Logistics Management Information System Research Articles

Tuberculosis commodities supply chain performance in the WHO African region: A scoping review.

Procurement and supply chain management [PSM] systems remain a critical pillar for the implementation of Directly Observed Therapy [DOTS] for tuberculosis [TB] and achievement of disease related aspirations such as 'ending TB by 2030'. We conducted a scoping review of literature using the Arksey and O'Malley [2005] framework to summarize and disseminate the results of available evidence in relation to TB commodities supply chain performance in the WHO African Region. We searched three electronic databases complemented by google search using relevant terms and identified 1,586 sources. Twenty-five studies published between 2009 and 2023 met the eligibility criteria, inclusive of 21 peer reviewed publications and four reports. The strengths we found included the existence of pooled procurement mechanisms [PPM], availability of funding through external sources, existence of logistics management information systems [LMIS] and integration of PSM systems into primary health care. The main challenge was frequent stock outs which mainly affected medicines for treating TB in children and those for preventing TB. Stock outs were found to follow a poverty gradient and pervasively inequitable since they disproportionately affected structurally disadvantaged populations and communities. Countries that rely on domestic mechanisms for procurement tend to be more vulnerable to stock outs due to inadequate and unpredictable financing, delayed disbursements of funds, longer procurement lead times and poor supplier management. We concluded that stock outs remain one of the foremost challenges to ending TB by 2030. We recommend leveraging existing performance-enhancing platforms such as PPMs, including utilization of such mechanisms by countries that utilize domestic resources to procure commodities. We recommend the design of people centric supply chains that are sensitive to the differentiated needs of the population to ensure that composite improvements in PSM performance do not mask underlying disparities. Context-relevant research is needed to inform future strategies for improving PSM performance.

Procurement process and shortages of essential medicines in public health facilities: A qualitative study from Nepal.

Ensuring access to essential medicines remains a formidable challenge in Nepal. The specific reasons for the shortage of essential medicines within Nepal have not been extensively investigated. This study addresses challenges associated with access to essential medicines, procurement process difficulties, and functionality of inventory management systems at different levels of public health facilities. Fifty-nine semi-structured in-depth interviews were conducted with health managers and service providers at provincial and local levels in six randomly selected districts of Bagmati province, Nepal. Interviews were audiotaped and transcribed verbatim, and the results were analyzed using the inductive approach and were later mapped within the four domains of "Procurement of essential medicines". The major barriers for the effective management of essential medicines included delays in the procurement process, primarily locally, leading to frequent stock-out of essential drugs, particularly at the health post level. Additionally, challenges arise from storage problems, mainly due to insufficient storage space and the need to manage additional comorbidities related to COVID-19. Other identified challenges encompass the absence of training on logistics management information systems, a lack of information technology resources in primary health facilities, inadequate qualified human resources to operate the IT system, and insufficient power backup. Moreover, unrealistic demand estimation from the service points, inadequate transportation costs, and manual inventory management systems further contributed to the complex landscape of challenges. This study identified procurement delays as the primary cause of essential medicine shortages in Bagmati Province, Nepal. We recommend implementing comprehensive procurement guidelines, collaborative training, and dedicated budgets to address this issue. Improving the procurement and inventory management process in low-resource settings requires a well-trained workforce, suitable storage spaces, and enhanced coordinated administrative tiers within health facilities at different levels to ensure the year-round availability of essential medicines in these settings.

Design of Rural E-commerce Logistics Information Management System Based on Spring Boot

With the improvement of science and technology, the Internet has more and more affected people's daily life. People can stay at home and learn the latest information, movies, animations, music, etc. through the Internet. They can also buy goods, learn knowledge, and even find jobs through the Internet. It can be seen that the development of the Internet has brought great convenience to people's lives, and many industries have been born. As an emerging Internet industry, e-commerce has provided a large number of job opportunities for the market. Merchants can promote through e-commerce platforms, and customers can purchase goods through the platform. To ensure the normal and orderly flow of this business activity, efficient logistics systems are indispensable. With the rise of the concept of smart logistics, it not only requires employees to have professional theoretical knowledge and management service knowledge, but also professional technical knowledge such as electronic information technology. Designing an efficient logistics information management system requires cultivating smart logistics talents. E-commerce logistics, through information management systems, can not only achieve intelligent management and control of the logistics process, improve logistics efficiency and reduce logistics costs, but also enhance the automation and intelligence level of logistics, promoting the development of the logistics industry towards a more intelligent, efficient, and sustainable direction.

