Multicountry immunization supply chain cost and performance benchmarking
Multi-country immunization supply chain cost and performance benchmarking Tapiwa Mukwash 1 20 th November, 2019
Thanks to our generous sponsors
Multi-country Immunization Supply Chain Cost And Performance Benchmarking Tapiwa Mukwashi & Gabo Ailstock 2019 Global Health Supply Chain Summit, Johannesburg, S. Africa
Background: The problem Countries lack referential cost measures and metrics due to: A wide variety of methods are used Costing studies are cumbersome Few links between cost and performance 2019 Global Health Supply Chain Summit, Johannesburg, S. Africa
Background: Our solution A Benchmarking approach which enables stakeholders to evaluate their immunization supply chain cost and performance metric against comparable peer groups. 2019 Global Health Supply Chain Summit, Johannesburg, S. Africa
Background: Project phases Phase II Define methodology and scope Refine methodology, tools and data analysis Develop data analysis plan and data collection tools Develop electronic database Pilot with 4 supply chains Recruit 10 additional supply chains Document lessons learned 2019 Global Health Supply Chain Summit, Johannesburg, S. Africa
Study Design: Project scoping and protocol development Benchmarking starts where costing ends Protocol developed to standardize the way cost and performance data is collected, in order to enable direct comparisons. Adapted USAID|Deliver costing methodology 2019 Global Health Supply Chain Summit, Johannesburg, S. Africa
Study Design: Benchmarking scope Administrative Level Sub-National level (including an allocation of national level costs) Target Population 0 -24 months Supply Chain Type Routine immunization Costed Activities Management, procurement, storage & transportation Vaccine Type Schedule for children 0 -24 months Cost Elements Personnel, supplier, buildings, overhead, per diem & travel allowances Analysis Period Latest completed budget year 2019 Global Health Supply Chain Summit, Johannesburg, S. Africa
Study Design: Benchmarking data inputs and outputs Procurement Management Storage Transportation Stock availability On-time in-full delivery Closed vial wastage CCE Functionality Stocked according to plan Network configuration Transport mix Throughput value Throughput volume Benchmarking outputs 1. Cost Measures 2. Cost Metrics Procurement Management Storage Transportation Cost per dose Cost per fully immunized child Cost as % of throughput value Cost as % of throughput volume Cost descriptions Cost vs outputs 3. Performance Metrics 4. SC characteristics Stock availability On-time in-full delivery Closed vial wastage CCE Functionality Stocked according to plan Network configuration Transport mix Throughput value Throughput volume Cost vs outcomes Key cost drivers 2019 Global Health Supply Chain Summit, Johannesburg, S. Africa
Study Application: Phase I participants Ethiopi a Nigeria Mozambique Amhara Region & Kaduna State Niassa Province Southern Nations, Nationalities, and People’s Region (SNNPR) 2019 Global Health Supply Chain Summit, Johannesburg, S. Africa
Results: Phase 1 participants were not directly benchmarked against each other Total Costs Total Throughput Managed Doses Delivered Fully Immunized Children $3, 847, 818 581 m 3 $1, 714, 469 394 m 3 $297, 493 106 m 3 10, 634, 773 7, 194, 125 1, 499, 963 621, 440 363, 757 260, 910 2019 Global Health Supply Chain Summit, Johannesburg, S. Africa
Results: Cost measures, Niassa, Mozambique Total i. SC Cost by Activity TOTAL: MZN 15, 169, 281 ($262, 951) Total i. SC Costs by Tier TOTAL: MZN 15, 169, 281($262, 951) [CELLRAN GE] [VALUE] Insufficien t 21% even with direct distribution [CELLRAN GE] [VALUE] Data [CELLRANG E] [VALUE] [CELLRAN GE] [VALUE] [CELLRANG E] [VALUE] National villagereach. org Provincial n=1 Distrito n=16 Unidade Sanitaria n=177 Procurement Management 2019 Global Health Supply Chain Summit, Johannesburg, S. Africa Storage Transportation
Results: Cost and performance metrics, Niassa Mozambique Performance Metric National Health Facility 100% 98% i. SC cost per dose MZN 10. 11 ($. 18) N/A i. SC cost per fully immunized child* MZN 58. 14 ($1. 01) On-Time In- Full Delivery (OTIF) 80% 20% Cost as a % of throughput value 15. 2% Cold Chain Equipment (CCE) Functionality 100% N/A 26% Stock Availability (Pentavalent) Open Vial Wastage (Pentavalent) Stocked According to Plan Cost Metrics 2019 Global Health Supply Chain Summit, Johannesburg, S. Africa
Results: Cost driver analysis, Niassa, Mozambique Total % of i. SC Costs Are we getting value for our money, from the district level? Are all district stores needed for non-hard-to-reach districts? Direct distribution of EPI commodities Provincial EPI (n=1) 58% Distrito (n=16) 21% High personnel costs for supervision of monthly distribution Large storage costs for a small amount of product High overhead costs for a tier with limited i. SC involvement 2019 Global Health Supply Chain Summit, Johannesburg, S. Africa Unidade Sanitaria (n=177) 21% High per diem costs for supervision of monthly distribution
In Phase I, we have achieved our goal of developing and testing a new methodology for cost and performance comparisons. In order for the true value of benchmarking to be realized, we are seeking opportunities to move into Phase II, recruit more participants and partner. If you are interested – please contact info@villagereach. org 2019 Global Health Supply Chain Summit, Johannesburg, S. Africa
Thanks to our generous sponsors 2019 Global Health Supply Chain Summit, Johannesburg, S. Africa
- Slides: 16