The Pulse of Public Healthcare Supply Chain in Africa

Changing the paradigm ofdecision making in the public health supply chain

Agenda

Introduction1

Context2

Before3

Execution4

Results5

Terminology

• eLMIS: Electronic Logistics Management System

In Context

Introduction to Rwanda

Population (2011) 11 Million 52 Million

Area 26,338 km2 1,221,037 km2

Population Density 419.8/km2 42.4/km2

GDP Per Capita $ 698 $ 6,354

Introduction to Rwanda

Some Numbers?

Health Spend Per Capita (2013) $ 71 $ 593

Before

How Things Used to Work…

• Paper based

• Timeous

Objectives

Design, build, and implementation of a computerized logistics management information system that will provide health commodity logistics data and order processing functionalities

Rwanda Ministry of Health Electronic Logistics Management Information System (eLMIS)

Project Overview• Ministry of Health supply chain covers 4 in-country

warehouses, 40 district pharmacies & regional hospitals, and approximately 900 local health clinics and dispensing facilities

• Supply chain-wide consumption (manual system updates from dispensing locations, similar to POS);

• Annual and semi-annual quantification (budgeting/forecasting, very light by commercial standards);

• Supply chain-wide inventory management (due-ins, due-outs, in stocks, on order, etc.);

• Light warehouse management (receipts, put away, pick list generation, shipments);

• Serialized item and lot tracking;

• Supply chain-wide order management;

• Supply chain-wide shipment visibility, with event notifications;

• Reporting and dashboards (incl. inventory control by program);

• Integration with their existing WMS (Sage), ERP (Sage) and HMIS (hospital MIS).

KEY FACTS• 11.78 million

population served• 500+ Local health clinics

and dispensing facilities• 40+ Distribution centers

and warehouses• Approx. 3000 SKUs

Rwanda Ministry of Health Electronic Logistics Management Information System (eLMIS)

Business Results• Improved patient service levels

• Reduced costs

• Replaces previous paper-based and manual-driven system

• Increased operational efficiencies

• Improved in-stocks at district pharmacies and health clinics

• Reduced wastages

• Reduced total system cost to deploy, maintain and support

Rwanda Leveraging One Network’s Cloud Platform to:• Improve the provisioning, inventory

control, and distribution of critical HIV/AIDS medicines and other pharmaceutical products to patients across Rwanda

• Enable better patient service levels from central supply facilities to hospitals, local clinics and other dispensing locations

Rwanda Health Distribution

Logi

stic

s M

anag

emen

t O

ffic

e (L

MO

)

Private Sector

MPPD(DC)

District Pharmacies

Referral Hospitals

Health Centres

National Blood Transfusion Centres

National Reference Laboratory

Regional Blood Transfusion Centres

Health Community Coordinator

MOH SystemsMPPD WMS

Health Posts

District Hospitals

Community Health Worker

eLMIS

Execution

Project Overview

Documentation

Project CharterProject Management PlanProject Work Breakdown StructureBudget and Financial PlansCommunication PlanRisk Management PlanReadiness Assessment PlanChange Management PlanTraining PlanTesting PlanImplementation Plan

Critical Success Factors:• GOR Leadership• AGILE Implementation• Early Champion Identification• USAID/GF Partnership• Stakeholder Buy In• Risk Management

Status: System Implemented in 30 District

Pharmacies, 43 District Hospitals, 2 Referral Hospitals, 527 Health Centres, LMO and MPPD

Usability Purchase Order Management -

98% of all facilities use eLMIS to create, collaborate and manage purchase orders

Consumption - 80% of all health facilities record daily consumption in the eLMIS

Transportation - 55% of orders have been delivered leveraging the transportation function in eLMIS

Impact Reduction in both LOE and

Cycle Time Value Chain Visibility Real Time Consumption Data

Implementation Framework

Rwanda eLMIS Implementation

Framework

Top management support, Cross functional project team with IT skills,

Business process reengineering, Quality function deployment,

Concurrent engineering, Life cycle approach, Project management,

Required financial support, Performance measures and metrics

Top management participation, Long-term business plan, Agility and cost, Strategic

partnerships, Integrated systems

Fitness for Business process, Change Readiness, Internet connectivity, IT

investment, ERP, Software

and hardware availability, Systems Integration, IT skills, Training and

Education in IT, IT evaluation

Solution Architecture

Inputs MPDD WMS Private Sector BUFMAR

eLMIS Platform

Pro

cess

es

& W

ork

flo

w

Forecasting & Netting

Order Management Transportation

Supply Planning & Allocation

Load Building

Appointment Scheduling

Consumption Data

Distribution/Logistics

Transactions

Compliance

Permissions& Security

Reporting

Alerts and Notifications

Business Rules and Policies

Operational Data Store

Outputs

Informatio

n and

Commoditi

es

Visibility GOR/MOH

Donor Partners

MPDDDistrict Pharmacies

Referral Hospital

Health CentersLMO

BUFMAR

Implementation Timeline

2012

20132013

2011

20122014

User Acceptance Testing

Conducted User

Acceptance Testing

.Procurement

Developed RFP

Proof of Concept Demonstration

System Procurement

Contract Negotiation

Determine Contract Deliverables

SOW Development

Contract AwardBusiness Case Analysis

Developed Problem Statement

Identified project boundaries

Defined Expected Benefits and

Improvements

Defined project goals and objectives

Defined Solution Scope

Conducted Analysis of Alternatives

Detailed project constraints assumptions

Determined Acquisition Approach

Incremental Implementation

1st Implementation - DP and LMO

2nd Implementation - District Hospitals

3rd Implementation - Health Centers

Project Initiation

Conducted Stakeholder

Identification

Selected system champions

Developed implementation blue

print

Performed Risk Identification

Developed Project Management

Plan

Developed Project Charter

Identified solution constraints

and dependencies

Conducted readiness

assessment and skills analysis

Training of Trainers

Conducted Training of Trainers

Training conducted through a

combination of training videos,

printed handouts and “hands on”

instruction to provide the

participants with an opportunity to

practice the use of the eLMIS

.

Results

Impact on work performance

Purchase OrderManagement

Inventory ManagementWarehouse

ManagementSupply Planning

Supply Chain andLogistics Reporting

Greater Extent 70% 52% 74% 21% 49%

Some Extent 28% 44% 24% 34% 44%

Not all 44% 5%

0%

10%

20%

30%

40%

50%

60%

70%

80%

%

Impact on LOE

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Is the effort required to process anorder reduced?

Is the effort required to manageinventory reduced

%

Is the effort required to process an order reduced? Is the effort required to manage inventory reduced

Yes 89% 84%

Not at all 9% 15%

Level of Effort Required to Process Orders/Manage Inventory

Acknowledgments

* Some logos designed by

CLOSING

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