National Policy Influences of Contraceptive Prevalence and Method Mix Strategy: A Longitudinal Analysis of 59 Low- and Middle-Income Countries, 2010-2021.

Understanding the impact of family planning policy and actions is essential for building effective strategies to increase contraceptive use. This study identifies policies that correlate with modern contraceptive prevalence rate (mCPR) and private-sector contraceptive method mix strategies (the number of contraceptive methods offered in the private sector) in low-income and middle-income countries. While education, contraceptive choices, and economic growth are known determinants of contraceptive prevalence, many national policies intended to increase contraceptive prevalence in the short term to medium term have ambiguous evidence that they indeed do so. By developing beta and Poisson regression models using 12 years of reported Contraceptive Security Indicators Survey data (2010-2021) from 59 countries, this study investigated the effect of 20 independent variables on mCPR or method mix strategies. Furthermore, to help interpret the potential consequences of economic status, separate models segmented by gross national income (low, low-middle, and upper-middle) were assessed. Of 20 independent variables, 10 are implicated with mCPR and 6 with a method mix strategy. Of these, increasing the share of domestic financing (versus donor funding) for contraceptives had the broadest and strongest contribution. mCPR is also predicted by the existence of national insurance systems that cover contraceptive costs, contraceptive security committees, family planning logistics management information systems, and, inversely, by client fees. A comprehensive private-sector method mix strategy-which itself influences mCPR-is also driven by these, as well as the inclusion of more contraceptives on the national essential medicines list. These findings have implications for countries seeking to expand access to and use of contraceptives through policy initiatives.

Evaluation of logistics management information system and availability of non-program tracer drugs in public health facilities in Bahir Dar City, Northwest Ethiopia.

The logistics management information system (LMIS) plays a crucial role in effective record-keeping and reporting, ensuring efficient management of stock status and consumption data. A proficient LMIS improves accountability and supports informed logistic decisions in healthcare. Conversely, a subpar LMIS negatively affects essential medicine availability, compromising overall healthcare service efficiency. This study aimed to evaluate the status of the logistics management information system and the availability of non-program tracer drugs (NPTDs) in public health facilities within Bahir Dar City. This study employed an institutional-based cross-sectional study. Data were collected from February 20 to April 30, 2022 in 12 public health facilities located in Bahir Dar City. Structured questionnaire and data abstraction formats were used to gather pertinent data. After checking for completeness, the data were analyzed using Microsoft Excel and SPSS version 23. The primary analytical outcomes involved descriptive statistics, encompassing frequencies, averages, and percentages, which were subsequently presented in tables and figures. Bin card and Internal Facility Report and Resupply Form were the only blank LMIS tools available in all health facilities, while stock-record card was the least available, present in only 2(16.7%) facilities. Nine health facilities (75%) used self-prepared forms to request NPTDs from the Ethiopian Pharmaceutical Supply Agency (EPSA) at the end of the review period, whereas 7(58.3%) used official letters for emergency orders. Additionally, seven health facilities (58.3%) used the Health Commodities Management Information System On the day of the visit, 78.68% of NPTDs were available. Tetracycline eye ointment 1% had the longest stock-out duration, lasting for a mean 69.64 days. Rather than using the RRF, most of facilities opted for their own forms to request NPTDs from EPSA. While it is advisable for all health facilities to maintain continuous availability of tracer drugs, this study revealed that the current state of non-program tracer drug availability falls short of meeting this expectation.

Reducing Supply Chain Management Risks in the Health Sector of Ghana: An Evaluation of the Central Level Supply Chain Management System of The Ghana Health Service

