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[DATE][SPEAKERS NAMES]

The 5th Global Health Supply Chain Summit

November 14 -16, 2012Kigali, Rwanda

 

The « Informed Push Model »  for Family Planning Commodities in SenegalDr. Cheikh Seck

Director of ISSU Project, IntraHealth International

Family planning commodity stockouts in Senegal

Recurring stockouts in family planning commodities Structural causes

1 Average number of stockout days per month (June 2010 – July 2011): 13 days2 Average number of stockout days per month (June 2010 – July 2011): 25 days

JadelleDepo provera

43%1

83%2

Stockout rates in service delivery points High medical staff turnover

Work overload

Lack of supervision

“There’s a high staff turnover. And the transition with new staff is not adequate.”

– Midwife

“I see so many patients everyday that I can’t keep up with the register.”

– Midwife

“There’s no supervision at the health post level to assess the quality of the procurement.”

– Family Planning Coordinator

60%

40%

Local

National

Testimonies

Objectives

The “Informed Push Model” is a distribution model based on the pushing commodities down the supply chain to service delivery points. It revolves around two key objectives:

Eliminating stockouts at service delivery points.

Transfer of reliable and accurate data on a regular basis to improve the supply chain.

Collaboration with stakeholders

Implementing Agency

Donor

Partners in the Public Health

System

Partners/

Technical Assistance

Senegalese Urban Health Initiative

Bill & Melinda Gates Foundation

Division of Reproductive Health

(Ministry of Health)

McKinsey & Company

5

▪ Collection of products by own means (eg., rental, taxi)

▪ Poor quality of demand forecast

▪ Cash balance issues▪ Etc.

Orders

Collection of products

Problems encountered

Delivery

Cost recovery

Order-based procurement system

Previous Supply Model prior to the “Informed Push Model”

PRA

District

SDP

Collection of products

Delivery

Cost recovery

Mobile Depot

PRA

District

SDP

▪ Regular delivery to complete stock levels

▪ A delivery voucher is signed at the delivery and shared with the district for the cost recovery process

▪ Products are paid after consumption

▪ Margins on sales are preserved

“Informed Push model” (No orders)

How does the “Informed Push Model” simplifies the procurement of products? Information

Safety threshold

Inaccurate Consumption Forecasts Order Delays

Maximum stocks

Frequent stockouts

0

5

10

15

20

AprilMarchFebruary

Stock levelsUnits

January

AprilMarchFebruary

Stock levelsUnits

January

How are stockouts eliminated through the “Informed Push Model ”?

Results

District of Pikine

Lessons learned

Strengths

• Rapid and concrete results (immediate elimination of stockouts)

• Logistical and financial constraints alleviated for providers

• Regular collection of updated/accurate data through check-ins at SDPs

• Documentation/use of consumption-related data

Lessons learned

Key aspects

• Need for a solid engagement from the National Procurement Pharmacy in order to ensure the sustainability of the system

• Need for increased communication with various stakeholders in order to improve the ownership of the system

• Importance of providing technical assistance to the logistics operator and other stakeholders in order to facilitate capacity building from the very beginning of the project

Conclusions

The “Informed Push Model” offers a concrete solution to FP procurement issues in Senegal. It is strongly supported at the national level and has yielded very encouraging results.

The main challenge will be to reach full and sustainable integration within, and ownership by, the national supply chain.

It is important to note that this approach can be replicated as part of other health programs in other countries.