Health Supply Chain Research Articles

System Dynamics Modeling for Assessing the Impact of COVID-19 on Food Supply Chains: A Case Study of Kenya and Rwanda

Disruptions in the food supply chains caused by the COVID-19 pandemic have destabilized the balance between production, supply, transport, distribution, and consumption. Consequently, these disruptions have affected food and nutritional security all over the world. This study proposes a framework for investigating the impact of COVID-19 on food supply chains, considering Eastern Africa as a focus region with Kenya and Rwanda as case studies. A systems thinking approach with three systemic components (food and nutrition, COVID-19 contagion, and human health) was applied. The contagion component was characterized by the susceptible, exposed, infected, recovered, and deceased (SEIRD) epidemiological modeling method. We then applied a causal loop diagram and stock and flow diagrams to map the links and interactions between variables from the contagion, health, and food supply chain components of the whole system. The results reveal that COVID-19 has adversely affected food and nutritional security in Eastern African countries. Key response measures to COVID-19 such as lockdowns, closure of borders, isolation, and quarantining have resulted in labor shortages, increased unemployment rates, loss of income, and the subsequent contraction of economies. The disruption of the food supply chain has negatively impacted the main pillars of food and nutrition security, which are availability, accessibility, utilization, and stability. We suggest direct food supply from local producers to the consuming communities to shorten the food supply chain and therefore enhance food self-sufficiency to reduce the severe effects of COVID-19 on food and nutrition security. Overall, our study provides a useful framework to help design better policies and build more resilient and inclusive food systems during COVID-19 and similar pandemics in the future.

Medical supply chain integrated with blockchain and IoT to track the logistics of medical products.

Nowadays blockchain technology plays a vital role in creative developments and important discoveries in the world. Blockchain develops secure and trustworthy platforms for data sharing in various application areas such as secure sharing of medical data, Anti-money laundering, tracking systems, Supply chain, and logistics monitoring, Crypto-currency exchange, etc. Today's Supply chain in the healthcare sector faces many problems like security, transparency, tampering with medical products, counterfeit drugs, more paperwork, high cost, and more time-consuming process while transporting medical equipment from manufacture to end-users. To overcome these problems, we introduce Novel Approach for Integrated IoT (Internet of Things) With Blockchain in Health Supply Chain (NAIBHSC) approach. By using this approach, we can eliminate all supply chain-related issues between suppliers and end-users. The goal of this research is by combining Blockchain technology with IoT to develop a smart health supply chain management system. This approach provides security, privacy, trust, visibility, decentralized tracking and tracing of the medical product, avoids counterfeit drugs, avoids the damage to medical components, authentication, reduces the cost, and provides the status of the products during the shipment process between manufacturers to end-user. In this approach, we conduct a series of experiments on a different group of users. The experimental results show that compare to existing approaches our proposed NAIBHSC approach gives better response time that is the average Transaction Per Second (TPS) for a group of 500 users is 100 milliseconds, reduces the latency time that is average latency time for 500 users group has 403 milliseconds, and improves the overall performance of the smart health supply chain management system.

Artificial intelligence and discrete-event simulation for capacity management of intensive care units during the Covid-19 pandemic: A case study

The Covid-19 pandemic has pushed the Intensive Care Units (ICUs) into significant operational disruptions. The rapid evolution of this disease, the bed capacity constraints, the wide variety of patient profiles, and the imbalances within health supply chains still represent a challenge for policymakers. This paper aims to use Artificial Intelligence (AI) and Discrete-Event Simulation (DES) to support ICU bed capacity management during Covid-19. The proposed approach was validated in a Spanish hospital chain where we initially identified the predictors of ICU admission in Covid-19 patients. Second, we applied Random Forest (RF) to predict ICU admission likelihood using patient data collected in the Emergency Department (ED). Finally, we included the RF outcomes in a DES model to assist decision-makers in evaluating new ICU bed configurations responding to the patient transfer expected from downstream services. The results evidenced that the median bed waiting time declined between 32.42 and 48.03 min after intervention.

