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Summary

In Mozambique, the USAID-funded Last Mile Health Supply Chain project aims to develop a more streamlined and effective distribution system to address chronic logistics and transport challenges. ThinkWell develops tools and visualizations to increase visibility on gaps vs. target performance. In addition, we help develop methods and tools for health facility capability development specifically relevant to last mile delivery. Third, we contribute to the program’s monitoring and evaluation (M&E) and costing workstreams. Finally, we provide capacity building technical assistance to provincial health departments, districts, and health facilities to improve their skills for data collection and analysis, use of data for decision-making, and continuous quality improvement.

Breaking New Ground

ThinkWell assessed the entire national public health supply chain system, covering 70 health facilities that were randomly selected among 22 districts. This is the first time that this type of assessment has been done—the majority were conducted at central and provincial levels, looking at discrete supply chain components. The data we collected provide insights into how to strengthen the availability of medical commodities in health facilities. In response, we are establishing an outsourced last mile distribution through a fourth party logistics provider to help do this.

Challenges

Adding to challenges related to infrastructure, limited warehousing space, lack of human resources, and poor stock management procedures, the supply chain also lacks end-to-end visibility in the logistics management information systems (LMIS). While information systems exist to meet the basic needs of the health system, the quality of data remains subpar and there is a huge need to improve the use of data for decision making.

Approach

ThinkWell worked closely with the Central Medical Store (CMAM) and the provincial directorate in Zambezia province to respond to specific challenges faced in the supply chain with a focus on improving the long-term logistics capabilities at the sub-national level.

Results

ThinkWell helped improve end-to-end data visibility on transport and commodity distribution through the development of a visibility and analytics network (VAN) manual and toolkit, including supporting processes, tools, and templates for data collection, analysis, reporting, and review. This also includes the set-up of a provincial-level dashboard. Additionally, ThinkWell developed a method and tools for a comprehensive health facility capability assessment. Our data analysis findings helped the Last Mile Health Supply Chain project to develop recommendations specifically relevant to last mile delivery.

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