Supply Chain Interventions Research Articles

Using Novel Multimethod Evaluation Approaches to Understand Complex Food System Interventions: Insights from a Supply Chain Intervention Intended to Improve Nutrition

BackgroundA “food system” approach to improve diet quality by intervening within areas such as food supply chains is gaining prominence. However, evidence of such interventions’ impact, and understanding of appropriate methods to evaluate them, is lacking. ObjectivesWe present an impact evaluation of an intervention that aimed to increase consumption of nutritious foods by supporting food-producing firms in Kenya. In doing so, we demonstrate how multiple methods, including those from other disciplines, can be used to evaluate a complex food systems intervention. MethodsFour methods focused on food-producing firms and their management, including a survey of intervention participants (n = 83 individuals), a “laboratory-in-the-field” experiment (n = 83 individuals), baseline/endline data on firm performance (n = 71 firms), and semistructured interviews (n = 19 firms). Three methods focused on consumers in neighborhoods targeted by a supported firm: a randomized field experiment tested effects of making a supported product exhaustively available on consumers’ purchases and consumption (n = 1295 consumers); 3 discrete choice experiments (n = 1295 consumers) tested factors influencing consumers’ willingness to pay for foods with relevant characteristics. ResultsAmong firms, we saw suggestive evidence of increased networking and business relationships, while laboratory-in-the-field experiments indicated the intervention might foster cooperation among participants. Qualitative interviews suggested that the intervention enabled firms to increase production, improve management, increase revenues, and lower costs. Baseline/endline data confirmed a positive effect only on the launch of new products and hiring workers. In the field experiment, consumption of the supported product increased in areas where it was made available relative to a control group, but this did not increase overall consumption of the food type or dietary diversity. ConclusionsResults showed positive signs of the intervention improving firm-level outcomes but limited impact on consumers’ diet quality. The evaluation also demonstrates how diverse methods can be used to evaluate complex interventions.

Supply Chain of Pahala Rasagola in Odisha

"Pahala Rasagola is known in every corner of the consumers in Odisha due to its taste, ethnicity and purity that mend the researchers to understand its supply chain and issues intricate in it through this study. For that sake, a total 10 retailors and 200 consumers were tested through a pre-structured schedule in which operations regarding Rasagola making, supply chain interventions, costs, margins and simultaneously various constraints were identified through this study. Seasonal impact, locational disadvantages, and spoilage of the Rasagola due to its perishable nature are coming as the major deterrents at the retailers’ level where as consumers also worry about poor shelf-life of the Rasagola and quality issues in their consumption centric behavior. It opens the scope of organized retailing and web based interface for better product delivery in future."

Assessing nutritional and economic aspects of food loss and waste in China

Food loss and waste (FLW) has been identified as a significant impediment to achieving Sustainable Development Goals. Addressing FLW requires comprehensive data to adequately prioritize FLW reduction and evaluate the effectiveness of supply chain interventions. However, the nutritional and economic losses associated with FLW in China are poorly understood. We used multiple indicators to assess FLW in China from nutritional and economic perspectives and conducted a scenario analysis of the benefits of its reduction. The national annual per capita FLW contains sufficient nutrients to provide one person with 66.2 days of a nutritious diet. Daily losses of vitamin K, copper, and vitamin C are particularly high, accounting for more than 74 % of the dietary reference intake (DRI). The economic loss caused by FLW is up to $263.55 billion ($188.48 per capita per year), with vegetables (48.7 %) causing the most losses, followed by meat (21.0 %). From a nutritional-economic perspective, vegetables are most affected by inefficiencies in the food supply chain, followed by meat, grains, and fruits. Additionally, post-harvest handling & storage and consumption are supply chain stages with the greatest potential to reduce FLW in nutritional and economic terms. The findings of this study assist in raising public awareness and supporting decision-making by providing a nutritional and economic loss analysis of FLW. Stakeholder cooperation will be essential to carry out successful policies and practices designed to reduce FLW in China.

