1. Zaragoza, 26-05-2008 Improving Public Health Impact Through Tailored Supply Chains: A Case Study of Ghana Chiamin Lai Michael Laverty

2. Introduction Slide 1

3. Sound Supply Chain Strategy Better Use of Assets & Increased Product Availability Better Use of Professional Health Workers Better Health Care Delivery Adequate resources & Willingness to implement How Sound Strategy Drives Improves Health Care Delivery Sound Supply Chain Strategy

4. Supply Chain Strategy: New Paradaim for Ministray of Health Constraint Constraints Needs Malaria supply chainstrategyHIV Supply Chain StrategyFamily Planning SupplyChain StrategyTB, Essential MedicinesSupply Chain StrategyLab Supplies Supply ChainStrategy Support Strategies Environments All Products Efficient Supply Chain Responsive Supply Chain Responsive Plus Supply Chain

5. Product Segmentation Efficient: Minimize logistics costs Responsive Supply Chain Type Responsive Plus Supply Chain Type Efficient Supply Chain Type Tailored Supply Chains Responsive: Provide a high level of product availability under uncertain demand Three Supply Chain Types Responsive plus: Keep inventory to a minimum and assure product integrity

6. Segment Environments Environment Type 1 Health Center in Southern Regions Environment Type 1 Health Center in Southern Regions Environment Type 2 Health Center in Northern Regions Environment Type 2 Health Center in Northern Regions Environment Type 3 Hospital in Southern Regions Environment Type 3 Hospital in Southern Regions Environment Type 4 Hospital in Northern Regions Environment Type 4 Hospital in Northern Regions Labour Market Economy Private Sector Infrastructure Social Factors Politics

7. Support Strategies Adoption: Facilities Inventory Support Strategy Categories Information Transportation Sourcing Pricing Budget Management at Facilities

8. + - Baseline Strategy Inventory stocked at CMS and RMS. High ordering costs will lead to high cycle stock level. Since demand is unpredictable and there is a high cost of stocking out, carry significant safety stock. Look for highest risk products (i.e. when scaling up treatment) and monitor closely. Adapted Strategy For facilities without cold chain capabilities stock CC products at district level. In remote areas keep safety stock at district rather than RMS (closer to facilities remote areas keep safety stock at district rather than RMS (closer to facilities). Potential Benefit Increase products assortment, thus improve the service level. For life saving products, the responsive time will be quicker. Support Strategies: Responsive Supply Chain Type Adapted to Health Center in Northern Regions for Inventory Strategy

9. Summary Research QuestionsResults How should MoH approach additional segmentation, based on product characteristic and country context/factors? Segment Products How should MoH approach setting support strategies to support product and country- context based segmentation? Segment Environment More coherent segmented supply chain & Appropriate to product needs and country context More coherent segmented supply chain & Appropriate to product needs and country context Clear Support Strategies that will drive investment decisions & Implementation plan with performance measurement Clear Support Strategies that will drive investment decisions & Implementation plan with performance measurement Adapt Support Strategies The Vision

10. Moving Forward Tailored Supply Chains Western Africa Southern Africa Middle East