Each story from the field piece narrates our work from the perspective of someone working at ARC. Today, Alemayehu Lemma Wolde shares his experience supporting health systems strengthening in Ethiopia.
Reframing government approaches
There is often a perception that governments in Africa lack the impetus to improve medicine availability. I believe this is a false impression, and a damaging one at that, which limits how we approach private sector and NGO collaboration with governments.
Governments are not inefficient, but there is a role that is enabling organisations like ARC – Africa’s public health supply chain institution – can and must play to help governments identify gaps and build systems to address them.
My professional experience includes work in government, the private sector, NGOs and now, as the Ethiopia Country Lead for ARC. I have also worked in Namibia, Eswatini, and Sudan – all of which have given me a first-hand understanding of what governments need in support and capacity building to achieve their public health supply chain goals.
It is crucial to begin by understanding that the goals of governments across Africa are almost always to ensure that people can access healthcare as and when they need it. Universal health coverage is a core driver of most healthcare delivery approaches on the continent, so governments know what they aim for. It’s just that they sometimes need support in charting how to achieve these outcomes.
Shining a light
What I have often seen happen, particularly in the supply chain sphere, is that effective partners come alongside ministries of health and help them see where there are blind spots. This includes opportunities not always visible to internal parties along the supply chain. Especially partners collaborating to address the unaddressed issues of governments and aligning with each other and the government’s long-term plan of action.
Offering a ‘bird’s eye view’ as an external advisor has provided valuable insights to government. Our work on transport and fleet management outsourcing with the Ethiopian Pharmaceuticals Supply Service (EPSS) is an excellent example. As a result of other work we were doing with the EPSS, we identified that transportation was an issue in the supply chain.
Then we could offer a unique solution using the Outsourcing Toolkit (OSTK) to improve this aspect of medicine delivery in the country by partnering with the private sector.
We identified a growth area in the supply chain. We also provided a solutions proposal that would have a meaningful impact on the government’s ability to deliver on its goals.
Building trust
One of the most important things about developing a positive working relationship with the government as an external advisory partner is to build trust and be willing to walk a process with people from across multiple governmental nodes to help align everyone on the proposed solution.
In the case of the OSTK, EPSS management was willing to listen to what we were proposing because of our existing depth of relationship and the proven expertise and experience in our field. Historically, external partners have not always expected a positive or healthy approach to government collaboration.
So we have also learned that it’s essential to take things step-by-step and to spend time on advocacy with all the different stakeholders in the supply chain to get genuine buy-in that will make it possible to achieve the desired outcomes during implementation. With the OSTK, we collaborated with technical teams from the relevant government departments and other partners on the ground to integrate their experience and insights into the solution being developed.
I believe government management teams want to see change, but how we approach this as partners is important. We need to show that we are adding value and supporting governments in the areas where they don’t have the capacity or systems to achieve certain aspects of supply chain efficiency that will help countries achieve their goals. Partners need to work together toward achieving strategic goals, impacting the lives of the people they serve and contributing to Universal Health Coverage.
Read more about ARC’s work in Ethiopia here. You can also work through the Outsourcing Toolkit (OSTK) here.
About the author
Alemayehu Lemma Wolde has over 30 years of experience managing the public health supply chain. He is the Ethiopia Country Lead for ARC and is based in Ethiopia.
