DPSA supported DFID by distributing pharmaceutical and medical supplies for Sierra Leone’s Free Health Care Initiative, which targets young children, pregnant and lactating women, and Ebola survivors. Watch our film to find out how we did it.
A logistical challenge
How do you deliver 1,500 tonnes of pharmaceutical and medical supplies to health facilities spanning some of the most remote parts of Sierra Leone? This was the challenge we faced when the UK’s Department for International Development (DFID) sought DPSA’s assistance with distributing supplies for the country’s Free Health Care Initiative (FHCI).
FHCI was launched in 2010. It aimed to reduce Sierra Leone’s very high under-five mortality rate, which stood at 187 per 1,000 births in 2009. It promises free preventative and curative health services to all children under five, pregnant and lactating women, and Ebola survivors. Since its inception, DFID was the sole funder of procurement and distribution for FHCI supplies, through UK aid from the British people.
DPSA was asked to securely distribute three batches of pharmaceutical and medical supplies, of up to 500 tonnes each, by the end of 2017. These had been procured by the humanitarian organisation UNICEF.
Orchestrating a multi-layered solution
The supplies were distributed to 1,244 locations across Sierra Leone’s 13 districts. Not only did this include 24 hospitals but each district also supports up to 100 peripheral health units. These range from relatively sophisticated urban facilities, to basic buildings in remote communities.
“Once we had received the stock from UNICEF, we worked in partnership with Logenix to store and manage the items,” explained Dean Stevens, Head of Logistics Services for DPSA. “We designed a plan for onward distribution and separated the supplies into relevant, allocated consignments for each facility.”
Each district’s consignment was taken by truck to a central District Medical Store, or, in the case of Freetown, to a hospital. Local ‘last-mile distributors’ completed the final part of the distribution to each peripheral health unit for DPSA. These were specialist firms with expertise in handling logistics within their individual, often remote, areas. Providing an end-to-end solution, with items packaged in advance for each end location, ensured supplies were ready for use straight away when they reached their final destination.
DPSA also worked with John Snow Inc., which concurrently undertook governance and assurance procedures at around 35% of the locations. “Governance concerns the structures needed to ensure performance, conduct and output comply with policies, process and procedures,” explained Dean. “While assurance confirmed that we delivered what we were asked to deliver.”
Keeping the supply chain running smoothly
Managing a supply chain that involves different parties requires close cooperation. In addition to UNICEF undertaking procurement and DPSA handling distribution, Clinton Health Access Initiative assisted the Sierra Leone Ministry of Health’s Directorate of Drugs and Medical Supplies (DDMS) in overseeing the project. Understandably, this arrangement called for strong partnerships and detailed collaborative work.
“As well as undertaking the physical distribution, we assisted with supply-chain management,” said Dean. “Because we were in the middle of the chain, we relied on the information and products that come to us. We helped to identify ways in which the process can be improved, and we worked with DDMS and DFID to develop procedures for the Government of Sierra Leone to take over FHCI’s supply-chain management in future.”
Building a capable local workforce
The long-term goal was that the Government of Sierra Leone would take full ownership of FHCI. With this goal in mind, staff were recruited and trained. At the time of writing, around 120 Sierra Leoneans were employed to work in the warehouse, in distribution operations and on assurance activities.
“The Government is developing a new National Medical Supply Agency (NMSA),” said Dean. “There’s a considerable amount of work going on to develop local capability. We supported capability-building by helping to train the current local FHCI staff, to ensure they can continue delivering a high standard of service once they are employed by NMSA.”
 For the purposes of this project, Western Rural and Western Urban were treated as one district.
 This is in line with international audit requirements as it equates to 40% of the value of the value of goods distributed.