Supply Chain Management plays an indispensable role in any organization’s overall performance and success. The domain of Supply Chain Management has been of great research interest in recent years. In the ever-growing healthcare world, where most healthcare organizations are confronted with diverse SCM risks and growing customer demand trends, effective and efficient SCM has been identified as a tool to help them overcome this challenge. However, the main hurdle had been how to find innovative approaches to meet customer demands that will minimize operational costs. To address these concerns and deliver effective and efficient healthcare, the Government of Ghana represented by the Ministry of Health (MOH) and Ghana Health Service (GHS) in partnership with the Global Fund, GAVI, and the World Bank have deployed several interventions fundamentally founded on procurement and supply chain management to improve healthcare service delivery across the country. The interventions: Health commodity supply chain master plan (HCSCMP), the Last Mile Distribution (LMD), and the Ghana Integrated Logistics Management Information System (GhiLMIS), focus mainly on procurement, inventory, warehousing, and transportation of medical and non-medical products. The success and sustenance of these collaborative interventions in Supply Chain management within the health sector in Ghana hinges on key elements such as putting in place stringent procurement policies, ensuring availability of qualified personnel, transportation facilities to aid effective and efficient distribution, and paying attention to risk management practices. This study sought to examine the supply chain risk management practices at the central level of GHS and its regional and districts medical stores to identify the challenges of the existing SCM system and propose measures of addressing these challenges. The scope of the study was limited to the Ghana Health Service Supply Chain Practitioners (GHSSCP) at the central level and their collaborators at the regional levels (the Regional Health Directorates). Quantitative method was used in the study and the main research instrument used for the study was questionnaire administration. However, the study used convenience and purposive sampling techniques due to the sensitive nature of the subject matter. The target respondents were mainly Supply Chain Practitioners: supplies managers, procurement officers, general stores and pharmacy stores officers. The study relied on SPSS and used descriptive and inferential statistics to analyze data. The study found that notwithstanding the introduction of key interventions such as health commodity supply chain master plan (HCSCMP), the Last Mile Distribution (LMD) of health commodities from the Central level to Regional medical stores and to health facilities (Hospitals and the District Health Directorates), and the introduction of the Ghana Integrated Logistics Management Information System (GhiLMIS) as a technology tool for health commodity management at all levels across the public health sector SCM system which collective objective is to ensure the effectiveness and efficiency of the system through the minimization of SCM risks, interruptions, and vulnerabilities, there still exist a yawning underperforming gap due to the systems overly centralization and lack of priority for SCM risk reduction measures making the system still not performing at its full potential. The study concluded that there are basic weaknesses in almost all the supply chain dimensions covered: risk identification, risk assessment and mitigation, Supply Chain Risk Management Governance, impact of supply chain risk management, and employee supply chain risk routine activities because the much-needed attention is not given to SCM activities. The study recommended reforms including the establishment of a Supply Chain Risk Management Unit (SCRMU) at all levels (national, regional, and districts) under the direct supervision of Health Administration and Support services (HASS), the introduction of SCM performance contracts, and the implementation of a stronger but user-friendly technology driven SCM system including e-procurement, warehouse management tracking, supported by a robust feedback system to ensure risk free SCM

Performance of Jazia Prime Vendor System in ensuring availability of health commodities in Singida Region, Tanzania: a pre- and post-evaluation study

BackgroundAvailability of the health commodities in public health facilities in Tanzania remains a challenge, and has been reported to be below 70%. Moreover, Medical Stores Department’s capacity to supply health commodities has been only 40%. Therefore, Jazia Prime Vendor System (Jazia PVS) was outsourced to complement the Medical Stores Department. In 2017 Jazia PVS was introduced in Singida Region after being piloted in three other Regions. This study therefore, was conducted to assess the performance of Jazia PVS in enhancing the availability of the health commodities in the public health facilities between 2017 and 2019 in Singida Region, Tanzania.MethodsA mixed method pre- and post-evaluation analytical study design was used in all the selected public health facilities in the Municipal and District Councils of Singida Region, Tanzania. These included 138 public health facilities: One Regional Referral Hospital, four District Hospitals, 19 Health Centres and 114 Dispensaries. Percent availability of health commodities was abstracted from electronic logistics management information system. Documentary review involved quarterly orders, Jazia PVS delivery notes, and payment vouchers; while all the 138 pharmacists incharge were interviewed.ResultsThe mean availability of health commodities was modestly higher after adoption of Jazia PVS (mean = 59.17%, SD = 6.12%) than before Jazia PVS (mean = 54.39%, SD = 5.36%); and the difference between means was 4.78% (t = -9.49, df = 136, p < 0.001). Furthermore, 20.3% (109/421) of orders were fulfilled, while 58% (312/421) were not, (χ2 = 10.46, df = 6, p = 0.1067). About 73.7% of orders (320/434) were delivered on time, while 26.3% (114/434) delayed, (χ2 = 121, df = 6, p < 0,001). Prompt payment to Jazia PVS was 43.0% (164/381) deliveries, while 57.0% (217/382) were not punctual, (χ2 = 26, df = 6, p < 0.001). Satisfaction level of the pharmacists incharge for Jazia PVS was 11.8%, (χ2 = 78.04, df = 3, p < 0.001).ConclusionWith Jazia PVS, availability of health commodities improved by 4.78% in 2 years. Prompt payment of Jazia PVS will enhance performance of the vendor.