Compliance of public health facilities with essential medicines and health supplies redistribution guidelines in Mbale district, Eastern Uganda: a mixed-methods study

IntroductionRedistribution of essential medicines and health supplies (EMHS) is a mechanism to address supply chain uncertainty by moving excess stock of health commodities from health facilities that are overstocked to health facilities with shortages, where it is most needed. It prevents the wastage of scarce resources and improves efficiency within a health supply chain system. Many public health facilities in Uganda experience stock-outs, overstocking, and expiry of essential medicines. This study assessed the compliance of public health facilities with the Uganda Ministry of Health redistribution strategy for EMHS in Mbale district, Eastern Uganda.MethodsA mixed-methods study was conducted among 55 respondents at public health facility level and five key informants at the district level. Audio-recorded data were transcribed and coded to develop themes. Thematic analysis was performed using ATLAS.ti Version 8.5. Quantitative data were analysed using IBM SPSS Version 24.0.ResultsAbout a third (33%) of the surveyed health facilities complied with EMHS redistribution guidelines. Respondents agreed that EMHS redistribution had helped reduce health commodity expiries and stock-outs in health facilities. Respondents who did not know about the timely release of funds for redistribution were 68% less likely to comply, and those who said the guidelines were never shared were 88% less likely to comply with the guidelines.ConclusionsCompliance with the EMHS redistribution guidelines was low and associated with failure to share the guidelines with staff and inadequate awareness about release funds for EMHS redistribution. The district local government should allocate more funds to the EMHS redistribution.

Public health supply chain for iron and folic acid supplementation in India: Status, bottlenecks and an agenda for corrective action under Anemia Mukt Bharat strategy.

The IFA supplementation program under the Anemia Mukt Bharat (AMB) program is one of the most ambitious nutrient supplementation programs in India. The delivery of services often suffers due to frequent stock outs and shortages. It is critical to understand the bottleneck in the supply chain adversely affecting the performance and coverage of the program. The paper attempts to identify the bottlenecks of the IFA supply chain in key areas of supply chain i.e., forecasting, procurement, warehousing and inventory management, transportation, distribution, logistic information system and suggests a plan of action aimed at ensuring uninterrupted supplies to the end beneficiaries. The data source for the present paper is the nationwide IFA Supply Chain Assessment (2018-19) conducted across 29 Indian states with a total of 58 districts, 116 blocks, 232 Sub-Centres, 232 Anganwadi centres and 232 schools covered under the assessment as a multi-partner collaborative initiative. Field insights from supply chain strengthening interventions under different public health programs in India and other developing countries were taken to arrive at corrective actions and recommendations. Findings were disseminated to government and an action plan was suggested for connecting service delivery points through an app-based system, developing a micro plan for ensuring fixed distribution schedule, followed by continuous monitoring and review meetings identified for follow up. The average lead time across states was 35 weeks with top three performing states being Goa, Sikkim, and Telangana. The average per unit cost of procurement was Rs 0.35 for IFA Red, Rs 0.25 for IFA Blue, Rs 0.31 for IFA Pink and Rs 7.30 for IFA syrup. Out of the 704 districts in India, only 213 has IFA Red, only 140 had IFA Blue, 152 had IFA Pink and 163 had IFA Syrup available in four quarters of 2018-19. The key issues identified in the assessment were-a lack of standardized forecasting process, absence of inventory management techniques, no fixed distribution schedule, inadequate availability of transport vehicles and an absence of an integrated MIS. The identification of bottlenecks in the IFA supply chain and its impact on the performance of the supply chain would provide policy guidelines for the government as well as development partner agencies to design an effective and efficient supply chain. It would also enable the policy planners to understand the challenges associated with managing different components of a supply chain, their interrelation and impact on the overall performance of the supply chain. The suggested recommendations would equip program managers with the tool to devise and implement field level solutions.

