EACH STORY FROM THE FIELD PIECE NARRATES OUR WORK FROM THE PERSPECTIVE OF SOMEONE WORKING AT ARC. TODAY, YACINE FATIME SHARES HER EXPERIENCE SUPPORTING HEALTH SYSTEMS STRENGTHENING IN SENEGAL.
As public health supply chain transformation advisors, we aim to increase health product availability in Africa. But what do we really mean by “health products availability”?
We do not get the medicine we need
At a health district in Senegal, a storekeeper told us, “We do not get the medicines we really need”. These types of comments help frame our thinking and keep us focused on how we should manage our supply chain, rather than how we have been managing it so far. This is because despite the tremendous efforts made by the Government of Senegal to improve the availability, accessibility, and affordability of medicines at all levels of the supply chain, as the storekeeper showed us, people still face challenges in getting the medicines they need.
So, what will it take to shift this reality? Our work on Senegal’s last mile distribution model, Yeksi Naa, including support for the long-term transformation of the supply chain, is one example of how we can help make this possible.
ARC’s journey in Senegal
We started our engagement in Senegal in 2017 by conducting a needs assessment based on a literature review. The main challenges we identified included a lack of strategic coordination of the supply chain, limited end-to-end visibility, misalignment of interventions and limited resources specialising in supply chain and logistics. We then facilitated sharing experiences and best practices from the private sector to show what success should look like in a supply chain environment. We also provided strategic advisory services for setting up supply chain governance and developing a national strategy to improve the coordination of interventions and performance management.
The support we provided during that period led to ARC being entrusted with the assessment of Yeksi Naa by the Ministry of Health (MoH) and its partners. Yeksi Naa (“I have arrived” in Wolof) is Senegal’s last mile distribution model launched in 2016 using third-party logistics providers for distribution and consumption data for planning. It drastically improved the availability of medicines and reduced stockouts to less than 2%. When challenges arose during Yeksi Naa’s maturation phase, ARC supported the MoH by evaluating the distribution model and thoroughly assessing the supply chain to identify root causes.
Prioritising inclusiveness
Many learnings from our work on Yeksi Naa are important for the MoH and us to incorporate into our future thinking. For instance, access to data was challenging during the evaluation. This challenge is inherent where public health supply chain data lacks visibility due to insufficient structures and governance around data collection and management. However, ARC adopted an inclusive and participatory approach to the process by organising socialisation workshops with key stakeholders in the public health supply chain at each milestone of the evaluation to:
- Present the preliminary results, draft solutions proposals for each thematic area, and specific technical aspects of the MoH’s key entities.
- Discuss feasibility, identify potential constraints and collect stakeholders’ feedback.
- Align on the results and solutions proposals before moving forward.
This inclusive approach ensured the MoH’s participation in the evaluation, and its ownership and implementation of the results.
Considering continuous improvement
With my background in quality management and continuous improvement in the private sector, I also firmly believe that engaging public health supply chain entities such as the Pharmacie Nationale d’Approvisionnement (PNA – Senegal’s central medical store) in setting up a certified quality management system is essential for organisational effectiveness, optimising processes, and reducing operational costs.
Having a certified quality management system at the PNA will ensure adequate processes and procedures are used, the roles and responsibilities of stakeholders are clearly defined, and there is a dynamic performance management framework.
All this will make it possible to keep the processes on track, maintain the focus on value-added activities and allow for continuous improvement in the PNA’s strategies and operations. This is even more important because the country is engaged in developing the local pharmaceutical industry regarding medicines availability for sovereignty and resilience.
Finally, it will provide high adaptability and responsiveness at the PNA thanks to the change management processes inherent in a good quality management system.
There will be no universal health coverage without the availability of medicines when and where the patients need them at an affordable price, and in the right quality and quantity.
We should ensure effective delivery to the right patients of the right products, right quantities and right quality to the right place at the right time for the right cost (The Seven Rights of Logistics).
As stakeholders in the public health system, we should find the right balance between doing the right things (performance) and doing things right (policies). If we don’t get it right, people like the shopkeeper will still tell us they don’t get the medicines they really need.
About the author
Yacine Fatime has nine years of experience in Program Coordination. She worked in the private sector for seven years as a Quality/Security/Environment (QSE) Assistant (ISO 9001 & 14001), then QSE Program Coordinator and the Corporate Tools/Equipments Manager.
Before joining ARC, she was a Senior Program Coordinator in a consulting firm for NGOs and foundations. She is currently the ARC Country Lead for Senegal and supports private actor and academia initiatives.
