CLICK TO ADD TITLE [DATE][SPEAKERS NAMES] The 5th Global Health Supply Chain Summit November , 2012 Kigali, Rwanda Measuring Supply Chain Maturity Diane Reynolds

Establishing a supply chain maturity assessment model for the public health environment to drive investment decisions Supply chain performance assessment - to understand a high-level status of the supply chain, comparing current-state operating environment and levels of supply chain performance against best practices, identify improvement opportunities, anticipate business impact and establish a program that drives improved business performance. 2 ForecastProcure Warehouse & Inventory TransportDispense

Common problem statements expressed in the public health supply chain. We need a new warehouse we don’t have enough space We don’t get forecasts from the facilities to order the right commodity The vendors never deliver the quantities we order We need an ERP to plan the delivery of commodities There are major stock outs at facility level because of the depot We need to be trained and tour other countries to learn best practice 3

Tools and frameworks to assess the supply chain maturity review both capability & performance levels. 4 Capability: Measures the capability of a supply chain, benchmarking against best-practice standards Capability Maturity Model Diagnostic tool Performance: Set of indicators that comprehensively measure the performance of a health supply chain Key Performance Indicator guide Maturity LevelMaturity Level Description 1- No/MinimalInformal processes and little or no systems 2- MarginalBasic not used consistently and mostly manual systems 3- QualifiedProcesses are defined and documented with some technology 4- Advanced Practices Processes are well defined and internal integrated technology 5- Best Practices Practice continuous improvements, fully integrated technology

Establishing capability & performance attributes of supply chain maturity enables planning & performance management 5 Capability: Benchmark to best practice Performance: Establish current performance Prioritize strengthening areas Measurement of intervention Monitor progress Demonstrate results

6 Supply Chain Maturity Assessment: South Africa Case Study: Applying the assessment to a systems strengthening decision-making process

Step 1: Environmental Study Step 1 Environment study Health Sector Overview Supply Chain Policies & Regulations National Infrastructure & Services Etc…… National Gauteng Reg Depot Hospital Clinic Region District SDP ForecastProd SelectProcure Warehouse & Inventory TransportDispense Functions

Step 2: CMM Diagnostic Tool implementation 8 SCORES Reg/ Prov DistSDPNDoH Functional Areas Product SelectionN/A Forecast and Supply Planning N/A ProcurementN/A Warehousing and Inventory Management TransportationN/A DispensingN/A Waste ManagementN/A Initial assessment part of a larger regional Field Office study Included provincial, district and SDP assessments (no central) 8 sites assessed (Depot, region depot, tertiary Hospital, clinic levels) Step 2 CMM Diagnostic tool Select functional area to assess Select sites to be visited across levels Interview functional leads or HQ Complete a Site walkabout for each relevant functional area

Step 3: KPI assessment tool implementation 9 Step 3 KPI framework Identify any KPI’s available Select KPI’s to be “determined” Collect data Update score sheet Indicators 1)Stock out rates 2)Excess stock 3)EDL compliance 4)% of products that meet QA standards 5)Off-contract spend 6)% of emergency orders 7)Order Fill Rate 8)Expiry 9)Pricing Variance 10)Order Cycle Time 11)Stock turnover rate 12)On-time delivery 13)Distribution cost 14)Inventory discrepancy 15)Backorder Follow the transaction, paper trails & data

Step 4: Scoring the assessment tools 10 Step 4 Score CMM & KPI Comprehensive country score for all assessed capabilities Key performance indicator benchmark Supply Chain capability and performance

Step 4: Reporting 11 Step 4 Score CMM & KPI Comprehensive country score for all assessed capabilities Key performance indicator benchmark Supply Chain capability and performance Facility capability level data Country level data Function by enabler level data

Step 5: Evidence-based decision-making 12 Sequence Interviews Step 5 Evidence Based Decision Prioritize strengthening areas to focus STTA & training ROI costing activity Determine recommendations & options Define roles & responsibilities Establish baselines to measure progress

Step 6: Intervention based on recommendations 13 Key Improvement Areas and Financial Impact (targeted savings) Step 6 Intervention Continuous trends and tracking through the project

Step 7: Measuring the ROI 14 Step 7 Measuring the ROI Measurement of intervention Demonstrate results Key Improvement Areas and Financial Impact (targeted savings) Back orders Immediate saving Long term saving

Lessons learnt in the pilots (South Africa, Botswana and Paraguay) and next steps Finalization of the KPI guidelines – selected core measures Collaborate with UNC to review and define an “ROI” approach Templates were created as a reference for vertical consistency within functional areas Conversion to a check box format to make maturity level descriptions succinct Include the addition of a SDP specific questionnaire Provides a practical, cost-effective approach to supply chain assessment for the public health supply chain Middle ground between an expensive, statistically significant assessment based on site-visits and qualitative workshop-based self assessment tools Comprehensive reporting enables informative client discussions to prioritize and define improvement programs Lessons Learnt Next steps Practical, relevant & cost effective