The Influence of IMPACT Approach in Financial Resource Mobilization to Improve Availability of Essential Health Commodities in Sikonge DC

The Tanzanian government, through the Ministry of Health, in collaboration with President’s Office, Regional Administration and Local Government (PORALG) and various stakeholders, has developed several robust electronic health systems such as e-LMIS, GoTHOMIS, FFARS and DHIS2 to streamline health supply chain management processes and improve data visibility. However, the use of this data for informed decision making at all levels of the supply chain was found to be very low, which led to the introduction of IMPACT (Information Mobilized for Performance Analysis and Continuous Transformation) to increase the use of data to improve the supply chain in the country, including Sikonge District Council. Following the implementation of the approach, the IMPACT team in Sikonge discovered low performance in the availability of health commodities among other monitored indicators major reason being inadequate financial resources to procure health commodities. This prompted the team to look for other innovative ways of fundraising to rescue the situation in the council. The objective of this study was therefore to assess the influence of the IMPACT approach methods employed in mobilizing financial resources to improve the availability of health commodities in Sikonge DC. Some of the methods employed by Sikonge team for such a purpose were; conducting a preliminary data-driven analysis and assessment to identify issues related to i-CHF and NHIF services, developing strategies to increase i-CHF enrolment, retention, and disbursements, working on the most common anomalies in the NHIF forms to reduce the number of rejected claims and finally clearing the MSD debt of health facilities to relieve them of the financial burden. These strategies resulted in an increase in i-CHF funds reimbursement from Tsh1.4 million in September 2020 to Tsh8 million in December 2021. NHIF funds reimbursement increased from Tsh696,170 in September 2020 to Tsh12 million in December 2021. The overall percentage of health facilities submitting NHIF claims increased from 17% to 77% over the same period. Thus, the concept of IMPACT and the employed data driven strategies, played a major role in the results achieved in Sikonge and in order to meet the alarming demand for health commodities at service delivery points, council teams should show strong commitment in using real-time data for problem identification and resolution through IMPACT team approach as a tool for continuous improvement.

Assessing performance using maturity model: a multiple case study of public health supply chains in Nigeria

PurposeThis study aims to determine the factors and dynamic systems behaviour of essential medicine stockout in public health-care supply chains. The authors examine the constraints and effects of mental models on medicine stockout to develop a dynamic theory of medicine availability towards saving patients’ lives.Design/methodology/approachThis study uses a mixed-method approach. Starting with a survey method, followed by in-depth interviews with stakeholders within five health-care supply chains to determine the dynamic feedback leading to stockout and conclude by developing a network mental model for medicines availability.FindingsThe authors identified five constraints and developed five case mental models. The authors develop a dynamic theory of medicine availability across cases and identify feedback loops and variables leading to medicine availability.Research limitations/implicationsThe need to include mental models of stakeholders like manufacturers and distributors of medicines to understand the system completely. Group surveys are prone to power dynamics and bias from group thinking. This survey’s quantitative output could minimize the bias.Originality/valueThis study uniquely uses a mixed-method of survey method and in-depth interviews of experts to assess the essential medicine stockout in Nigeria. To improve medicine availability, the authors develop a dynamic network mental model to understand the system structure, feedback and behaviour driving stockouts. This research will benefit public policymakers and hospital managers in designing policies that reduce medicine stockout.