Pantry direct: A transformative supply chain for reducing food insecurity

AbstractThe food bank, a nonprofit, humanitarian organization, recovers charitable food donations from retail stores via collaborative relationships. We demonstrate that decentralized supply chains enable local partnerships and drive value creation via increased exchange of products and services that also better align with community needs. Our supply chain intervention resulted in a reduction in waste disposal costs for the retailer and a greater supply of food for the food bank. We study the private–public partnership (PPP) in retail food recovery in two successive phases. The first exploratory phase incorporates qualitative data from key informants at multiple Feeding America partners across the United States. The second phase was a researcher‐led supply chain intervention involving multiple stakeholders and executed with our partner food bank. Our intervention, Pantry Direct, represents a transition in the PPP to a decentralized, community network. It shifts the pickup responsibility for retail food recovery to a purely volunteer workforce at the pantry. Retail store management noticed lower pickup service reliability; however, more frequent interactions between food pantry volunteers and retail store employees improved communication, which overshadowed the limitations of the volunteer workforce. Owing to several factors, the gain in PPP performance was not universal. Among the five retail stores that participated in the supply chain intervention, two increased food donations and two others decreased food waste. The Pantry Direct model is transformative in the fight against food insecurity, as increased volume (and quality) of retail food donations enabled downstream pantries to provide end clients with more adequate, consistent, or appropriate access to food.

Risk of intact forest landscape loss goes beyond global agricultural supply chains

•More than one-third of IFL loss was related to export production for the global market •Global supply chains of forest, energy, and mining products dominated IFL loss •Mainland China, the EU, and the United States were major final consumers of IFL-risk products •The dispersed nature of IFL loss drivers calls for stronger government engagement The continued loss of unfragmented intact forest landscapes (IFLs) despite numerous global conservation initiatives indicates the need for improved knowledge of proximate and underlying drivers. Yet the role of non-agricultural activities in forest degradation and fragmentation has not received adequate attention. We focus on IFL loss caused by various economic activities and investigate the influence of global consumption and trade via the multi-regional input-output model. For IFL loss associated with the 2014 world economy, over 60% was related to final consumption of non-agricultural products. More than one-third of IFL loss was linked to export, primarily from Russia, Canada, and tropical regions to mainland China, the EU, and the United States. Of IFL loss associated with export, 51% and 26% was directly caused by logging and mining or energy extraction, respectively. The dispersed nature of IFL loss drivers and their indirect links to individual final consumers call for stronger government engagement and supply chain interventions. The continued loss of unfragmented intact forest landscapes (IFLs) despite numerous global conservation initiatives indicates the need for improved knowledge of proximate and underlying drivers. Yet the role of non-agricultural activities in forest degradation and fragmentation has not received adequate attention. We focus on IFL loss caused by various economic activities and investigate the influence of global consumption and trade via the multi-regional input-output model. For IFL loss associated with the 2014 world economy, over 60% was related to final consumption of non-agricultural products. More than one-third of IFL loss was linked to export, primarily from Russia, Canada, and tropical regions to mainland China, the EU, and the United States. Of IFL loss associated with export, 51% and 26% was directly caused by logging and mining or energy extraction, respectively. The dispersed nature of IFL loss drivers and their indirect links to individual final consumers call for stronger government engagement and supply chain interventions.

A mixed methods approach to analyze and predict supply disruptions by combining causal inference and deep learning

In today's complex supply networks, disruptions caused by diverse events represent major unknown operational conditions and risk factors requiring research on supply chain risk management. Hereby, operations management (OM) researchers are traditionally focusing on defining analytical and mathematical risk mitigation strategies characterized by a variety of different constraints, such as capacities, timeliness, or relations, leading to limited transferability into practice. Given the complexity of modern supply chains we argue that a data-driven approach to supply chain risk management enhances the assessment and comparability of risk mitigation strategies. Thereby an approach that allows conclusions about causal relationships between supply chain interventions and potential outcomes is of particular importance. Inspired by deep learning as well as causal learning theory and following a design science research approach, we design an analytical model that can predict supply disruptions based on external and internal data and quantify causal effects on delivery reliability. The model is evaluated in a single case study using data from a large first tier automotive supplier. The results show that the model has a high predictive performance and can learn causalities from observed data and analyze interventions effecting supply disruptions. The identification of causal relationships offers the potential to identify lacking supplier relationships and consequently bundle supply chain risk management activities. Building on the empirical and analytical insights, we discuss implications for both theory and practice.