INVESTIGATING THE EVOLUTION OF OPTIMAL PRODUCT AVAILABILITY FOR PUBLIC HEALTH PROGRAMS IN KATSINA STATE, NIGERIA

Objective: This study aimed to explore the evolution of the availability of public health commodities across all the supported health facilities in Katsina State, northwestern Nigeria. Methods: To achieve this, Quarterly Stock Status Reports (QSSR) were produced from the analysis of the Logistics Management Information System (LMIS) reports of facilities, local government stores, and central stores of all the public health programs in the state from April 2017 to March 2018 (one year). Analyses entailed computing the Month of Stock (MoS) for all commodities by dividing their Stock on Hand (SoH) by the Average Monthly Consumption (AMC). The product availability for the following public health programs was assessed for four consecutive quarters (Apr.-Jun. 2017, Jul.-Sep. 2017, Oct.-Dec. 2017, and Jan.-Mar. 2018)-HIV/AIDS, tuberculosis, malaria, reproductive health/family planning (FP), routine immunization, nutrition, Neglected Tropical Diseases (NTD), Maternal, Newborn, and Child Health (MNCH), and the state’s Free Medicare Scheme (FMS). Results: The one-year trend provided a precise representation of the commodity security of each public health supply chain across various programs within the state. While only one program (routine immunization) recorded 100% all-time product availability, TB appeared to be the most stable (95% of products in optimal quantities) of all the assessed public health programs employing MoS as a performance measure. It is important to note that nutrition, neglected tropical diseases, and the Free Medicare scheme did not operate with MoS as a measure of stock status but recorded product availability of 78.5%, 80%, and 84.6%, respectively. Conclusion: There is a necessity for periodic stock assessment across all public health programs for other states to establish accurate stock positions and identify programs that require enhanced logistical and supply chain technical support.

Cross-sectional study on the availability of essential medicines at public health facilities in Jur River County, South Sudan

Introduction: The availability of essential medicines in health facilities in Jur River County (JRC), South Sudan, is below expectations. This is despite the requirement that all citizens should be provided with adequate quality health care services. The objective of the study was to assess the availability of essential medicines and inventory management practices in JRC.Method: This was a cross sectional study conducted in 31 of the 51 health facilities in JRC. These were 23 primary health care units (PHCUs) and eight primary health care centres (PHCCs). Data were collected using a structured questionnaire, logistics management information system (LMIS) data reports and checklist forms. All the completed checklists and questionnaires were analysed using IBM SPSS statistics version 20.0 and LMIS data was analysed using excel spreadsheet.Results: The main findings were stockouts and overstocking of essential medicines, low skilled health workers (HWs) and ineffective rotation of medicines in the health facilities. From January – August 2021, the stockouts of essential medicines in PHCUs and PHCCs were 44% and 34% respectively, whereas the incidences of over stockings were 22% and 31% respectively. Almost all (97%) of the health facilities kept records of essential medicines, revealing stockouts of 90.3% on the day of the visit. Of the 31 HWs interviewed 23 (74.9%) were community health workers (CHWs), four (12.9%) nurses and four (12.9%) pharmacy technicians; most (87.1%) had attained secondary education.Conclusion: The quantities of essential medicines were inadequate and able to cover only two months. The major reasons were inadequate supply of essential medicines; recruitment of CHWs and nurses, instead of pharmacy technicians in the management of supplies; ineffective rotation of medicines within and other health facilities. More research is needed on the factors affecting the availability of medicines at the health facilities in JRC.

Integrating PrEP in maternal and child health clinics in Kenya: analysis of a service availability and readiness assessment (SARA) survey.