Data, analytical techniques and collaboration between researchers and practitioners in humanitarian health supply chains: a challenging but necessary way forward

PurposeThis paper aims to provide a discussion on the interface and interactions between data, analytical techniques and impactful research in humanitarian health supply chains. New techniques for data capturing, processing and analytics, such as big data, blockchain technology and artificial intelligence, are increasingly put forward as potential “game changers” in the humanitarian field. Yet while they have potential to improve data analytics in the future, larger data sets and quantification per se are no “silver bullet” for complex and wicked problems in humanitarian health settings. Humanitarian health supply chains provide health care and medical aid to the most vulnerable in development and disaster relief settings alike. Unlike commercial supply chains, they often lack resources and long-term collaborations to enable learning from the past and to improve further.Design/methodology/approachBased on a combination of the authors’ research experience, interactions with practitioners throughout projects and academic literature, the authors consider the interface between data and analytical techniques and highlight some of the challenges inherent to humanitarian health settings. The authors apply a systems approach to represent the multiple factors and interactions between data, analytical techniques and collaboration in impactful research.FindingsBased on this representation, the authors discuss relevant debates and suggest directions for future research to increase the impact of data analytics and collaborations in fostering sustainable solutions.Originality/valueThis study distinguishes itself and contributes by bringing the interface and interactions between data, analytical techniques and impactful research together in a systems approach, emphasizing the interconnectedness.

The Quality Management Improvement Approach: Successes and Lessons Learned From a Workforce Development Intervention in Rwanda's Health Supply Chain.

Rwanda's supply chain is decentralized, with regional warehouse pharmacies and service delivery points (SDPs) ensuring a reliable health commodities supply. However, in 2016, the Rwanda Ministry of Health (MOH) identified challenges with the supply chain workforce contributing to a high stock-out rate, inventory stock inaccuracies, and underutilization of the electronic logistics management information system (e-LMIS). We aimed to document successes and lessons learned from implementing a workforce development intervention to address these challenges. Rwanda's MOH and the U.S. Agency for International Development Global Health Supply Chain Program-Procurement and Supply Management project implemented a workforce development intervention, the Quality Management Improvement Approach (QMIA), to improve and sustain Rwanda's service delivery and medicines availability. The QMIA monitors the performance of supply chain professionals while continuously building their capacity to run a smooth supply chain operation. The QMIA includes supervisory visits to measure key performance indicators and discussion sessions for experience-sharing and skill-building. The central level conducts both components, supporting regional warehouses that in turn assist SDPs through supervisory visits and discussion sessions. Since 2017, the QMIA has been conducted twice a year in 596 SDPs and 30 regional warehouses and has trained 1,296 supply chain staff members. The intervention has contributed to major improvements in several key supply chain outcomes (2017 versus 2019): increased utilization of the e-LMIS (55% to 96%), higher inventory data accuracy (25% to 85%), and reduced stock-outs (10% to 1%). The QMIA has proven to be a successful training and capacity-building platform for supply chain management in Rwanda, enhancing system utilization and availability of accurate data to guide decision-making. Notably, the approach fosters a positive behavioral change to build local solutions and improves communication.

Green human resource management and green supply Chain Management on Sustainable performance of nickel mining companies in Indonesia

The green economy with Islamic perspective is the primary discussion point in this study since it is seen as a potential solution to the current economic and environmental concerns. This study aims to analyze the Sustainability Performance of a nickel mine in North Maluku using Islamic economic perspective. A total of 80 mining workers in North Maluku were respondents in the study who were selected using the convenience sampling method. The results of data processing using structural equation modeling show that five of the six proposed hypotheses are empirically proven, the findings in this study indicate that the Sustainability Performance of nickel mining companies in North Maluku can be achieved through the practice of Green Human Resource Management which forms Health, Safety, Environmental Culture, and Green Supply Chain Management practices. The managerial implication of the findings in this study is that mining companies in North Maluku pay attention to recruitment supervision, training, and impose a system of rewards and punishments for workers related to safe work behavior and environmental preservation. In addition, the company also reports holding regular meetings with workers to socialize company policies related to work safety and environmental preservation. Finally, a license to carry out ISO certification to support the implementation of a supply chain that is environmentally sound and to have and carry out environmental program audits and support environmental-related regulations.

