1. Outsourcing and Partnering for an improved Distribution Model Rob Botha Amref Health Africa International Conferecne 24 th November 2014

2. The Challenge The Solution Direct Delivery Support Structures Outsourcing Partnerships Performance management Results Next steps Conclusion Agenda

3. 33 10 central medical stores or depots Insufficient scale in warehousing and distribution Multiple tiers Lack of visibility and information Financial Administrative inefficiencies The Challenge SupplierDistributorDepotSub-DepotHospitalClinic

4. 44 SupplierDistributorHospital The Solution Direct Delivery model Bypassing the depot model Leveraging existing private sector Infrastructure Capacity Resources SupplierDistributorDepotSub-DepotHospital

5. 55 Direct Delivery Matching Responsibility with Capacity 7 X 27 = 70% Top suppliers Major hospitals Of volumes going through the Depot (that can be streamlined)

6. 66 Support Structures

7. 77 Selection Quantification/ Forecasting ProcurementStorageDistribution Indirect outsourcing to suppliers Leveraging private sector supply chain Shifted the risk to suppliers Focus on core competences Outsourcing Medicine Management Cycle, www.who.int

8. 88 Partnerships SIAPS and SCMS partnered to customise existing RXSolution software SIAPS IT development and technical support SCMS process definition and user specifications Iterative approach as requirements evolved Providing visibility and information Partnerships and collaboration is critical to a co-ordinated approach to systems strengthening and results in a superior outcome

9. 99 Performance Management Visibility into performance of all stakeholders Facilities Provincial departments of health Suppliers PMPU Finance Improved supplier performance and contract management Performance monitoring Improved supply Demand planning and forecasting Evidence based decision making Sales and Operations Planning (S&OP) meetings with suppliers

10. 10 Results Successes Supplier on-time delivery – improved from 14% to 85% Orders cancelled due to supplier stock-outs – improved from 19% to >1% Order fulfilment – improved from 77% to 97% Challenges Documentation from facilities Manual re-entry of data Connectivity and IT infrastructure

11. 11 Next Steps Increase coverage to new provinces Software developments to increase electronic interfaces Improved document management and flow Cross Docking for other levels of care Nominated Delivery Days (NDD) SupplierDistributor Cross- Dock Clinic

12. 12 Conclusion The success of the Direct Delivery model required: Outsourcing Private Sector Engagement Partnerships Results Improved supply of medicine to facilities Improved performance management and contract management through visibility

13. THANK YOU