Risk of HIV acquisition is high during pregnancy and postpartum, and pre-exposure prophylaxis (PrEP) is recommended for peripartum populations. Integrating PrEP into maternal and child health (MCH) clinics is feasible and acceptable. Understanding clinics' service availability and readiness is essential for effective scale up. The PrEP in Pregnancy, Accelerating Reach and Efficiency study (PrEPARE; NCT04712994) engaged PrEP-experienced facilities previously linked to a programmatic or research study in Western Kenya to document available services and commodities via a modified service availability and readiness assessment (SARA) survey with 20 PrEP tracer items covering: staffing/guidelines, services/equipment, and medicines/commodities. Facilities' prior study engagement occurred between 2017 and 2019; SARA survey data was collected between April 2020 and June 2021. Descriptive statistics were stratified by prior study engagement. ANOVA tests assessed associations between facility characteristics and gaps. Fisher's tests assessed differences in commodity availability and stockouts. Of the 55 facilities surveyed, 60% had received PrEP training in the last two years, 95% offered PrEP integrated into MCH, and 64% and 78% had both auditory and visual privacy in PrEP and HIV testing service (HTS) delivery spaces, respectively. Supervision frequency was heterogeneous, but 82% had received a supervision visit within 3 months. Availability of commodities was variable and the most commonly unavailable commodities were PrEP in MCH (71% available) and risk assessment screening tool (RAST) and PrEP cards (60% and 75% available, respectively). The number of service and commodity gaps per facility ranged from zero to eight (median: 3; IQR: 2, 5). The most frequent gaps were: PrEP training and risk assessment cards (40% each), lack of privacy in PrEP (36%) and HIV testing services (31%) spaces, PrEP pills in MCH (29%), and PrEP cards (25%). There were no differences in mean number of gaps by county, previous study engagement, or public vs. private status. Level 4 facilities had fewer gaps (mean 2.2) than level 2, 3, and 5 facilities (mean 5.7, 4.5, and 5.3 respectively; p < 0.001). PrEP service availability and readiness was generally high across MCH facilities. However, there is a need for increased frequency of provider training and supportive supervision focused on fidelity. To address key commodity stockouts such as PrEP pills, implementation of electronic logistics management information systems may be needed. Targeting these gaps is essential to effectively scale up integrated PrEP delivery, especially among facilities with limited infrastructure.

Supply Chain Management Practices and Quality Performance of Butaro Level II Teaching Hospital

This study aimed to evaluate Butaro Hospital's supply chain management practices and quality performance. Study's goals were to evaluate the impact of procurement of health commodities processes on quality performance, to assess the effects of storage and distribution of health commodities processes on quality performance and to determine the role of electronic logistics management information system (e-LMIS) on quality performance of Butaro Hospital. A descriptive research design carried out, utilizing both qualitative and quantitative data, study's design directed the data collection, analysis, and interpretation processes. Sample size of the study made up with 62 respondents were selected by using a census sampling method from the five different departments which are concerned with hospital supply chain management practices and quality performance of Butaro Hospital. Collected data were analyzed by SPSS version 22.0 for descriptive analysis and inferential statistics analysis, thematic analysis was applied to data captured from interviews. Findings shows that procurement of health commodities and quality performance are positively correlated, as shown by a positive coefficient; this relationship is statistically significant (p=0.0220.05). One-unit increase in the procurement of health commodities will result in a quality performance score of (0.119). Probability is (p=0.440.05), which indicated that there is a positive correlation between distribution and storage of health commodities on quality performance. (e-LMIS) has a statistically significant positive correlation on quality performance, with a probability of (p=0.0000.05) and a contribution to quality performance of (0.807). Quality performance of Butaro Hospital changes by 0.109 due to an increase of one unit. Study concluded that supply chain management practices have a positive impact on quality performance of Butaro hospital, by ensuring the availability of medicines at the dispensing points, ensuring the effective services delivery and promotes Hospital’s performance in general. It recommended that Butaro Hospital should improve internet connectivity availability in order to provide better services delivery and to be able to navigate and efficiently use (e-LMIS) system in health supply chain cycle. And that the Hospital should invest in the storage facilities and have a required enough storage space together with required materials and equipment to promote a good storage practice (GSP). Keywords: Supply chain management, Quality performance, Butaro Level II Teaching Hospital, Healthcare logistics, Inventory management.

Understanding the implication of direct health facility financing on health commodities availability in Tanzania.