Routine Supportive Supervision and Management of Medicines and Other Health Products and Technologies in Vihiga County, Kenya

Health Products and Technologies (HPTs) are pivotal for an efficient health system. Availability and accessibility to affordable health products are critical indicators towards achieving universal health coverage. Routine supportive supervision, performance monitoring, recognition of efforts and client feedback are vital activities toward health supply chain system strengthening. This is a descriptive paper that describes a model of integrated commodity supportive supervision, and mentorship and its impact on various outcomes of health commodity management. Data were abstracted from the standardized scored checklists used during integrated commodity supportive supervision and supply chain audit in public health facilities in Vihiga County. Scores for the period 2020 to 2022 were analyzed on the eight key areas of interest. The analysis was done using Statistical Package for Social Sciences (SPSS version 26). Results are interpreted at 95% Confidence interval. This paper also shares findings from both quantitative and qualitative data from client exit and facility managers’ interviews. Six complete rounds of supervisions, three clients and service providers’ interviews, and three annual award events have been conducted. We observed trends across six data collections points and compared the results at first point or baseline (January-June 2020) to the results at the last point or end line (April-June 2022). Findings show significant improvements on the eight parameters in terms of mean scores as follows: resolution of issues from previous visits by 35.06% (46.75% - 81.81%); storage of HPTs by 17.41% (68.72% - 86.13%); inventory management by 28.16% (42.67% - 70.83%); availability and use of commodity data management information systems (MIS) tools by 22.39% (74.40% - 96.79%); verification of commodity data by 25.61% (65.56% - 91.17%); availability of guidelines and job aids for commodity management by 46.28% (36.65% - 82.93%). There was an improvement on the mean score on accountability by 20.22% (58.58% - 83.51%). The composite (final) score improved by 28.33% (56.19% - 84.52%). There was progressive narrowing of the standard deviations on all the indicators across the study period. This demonstrates that there is standardization of practices and positive competition among all the public health facilities. There were significant improvements on all the eight indicators. Routine integrated commodity supportive supervision has proven to be an effective high impact intervention in improving management of health products and technologies in Vihiga County, Kenya.

Evaluating the Performance of Health Supply Chains Using Network Data Envelopment Analysis Model under Uncertainty Conditions in Selected Tehran Hospitals

Objective: Objective: The objective of this research is to expand the models of Network Data Envelopment Analysis with approaches to uncertainty for evaluating the performance of supply chains. Method: The method used in this research is descriptive and, in terms of outcome, falls under applied research. From a strategic research perspective, it is descriptive and cross-sectional retrospective based on an analytical approach, conducted through fieldwork and a survey method in the research community. A census method was employed. Findings: In this study, Razi Hospital, with a score of 0.99, has the highest average efficiency in outpatient services, while Sina Hospital, with a score of 0.139, has the lowest level of average outpatient efficiency among multi-specialty hospitals. Additionally, Yas Hospital, with an average efficiency of 0.99 in inpatient sections, has the highest efficiency, whereas Razi Hospital with a score of 0.58 has the lowest efficiency. Bahrami Hospital among children's hospitals is in a better condition. Conclusion: Based on the findings of the research, it was determined that the use of the fuzzy Network Data Envelopment Analysis model with variables such as the number of doctors, the number of healthcare workers, active beds, total inpatient days, the number of outpatient visits, and the number of inpatients, can compare the performance of selected decision-making units providing services in the studied medical centers from the perspective of inputs and outputs and across the entire health service supply chain. In the long term, it serves as a suitable tool for officials and policymakers of the selected centers for continuous performance evaluation of these services.