Putting consumers first in food systems analysis: identifying interventions to improve diets in rural Ghana

A critical, yet underexplored, dimension of food systems is how consumer food preferences and beliefs interact with the food environment. We present a consumer-centered approach to identifying options for improving diets. The Value Chains for Nutrition (VCN) mixed-methods multi-disciplinary analytical approach was applied in rural Ghana. Data from in-depth consumer interviews, structured vendor interviews, and (secondary) household consumption surveys were analyzed to assess consumer diet patterns, related norms and preferences, and supply and demand characteristics of a set of empirically defined high-potential nutritious foods. Mapping results onto a supply–demand typology, we identify promising interventions to support increased availability, access, and affordability of these foods. Consumption data suggested that diets among Ghanaians were deficient in key micronutrients and calories. Fresh nutritious fruits and vegetables tended to be grown for home consumption rather than sale due to transportation challenges and seasonality of demand, especially near rural markets. Seasonal availability (fruits and vegetables) and affordability (animal foods) severely limited consumption of many nutritious foods. A set of supply, demand, and value chain interventions to enhance availability and affordability of nutritious foods are presented. Critical to success is to consider the set of interventions along each value chain required for impact.

Knowledge Management for Integration of Agricultural Supply Chain in India

Paper tries to explore the problems faced by Indian agriculture for food security in terms of inadequate infrastructure and highly inefficient supply chain in context of information technology. This paper broadly covers some of important aspects of agriculture supply chain in India-identification of issues at different levels in the supply chain; transformation in the agriculture due to various supply chain interventions; the role of information management in supply chain: and this paper also covers the suggestion to improve efficiency at different levels in supply chain. The paper concludes that information management plays very important role for development and contemporary issue for agriculture.

Sustainable supply chain intervention: a case-based analysis of the economics of land degradation

Sustainable supply chain intervention: a case-based analysis of the economics of land degradation

Sustainable supply chain intervention: a case-based analysis of the economics of land degradation

Sustainable supply chain intervention: a case-based analysis of the economics of land degradation

Emerging agricultural expansion in northern regions: Insights from land-use research

Emerging agricultural expansion in northern regions: Insights from land-use research

Broadening the Perspective of Zero-Deforestation Interventions in Peru by Incorporating Concepts from the Global Value Chain Literature

Global narratives around the links between deforestation and agricultural commodity production have led to the application of voluntary zero-deforestation agreements between companies, governments, and civil society. The continued tropical deforestation warrants a re-examination of this approach in order to customize its application for a particular location. Our paper contributes to this by exploring the spatial associations between deforestation and the production of cacao, coffee, and oil palm in the Amazon region in Peru. The geographical overlaps between deforestation, and the distribution of these commodity crops, indicate four types of spatial associations: (1) a high degree of deforestation and a high degree of commodity production (high-high); (2) a high degree of deforestation and a low degree of commodity production (high-low); (3) a low degree of deforestation and a high degree of commodity production (low-high); and (4) a low degree of deforestation and a low degree of commodity production (low-low). On the basis of these associations, we present four scenarios in which zero-deforestation supply chain interventions may operate in Peru and argue that broadening the perspective of such interventions by adopting a global value chain lens can improve the use of previously deforested lands, prevent unintended or future deforestation and, in turn, ensure that no forest area is left behind.

