means that our clients only need to liaise with one person, saving them time in overseeing the procurement. Although the country manager is the ‘face’ of DPSA, each one is supported by a global network of procurement and logistics experts and specialist technical advisors, as needed.
Ghana’s Community-based Health Planning Services (CHPS) programme supports midwives in providing essential healthcare services at more than 100 district health centres. When DPSA was asked to assist CHPS with a complex procurement, our country manager ensured the process was simplified for the client.
The CHPS requirements were wide and extensive: 12 pick-up trucks; 200 motorbikes; 500 bicycles; 24 laptops; and assorted medical goods, including 3,000 maternal delivery kits, 3,000 surgical instrument kits, and 1,000 weighing and measuring instruments. To deliver this project, we sourced goods and equipment from multiple suppliers around the world. However, from the client’s perspective, their staff simply worked with a single provider that delivered the procurement from end to end.
Efficient procurement delivers benefits quickly
The Delivering Increased Family Planning Across Rural Kenya (DIFPARK) Programme required quick and simple access to 325,500 contraceptive implant kits in Kenya. We ensured that the kits were manufactured by WHO-approved sources, with packaging and labelling to meet the client’s requirements. Clear communication helped us to understand the scope of needs and deliver everything within the set delivery timelines. The procurement is contributing to helping DIFPARK cut the number of unplanned pregnancies and reduce the 1-in-38 lifetime risk of maternal death faced by mothers in Kenya.