Comprehensive Systematic Literature Review of Public Health Supply Chain Studies in Sub-Saharan Africa

The paper presents a systematic comprehensive literature review of Sub-Saharan African public health supply chain studies. It shall involve both formal academic studies and consulting studies where available in the public domain. The key focus of the literature review shall be: to create a themed catalogue of African public health supply chain studies that have been done in academia and by non – academic institutions. The specific objectives of the study shall revolve around: Conducting a systematic literature review of public health supply chain studies in sub-Saharan Africa; Conducting a systematic literature review of non- academic publications in public health supply chain studies in sub- Saharan Africa; Categorising the current publications according to supply chain functions; Determining a database of contributors to public health supply chain studies for academic and non-academic knowledge; and, proposing an approach to develop a database of research in public health supply with both academic and non-academic literature and develop a way forward. The research philosophy adopted for the study was exploratory through desk research of Public health supply chain studies conducted within the last 15 years(2007 – 2022) and themed based on the supply chain functions of the Supply Chain Operations Reference (SCOR) model. The output for the study shall entail: catalogues / documentation of Africa public health supply chain; contribution to easily searchable body of knowledge that informs public health supply chains in sub- Saharan Africa; dissemination through publications in peer reviewed academic journals ( at least 5 articles); and dissemination Through International Conferences And Symposiums.

Leveraging Blockchain-Based Electronic Health Record Systems in Healthcare 4.0

Digitalization has become a crucial part of healthcare 4.0 by transforming systems such as electronic health records (EHR), electronic medical records (EMR), and electronic personal medical records (ePHR). Healthcare 4.0 is derived from industry 4.0 and aims to enhance collaboration, virtualization, coherence, and convergence, which helps transform modern healthcare into more personalized and predictive. Healthcare 4.0 also aims to develop digital enablers which will support coordination among various stakeholders and seamless information flow in the patient journey towards wellbeing. These systems enhance patient care through the timely sharing of patient data across different providers globally. Timely sharing helps, but it also makes the electronic system vulnerable to alteration and breaches. In healthcare, blockchain application is widely used in various areas, such as health information exchange, pharmaceutical counterfeit, clinical trials, health supply chain management, patient data management, insurance claims, and product recall in case of adverse events. This research paper aims to identify how blockchain technology can help enhance the privacy and security of electronic health record systems. This paper discusses various blockchain-based systems, which provide a more efficient and secure option than client-server architecture-based traditional EHR systems.

A SYSTEMATIC REVIEW OF BLOCKCHAIN TECHNOLOGY USE IN E-SUPPLY CHAIN IN INTERNET OF MEDICAL THINGS (IOMT)

For every sector, managing supply chains is a difficult task, but the healthcare sector faces risks and complication since a disrupted supply chain could have a direct impact on patient security and medical results. In this assignment we will discuss how Blockchain technology is one possible method for enhancing the health E-supply chain's security, integrity, data provenance, and usefulness. The medical supply, medical product and supply, Internet of Medical Things (IOMT), and health care sector are all given such priority, the goal of this research is to provide a description of the advantages and drawbacks of using blockchain technology in the medical distribution and supply network. The unfulfilled potential of blockchain technology to increase the health supply chain requires greater research, analysis, and integration with regulatory frameworks has been discussed.

Food Insecurity, Population Health and Food Supply Chain: A Framework Integrating Three Constructs

Food Insecurity, Population Health and Food Supply Chain: A Framework Integrating Three Constructs

Managing health supply chain using blockchain technology: state of art challenges and solution

The COVID-19 flare-up in late 2019 caused a worldwide medical crisis. In a littlemore than a quarter of a year, the quantity of COVID new cases has risen to in excessof 1,000,000 around the world.The fast transmission of the infection prompts newcases to be accounted for all around the world constantly. At the same time, mortalityrate and contaminations keep on rising rapidly. Therefore, the COVID-19 pandemichas led to the implementation of lockdowns and social distancing rules that negativelyimpact global economies. It has upturned many challenges which are mentioned inthis paper,we proposed a solution to these major problems, blockchain technology canplay a vital role in closing maximum escape clauses in the present system to improvevisibility and traceability and to provide a clear far vision for the stakeholders presentin pharmaceutical industry.