Prevalence and antimicrobial resistance of foodborne pathogens in value‐added commodities procured from farmers' markets in Central Virginia

AbstractFood safety concerns associated with products purchased at farmers' markets have arisen, highlighting the growing need for farmers' market consumer and producer awareness of potential public health issues. The focus of this quantitative research study was to assess the prevalence and antimicrobial resistance of foodborne pathogens in select value‐added commodities (i.e., animal treats, soil amendments, herbs, honey, dressings, exotic foods, etc.) randomly procured from farmers' markets in Central Virginia. Between March and November 2017, collection of 194 samples originating from 40 individual farmers' market vendors selling at 11 different farmers' markets transpired. Detection of potentially harmful bacterial species within collected samples was as follows: 0.5% Campylobacter, 24.5% Escherichia coli, 16.7% Listeria, and 1.0% Salmonella. Bacterial isolates (n = 155) of Campylobacter, E. coli, Listeria, and Salmonella were tested for their susceptibility to 12 antimicrobials. Tetracycline and ampicillin resistance showed the highest frequency among E. coli (approximately 30%) isolates. Nalidixic acid resistance was the highest in Listeria isolates (79.4%). Approximately 17% of E. coli isolates and more than 50% of each Campylobacter, Listeria, and Salmonella isolates exhibited multidrug resistance (MDR). No E. coli isolates had matching pulsed‐field gel electrophoresis profiles demonstrating that the isolates had a high degree of genomic diversity and farm specificity. This study demonstrated an emerging public health threat of the presence of MDR arising from farmers' market‐acquired value‐added commodities. The importance of this research study highlights the value of implementing good agricultural and handling practices from farm (producer vendors) to table (consumers) to avert potential foodborne illness occurrence. Future research to determine potential reasons and supply chain interventions for the observed prevalence of MDR bacterial isolates from farmers' market value‐added products is paramount.

Identifying Land Use Change Trajectories in Brazil’s Agricultural Frontier

Many of the world’s agricultural frontiers are located in the tropics. Crop and cattle expansion in these regions has a strong environmental impact. This paper examines land use and land cover transformations in Brazil, where large swaths of natural vegetation are being removed to make way for agricultural production. In Brazil, the land use dynamics are of great interest regarding the country’s sustainable development and climate mitigation actions, leading to the formulation and implantation of public policies and supply chain interventions to reduce deforestation. This paper uses temporal trajectory analysis to discuss the patterns of agricultural practices change in the different biomes of Mato Grosso State, one of Brazil’s agricultural frontiers. Taking yearly land use and cover classified images from 2001 to 2017, we identified, quantified, and spatialized areas of stability, intensification, reduction, interchange, and expansion of single and double cropping. The LUC Calculus was used as a tool to extract information about trajectories and trajectories of change. Over two decades, the land use change trajectories uncover the interplay between forest removal, cattle raising, grain production, and secondary vegetation regrowth. We observed a direct relationship between the conversion of forest areas to pasture and of pasture to agriculture areas in the Amazon portion of the Mato Grosso State in different periods. Our results enable a better understanding of trends in agricultural practices.

Health systems readiness and quality of inpatient malaria case-management in Kano State, Nigeria

BackgroundNigeria was among the first African countries to adopt and implement change of treatment policy for severe malaria from quinine to artesunate. Seven years after the policy change health systems readiness and quality of inpatient malaria case-management practices were evaluated in Kano State of Nigeria.MethodsA cross-sectional survey was undertaken in May 2019 at all public hospitals. Data collection comprised hospital assessments, interviews with inpatient health workers and data extraction from medical files for all suspected malaria patients admitted to the paediatric and medical wards in April 2019. Descriptive analyses included 22 hospitals, 154 health workers and 1,807 suspected malaria admissions analysed from malaria test and treat case-management perspective.Results73% of hospitals provided malaria microscopy, 27% had rapid diagnostic tests and 23% were unable to perform any parasitological malaria diagnosis. Artemisinin-based combination therapy (ACT) was available at 96% of hospitals, artemether vials at 68% while injectable quinine and artesunate were equally stocked at 59% of hospitals. 32%, 21% and 15% of health workers had been exposed to relevant trainings, guidelines and supervision respectively. 47% of suspected malaria patients were tested while repeat testing was rare (7%). 60% of confirmed severe malaria patients were prescribed artesunate. Only 4% of admitted non-severe test positive cases were treated with ACT, while 76% of test negative patients were prescribed an anti-malarial. Artemether was the most common anti-malarial treatment for non-severe test positive (55%), test negative (43%) and patients not tested for malaria (45%). In all categories of the patients, except for confirmed severe cases, artemether was more commonly prescribed for adults compared to children. 44% of artesunate-treated patients were prescribed ACT follow-on treatment. Overall compliance with test and treat policy for malaria was 13%.ConclusionsTranslation of new treatment policy for severe malaria into inpatient practice is compromised by lack of malaria diagnostics, stock-outs of artesunate and suboptimal health workers’ practices. Establishment of the effective supply chain and on-going supportive interventions for health workers accompanied with regular monitoring of the systems readiness and clinical practices are urgently needed.

