Uganda 2009-2010

A four person GEG team conducted a comprehensive health supply chain review for UNICEF

Background: Adequate access to a functioning healthcare system is particularly difficult in rural districts in Northern Uganda (including Karamoja).  Lack of a consistent drug supply is identified as the primary reason why health centres are not utilised. All Karamoja districts rank low on the annual performance index published by the health sector with four of the five ranking at 69, 71, 75 and 79 out of a total 80. Healthcare is complicated by food insecurity, creating increasing vulnerability of the Karamajong people; the World Food Programme (WFP) estimates that droughts and ongoing violence have left an estimated 1,130,000 of Karamoja’s inhabitants (94 percent of the region’s entire population) unable to provide for their immediate food needs.

Requirement: An independent and rigorous review that identified the key issues, challenges and opportunities for improvements in the supply chain used for delivery of health commodities in the five districts of the Karamoja region. The six tracer drugs used included artimisinin-based combination therapy (ACTs such as Coartem), sulfadoxine pyrimethamine (malaria treatment), co-trimoxazole (antibiotic for bacterial infections – particularly in HIV/AIDS patients), oral rehydration salt (diarrhoea treatment), medroxyprogesterone injection (birth control) and measles vaccine. The review was tasked with designing tactical and strategic actions that will promote sustainable change in the supply chain for improved availability of health commodities and alleviate the challenges identified including a method for more effective dissemination of information. 

GEG Contribution: A four person GEG team (Team Lead, 2 X Supply Chain Experts and 2 X Review Specialists) conducted a rigorous review and analysis of the health commodities supply chain in one of the world’s poorest areas.  Supply chain maps of current health commodity supply chains were identified and their performance measured by use of site visits and interviews. The initial mapping of the primary supply chain was undertaken using desk research and interviews, thus forming the basis for a detailed framework. Field studies in Karamoja incorporated interviews with district authorities, DHOs and other stakeholders.  The team also also visited the five district medical stores and a selection of health centres belonging to each district. The project focused on problem identification and the creation of stakeholders- led solutions aimed at significantly enhancing the delivery of medical supplies.

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