The Government of Tanzania (GoT) has in the last decade made progress in strengthening the health system financing with progress towards Universal Health Coverage (UHC). The major reforms includes development of the health financing strategy, reforming the Community Health Fund (CHF) and introduction of the Direct Health Facility Financing (DHFF). DHFF was introduced in all district councils in the 2017/18 financial year. One of the anticipated goals of DHFF is to improve availability of health commodities. The objective of this study is to assess the effect of DHFF in improving the availability of health commodities in primary health care facilities. This study employed cross sectional study design, using quantitative techniques to analyze data related to expenditures and availability of health commodities at the primary health care facilities in Tanzania mainland. Secondary data was extracted from Electronic Logistics Management Information System (eLMIS) and Facility Financial Accounting and Reporting System (FFARS). Descriptive analysis was used to summarize the data using Microsoft Excel (2021) and inferential analysis was done using Stata SE 16.1. There has been an increase in allocation of funds for health commodities over the past three years. The Health Basket Funds (HBFs) accounted for an average of 50% of all health commodities expenditures. The complimentary funds (user fees and insurance) contributed about 20%, which is less than the 50% required by the cost sharing guideline. There is potentiality in DHFF improving visibility and tracking of health commodities funding. Implementation of DHFF has increased the amount of funding for health commodities at health facilities. The visibility and tracking of health commodity funding has improved. There is a scope of increasing health commodity funds at health facilities since the expenditures on health commodities is lower than what is indicated in the cost sharing collection and use guideline.

Logistics management information system performance for laboratory commodities in public health facilities of west Shoa zone, Oromia regional state, Ethiopia: A facility-based concurrent explanatory mixed-method design

Background: A logistics management information system is a mechanism of recording and reporting that captures, analyzes, and displays logistics data. It works well if trained and skilled people record, analyze, manage, validate and use at all levels to make informed logistics decisions thus prevent shortages of commodities. Objective: To assess the logistics management information system performance for laboratory commodities in the case of public health facilities of West Shoa zone, Oromia regional state, Ethiopia Methods: A facility based concurrent explanatory mixed-method design was employed to assess the logistic management information system performance for laboratory commodities in public health facilities of West Shoa zone, Oromia regional state, Ethiopia from June 2021 to July 2021. Twenty health facilities were selected by using simple random sampling and purposely. Data were collected by reviewing logistic management information system tools. Data were checked for its completeness, coded, and entered into a statistical package for social sciences version 23 and analyzed using descriptive (percentage and frequency table) and inferential statistics (chi-square test). An in-depth interview was carried out to explore the challenges to logistic management information system performance and thematically analyzed. Results: Logistic management information system tools availability ranges from 30-100% with utilization ranges from 15-95%. Data quality like timeliness and completeness of the reports were 80% and 75% with 80% facility reporting rate. A significant association was observed between IFRR completeness and training pattern ꭓ2 (1, N = 109) = 4.127, P = 0.041, experience ꭓ2 (2, N = 109) = 12.203, P = 0.002, supervision ꭓ2 (5, N = 109) = 17.07, P = .004, and feedback ꭓ2 (4, N = 109) = 10.037, P = 0.04. Staff turnover, workload, and inadequate manpower were major challenges identified. Conclusion: The availability and utilization of logistic management information system tools need an improvement. Data quality like bin card accuracy, timeliness, and completeness still need focus. Staff turnover, lack of commitment, workload and inadequate manpower were the challenges identified.

The Quality of Logistics Management Information System and the Availability of Tracer Drugs at Health Posts in Rural Ethiopia: A Mixed-Method Study.

Proper implementation of the logistics management information system (LMIS) would facilitate access to essential pharmaceutical products. It also prevents wastage at health posts. The aim of this study was to assess the implementation of the LMIS and the availability of tracer drugs at health posts in rural Ethiopia. We employed a cross-sectional descriptive design with a mixed-method approach. The data used for this paper was collected from March to May 2019 as part of the National HEP assessment. The study involved 343 health posts randomly selected from nine regions of Ethiopia. Women's Development Army members and household heads participated in the qualitative study (i.e. in FGD and KII). The quantitative data were exported from Open Data Kit (ODK) to Stata 15.1 for statistical analysis, and the qualitative data were entered into NVivo 12 and analyzed using thematic content analysis. Of the health posts, 59.4% had a space for storing drugs; less than half (41.9%; 95% confidence interval (CI) [36%, 48%]) had a functioning refrigerator. The mean percentage of the availability of selected tracer drugs at health posts was 59.6%, with a 95% CI (58.9%, 60.3%). Bin cards were available at 43% (95% CI [40%, 46%]) of health posts, and among these, only 27.5% of the health posts adequately used the bin cards. The absence and poor use of LMIS tools was observed at health posts. Proper implementation of the LMIS has the potential to improve the availability of essential drugs that, in turn, improve health post level delivery of health services.