Evaluation of Senegal supply chain intervention on contraceptive stockouts using routine stock data.

BackgroundUntil 2011, stockouts of family planning commodities were common in Senegalese public health facilities. Recognizing the importance of addressing this problem, the Government of Senegal implemented the Informed Push Model (IPM) supply system, which involves logisticians to collect facility-level stock turnover data once a month and provide contraceptive supplies accordingly. The aims of this paper were to evaluate the impact of IPM on contraceptive availability and on stockout duration.Methods and findingsTo estimate the impact of the IPM on contraceptive availability, stock card data were obtained from health facilities selected through multistage sampling. A total number of 103 health facilities pertaining to 27 districts and nine regions across the country participated in this project. We compared the odds of contraceptive stockouts within the health facilities on the 23 months after the intervention with the 18 months before. The analysis was performed with a logistic model of the monthly time-series. The odds of stockout for any of the five contraceptive products decreased during the 23 months post-intervention compared to the 18 months pre-intervention (odds ratio, 95%CI: 0.34, 0.22–0.51).To evaluate the impact of the IPM on duration of stockouts, a mixed negative binomial zero-truncated regression analysis was performed. The IPM was not effective in reducing the duration of contraceptive stockouts (incidence rate ratio, 95%CI: 0.81, 0.24–2.7), except for the two long-acting contraceptives (intrauterine devices and implants). Our model predicted a decrease in stockout median duration from 23 pre- to 4 days post-intervention for intrauterine devices; and from 19 to 14 days for implants.ConclusionsWe conclude that the IPM has resulted in greater efficiency in contraceptive stock management, increasing the availability of contraceptive methods in health facilities in Senegal. The IPM also resulted in decreased duration of stockouts for intrauterine devices and implants, but not for any of the short-acting contraception (pills and injectables).

Why didn’t you write this in your diary? Or how nurses (mis)used clinic diaries to (re)claim shared reflexive spaces in Senegal

Between 2015 and 2017, we implemented the clinic diaries project as part of the qualitative component of an evaluation of a supply chain intervention for family planning in Senegal. This project combined different tools including the diaries and participatory workshops with nurses. At the intersection between writings and silences, this paper explores the role played by the clinic diaries to mediate ethnographic encounters, and the iterative nature of ‘doing fieldwork’ to produce knowledge in hierarchical health systems. This paper also reflects on the processes through which the diaries created a space where accounts of lived experiences routinely unfolding in health facilities could be shared, in the context of a health system increasingly dominated by metrics, performances and vertical reporting mechanisms. The clinic diaries research process therefore sheds light on the limits of approaching bureaucratic norms and practices as coming from the top, an approach reinforced by data reporting and coordination mechanisms in the Senegalese pyramidal health system. In contrast, the diaries suggest a role for participative ethnography to identify collegial spaces to reflect on shared experiences in and of bureaucratic spaces.

Management of socioenvironmental factors of reputational risk in the beef supply chain in the Brazilian Amazon region

Increased production of Brazilian beef has been associated with negative impacts in the Amazon region. Supply chain interventions are increasingly common to avoid social and environmental consequences in the area, but evidence about how companies have managed these efforts is scarce. The present study identified the main sources of reputational risks in Brazilian Amazon beef supply chains and the actions taken by slaughterhouses to manage these types of risk. A multiple case study was developed in Brazilian beef supply chains that have suffered consequences to their operations from consecutive actions of stakeholders that link meat production with deforestation and the worst practices of production in the Amazon region. Public agreements with stakeholders and the development of supplier management were used to identify reputational risks. The present study also describes the types of risk and how they are mitigated. Based on the results, the authors propose a set of risk management practices in the supply chains to manage risks through stakeholder engagement, use of government open data sources, and sharing information with direct suppliers.