Food Insecurity, Population Health and Food Supply Chain: A Framework Integrating Three Constructs

Design/methodology/approach: food insecurity is discussed within population health and food supply chain framework. Research shows that food insecurity is one of the three main causes in impacting population health. After exploring the relationship between food insecurity and population health, this study explores possible solutions to address food insecurity through food supply chain management framework. Food supply chain is different from commercial supply chain in many important attributes. Literature does not provide research framework linking these three attributes (food insecurity, population health and food supply chain). Therefore, we use an exploratory map to build roadmap to a successful integration of these three attributes. Purpose: social determinants of health are considered as a precondition for population health. Food security forms basis for catalyst in population health. Food security touches human dignity. Many people face starvation while tons of foods are wasted globally. There is a mismatch between supply and demand for food production and consumption. Distributions of foods from producers to consumers become a focal point in managing starvation and waste/glut of foods. The purpose of this paper is to investigate how food supply chain mitigates food insecurity and provides sustainable food supply. Findings: this paper reveals mismatch between supply and consumption of food at a global scale. Inadequate supply chain assets -technologies, storages, distribution networks, etc. - at the producer’s ends causes lower return on investments for producers. Unique characteristics of food supply chain compared with commercial supply chain raises challenges to the imbalance between supply and demand. Oligopolistic market structure may solve the chronic mismatch. Originality/value: literature addresses these three constructs – food security, population health and food supply chain – separately and independently from each other. This paper argues these three constructs should be addressed together in order to solve global food insecurity and waste. As far as we know, this is the first attempt to unify these three constructs.

Food Insecurity, Population Health and Food Supply Chain: A Framework Integrating Three Constructs

Food Insecurity, Population Health and Food Supply Chain: A Framework Integrating Three Constructs

The procurement and supply chain strengthening project: improving public health supply chains for better access to HIV medicines, Uganda 2011–2016

BackgroundWith countries moving towards reaching the UNAIDS 90-90-90 goal to achieve HIV epidemic control, there are going to be an unprecedented number of persons who will need to be tested, treated, and regularly monitored for viral suppression. However, most of the countries with the greatest burden of HIV/AIDS experience regular stock outages which could be detrimental to reaching these targets. ART and other commodities such as HIV test kits and laboratory supplies need to be readily and consistently available to achieve these targets. The main objective was to improve access to HIV/AIDS related commodities and strengthening institutional capacity for the management of HIV/AIDS logistics services through the MAUL procurement and supply chain strengthening project (PSSP) that rolled out four interventions on mentorship and support supervision, stock level monitoring, spatial visualization of stock indicators using GIS, and using WhatsApp to submit order reports as photo images.MethodsMedical Access Uganda Limited, a private-not-for-profit supply chain management company in Uganda, implemented these interventions as part of a procurement and supply chain strengthening project (PSSP). These interventions were evaluated using performance monitoring indicators from 2011–2016. We tested for the significance in the change in scores of performance monitoring indicators using the test for difference in proportions. Health facilities were scored on 6 categories and accredited as bronze, silver or gold based on their total scores. Kaplan–Meier estimates were computed for time to silver, and gold ranking and univariate and multivariate Cox proportional hazards models were computed for time to gold ranking.ResultsWe observed a significant reduction in reported stock-outs from 46 to 4% (p < 0.001) in the analysis period. Accurate stock card inventory rose from 79 to 91% (p < 0.001); adequate stock levels rose from 54 to 71% (p = 0.002) and stock reporting rates from 91 to 100% (p < 0.001). The stock order fill rate improved from a high of 93% to 97% (p = 0.375). Patient load (medium vs low adjusted hazard ratio (aHR): 2.19, p = 0.026; high vs low aHR: 2.97, p = 0.034) and number of support supervision visits (6–10 aHR: 3.33, p = 0.024; > 10 aHR: 5.78, p = 0.003) were associated with better stock management ranking scores.ConclusionsImprovements in supply chain management in countries committed to achieving the 90-90-90 goals are crucial to achieving HIV epidemic control. Health system strengthening and mentorship investments in Uganda were feasible and are essential for sustainable disease control efforts.