Effect of IMPACT team approach implementation processes on health supply chain management data use in Singida region: A quantitative study

The Government of Tanzania (GoT), in collaboration with development partners, has made significant improvements in the health supply chain since 2013 through developing of an electronic Logistics Management Information System (e-LMIS) and strengthening of the Logistics Management Services (LMS) component. Nevertheless, the use of reported data in the e-LMIS remained very low. In efforts to respond to low data use at all supply chain levels, the GoT introduced the Information Mobilized for Performance Analysis and Continuous Transformation (IMPACT) approach to reinforce data use culture for decision-making to improve the supply chain. Therefore, this study aimed to determine the effect of IMPACT team approach implementation processes on health supply chain data use in Singida region. This was a pre- and post-cross-section study whereby the quantitative data were obtained from e-LMIS stock imbalance reports. This data was processed using Microsoft Excel power query and analysed using Microsoft Excel 2019 pivot tables to get indicator results on availability, not-in-demand and overstocked health commodities. The overall pre (2018) and post (2020) intervention results for both Iramba district council (DC) and Singida municipal council (MC) were 66% and 81% for the availability of essential health commodities, 17.2% and 21% for not-in-demand health commodities and 17% and 20.7% for overstocked health commodities respectively. Iramba DC demonstrated a significant statistical increase in both indicators compared to Singida MC, as the P-value was less than 0.05 at a 95% confidence level (df=35). Conclusively, the IMPACT team approach positively influenced data use and availability of health commodities. However, it was not the case for overstocked and not-in-demand indicator results. Apart from the possible low quality of logistics data, further studies should explore other contributing factors behind the increasing trends of overstocks and not-in-demand health commodities in the region.

Stakeholders' Perspectives of Healthcare Commodities Supply Chain Management Practices, Processes, and Challenges: Implications for Achieving Universal Health Coverage in Southeast Nigeria.

Healthcare commodities supply chain management is critical for achieving universal health coverage (UHC). In Southeast Nigeria, healthcare commodities supply chain management faces several challenges, including inadequate infrastructure, poor logistics systems, and inadequate human resources. Understanding stakeholders' perspectives of healthcare commodities supply chain management practices, processes, and challenges is essential for improving supply chain performance and achieving UHC. The objectives are to: explore stakeholders' perspectives of healthcare commodities supply chain management practices, processes, and challenges in Southeast Nigeria, identify gaps and challenges in healthcare commodities supply chain management and provide recommendations for improving healthcare commodities supply chain management practices and processes to achieve UHC in Southeast Nigeria. This study used a qualitative approach. We conducted in-depth interviews among 30 key stakeholders involved in healthcare commodities supply chain management in Southeast Nigeria. Stakeholders included healthcare supply chain managers and programme officers. We used a purposive sampling technique to select participants based on their involvement in healthcare commodities supply chain management. Data were analyzed using a thematic analysis approach. The supply chain management practices within the States is the pull system and the processes which include, selection, quantification, procurement, storage, inventory management, distribution, and logistics management information systems are done differently in the States. Several factors affect supply chain management in southeast Nigeria, and these include material, human and financial resources as well as policy issues. The study's findings will be relevant to policymakers, healthcare providers, and supply chain managers in Nigeria and other low- and middle-income countries facing similar challenges.

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.

Utilizing logistics Information Management System in logistic companies

Great advancement occurring in technology and information flow has already made myriads of changes in all industries of the world economy especially in logistics and supply chain sector. Some said this is a result of true contemporary globalization happening in the world while others think huge increasing demand in service and manufacturing have brought all these changes. Simultaneously, In the moment of fast development of information, with the widely-use of computers, the advancement in science and technology, and the continuous growth of IT techs and business, programming of information flow has become a real trend in world economy, nowadays. A fast data transfer can be taken a fruit of information technology in supply chain management eventually resulting in increased cooperation. Information technology helps to reconstruct the entire business system set up to achieve higher service levels and lower inventory and lower supply chain costs. So, establishing a logistics management information system is an important means for all logistic companies to improve their logistics efficiency. This article focuses the role of programming of information flow in logistic sector.