Jazia prime vendor system- a public-private partnership to improve medicine availability in Tanzania: from pilot to scale

BackgroundThe availability of medicines in public health facilities in Tanzania is problematic. Medicines shortages are often caused by unavailability at Medical Stores Department, the national supplier for public health facilities. During such stock-outs, districts may purchase from private suppliers. However, this procedure is intransparent, bureaucratic and uneconomic.ObjectivesTo complement the national supply chain in case of stock-outs with a simplified, transparent and efficient procurement procedure based on a public-private partnership approach with a prime vendor at the regional level. To develop a successful pilot of a Prime Vendor system with the potential for national scale-up.MethodsA public-private partnership was established engaging one private sector pharmaceutical supplier as the Prime Vendor to provide the complementary medicines needed by public health facilities in Tanzania. The Dodoma pilot region endorsed the concept involving the private sector, and procedures to procure complementary supplies from a single vendor in a pooled regional contract were developed. A supplier was tendered and contracted based on Good Procurement Practice. Pilot implementation was guided by Standard Operating Procedures, and closely monitored with performance indicators. A 12-step approach for national implementation was applied including cascade training from national to facility level. Each selected vendor signed a contract with the respective regional authority.ResultsIn the pilot region, tracer medicines availability increased from 69% in 2014 to 94% in 2018. Prime vendor supplies are of assured quality and average prices are comparable to prices of Medical Stores Department. Procurement procedures are simplified, shortened, standardized, transparent and well-governed. Procurement capacity was enhanced at all levels of the health system. Proven successful, the Prime Vendor system pilot was rolled-out nationally, on government request, to all 26 regions of mainland Tanzania, covering 185 councils and 5381 health facilities.ConclusionThe Prime Vendor system complements regular government supply through a regional contract approach. It is anchored in the structures of the regional health administration and in the decentralisation policy of the country. This partnership with the private sector facilitates procurement of additional supplies within a culture of transparency and accountability. Regional leadership, convincing pilot results and policy dialogue have led to national roll-out. Transferring this smaller-scale supply chain intervention to other regions requires country ownership and support for sustainable operations.

Comparing time and motion methods to study personnel time in the context of a family planning supply chain intervention in Senegal

BackgroundA family planning (FP) supply chain intervention was introduced in Senegal in 2012 to reduce contraceptive stock-outs. Labour is the highest cost in low- and middle-income country supply chains. In this paper, we (1) understand time use of personnel working in the FP supply chain at health facilities in Senegal, (2) estimate the validity of self-administered timesheets (STs) relative to continuous observations (COs), and (3) describe the cost of data collection for each method.MethodsWe collected time use data for seven stockroom managers in six facilities using both ST and CO. Activities were categorized as follows: stock management associated with FP, non-FP stock management, other productive activities, non-productive activities, and waiting time. Paired t tests were used to compare the mean differences between the two methods in all categories and in productive time alone.ResultsAmong all activities, the absolute and relative time spent on productive activities was higher when estimated by ST compared to CO. Conversely, waiting time was underestimated by STs. There was no difference in the relative time spent on non-productive activities. When comparing the distribution of the three productive activity categories, we found no evidence of a difference in relative time percentage estimates between CO and ST (FP stockroom management − 3.0%, 95% CI − 7.4 to 1.4%; non-FP stockroom management 3.4%, 95% CI − 2.8 to 9.6%; and other productive activities − 0.1%, 95% CI − 6.3 to 6.0%). Data collection costs for CO are 140% more than ST.ConclusionSTs were not a reliable method for measuring absolute labour time at health facilities in Senegal due to considerable underestimates of time waiting for clients. However, ST had acceptable reliability when examining distribution of productive time. Although CO provides more accurate absolute time estimates, the unit costs for data collection using this method are more than triple those for STs in Senegal.