Enablers and Barriers to Chlorhexidine Use in Umbilical Cord Care: Voices of Care Givers and Healthcare Providers in Selected Counties in Kenya

Neonatal sepsis contributes to increased rates of mortality among newborns during their first month of life. Chlorhexidine (CHX) has proven effective in the prevention of neonatal sepsis due to umbilical stump infection after birth. Despite shifting from dry cord care techniques to CHX use, there is still a high prevalence of improper cord care in low-resource settings in Kenya. This study sought to explore barriers and enablers to CHX use in Kwale, Vihiga and Machakos counties in Kenya. We adopted mixed methods cross-sectional survey with 582 women of reproductive age with a young child less than one year as respondents to the quantitative survey. Qualitative data entailed thirty (30) key informant interviews with healthcare workers and national policymakers. Six (6) focus group discussions with mothers, caregivers, community health volunteers (CHVs) and traditional birth attendants were conducted. An observation checklist was used to assess the availability of CHX services and supplies in fourteen (14) health facilities was conducted. Results indicated variation in umbilical cord care practices for newborns across counties. Of 582 caregivers, only 1.3% reported having ever used CHX. Majority mentioned using methylated spirits (41.6%), other antiseptics (23.3%) and salty water (11.3%). Other substances used for cord care included plain water, herbal extracts, cow dung, soil, and breast milk. Despite 100% awareness of CHX among health workers, only a third of caregivers (38.7%) had heard of CHX. About 76.9% of participants preferred the gel formulation and 8.9% did not know where to get the product. Drivers of CHX use included faster cord healing, infection control in hospitals, ease of use, cost implications, ease of access, influence from key decision makers and preferred CHX formulation. Barriers included minimal awareness among caregivers, cultural practices and taboos on cord care, inadequate capacity building of CHVs on CHX, unclear CHX user guidelines for caregivers, prolonged stockouts and inadequate knowledge of CHX in communities. Healthcare workers highlighted poor dissemination of CHX guidelines by the Ministry of Health, unavailability in the Kenya Medical Supplies Authority (KEMSA) and Mission for Essential Drugs and Supplies logistic management information system making it difficult to procure. There is a need for advocacy to promote the uptake of CHX in facilities and increase knowledge of communities on CHX as well as manage the supply chain to increase CHX availability

Health supply chain system in Uganda: assessment of status and of performance of health facilities

BackgroundHealth supply chain systems are essential for effective and efficient healthcare system by ensuring availability of quality essential medicines and health supplies. While several interventions have been made to ensure the availability of quality essential medicines and health supplies, health facilities continue to report stockouts in Uganda.ObjectivesThis study aimed to assess the status and performance of the supply chain system across all levels of care in health facilities in Uganda.MethodsThis was a cross-sectional study conducted in 128 public and private-not-for-profit health facilities across 48 districts in Uganda. These facilities included all levels of care from Health Centres II, III, IV, general and referral hospitals, and national referral hospitals. Data were collected using desk reviews, health facility surveys, and key informant interviews with key personnel. Stock registers were reviewed to assess the availability of a basket of essential medicines based on the essential medicines list of the Ministry of Health.ResultsLess than half (42%) of health facilities had computer hardware. Most (84%) of health facilities were using a form of Logistics Management Information System with only (6%) were using the Electronic Logistics Management Information System. Just under a third (33%) of health information officers and (51%) of public health officers’ positions were filled in the health facilities. Nearly (66%) of health facilities used supply chain data to support decision-making. Most (84%) of health facilities reported stockouts of Essential Medicines and Health Supplies in the past 6 months. The main reasons for stockouts were (59%) a sudden increase in demand (40%) delivery gaps/delayed deliveries and (35%) discrepancies in orders and deliveries. Health facilities responded to stockouts through various means including (75%) redistribution (43%) purchased from a distributor, and (30%) placing emergency orders.ConclusionsThe findings from this study show that the performance of health facilities in different supply chain processes and functions was defective. To improve the supply chain performance of health facilities, it is important to invest in infrastructure development, provide computer hardware and internet connection and strengthen the capacity key personnel. This is key for ensuring full functionality of the supply chain and availability of quality medicines and health supplies to the end-user.