The project is a follow-on to the DELIVER project and the Family Planning Logistics Management (FPLM) project which, from 1986 to 2006, facilitated the improvement of logistics systems for family planning, reproductive health, and other preventive and curative health programs in more than 30 countries.
The project is managed by John Snow, Inc., and partners with the following organizations:
The project, headquartered in Arlington, Virginia, has field offices in 15 countries.
The project works on a number of different health commodities including contraceptives and condoms, essential drugs, as well as select commodities for HIV/AIDS, laboratories, malaria, maternal and child health, infectious diseases, outbreak response, and avian influenza. The project’s three task orders support USAID’s efforts to improve product availability.
The project creates and publishes a variety of innovative tools that help logistics professionals manage health programs in developing countries. For example—
Logistics Indicators Assessment Tool (LIAT): The project’s standardized quantitative data collection instrument that measures the availability of health commodities at service delivery points.
Logistics System Assessment Tool (LSAT): A primarily qualitative diagnostic instrument developed by the project to provide an overall picture of the strengths and weaknesses of a logistics system. To date, the LIAT and LSAT have been used in over 15 countries.
PipeLine Software: Manages the flow of essential health commodities.
The Strategic Pathway to Reproductive Health Commodity Security (SPARHCS): Is a framework, process, and tool that helps countries assess and address reproductive health commodity security. Collaborating with USAID missions and the POLICY Project, the DELIVER project helped develop and implement the SPARHCS initiative.
The project fulfills order requests for project-related publications, tools, and software that are requested by individuals and organizations in more than 54 countries. The publications, best practices, and lessons learned on logistics and supply chain management are shared, disseminated, and used throughout the world.
Task Order 1- Public Health In its first year of operation, TO1 responded to requests for assistance and continued its field work in 21 countries, including 15 with field offices; D.C.-based staff supported USAID’s central contraceptive procurement system. The task order also established new core-funded teams, transitioned to a new management information system (MIS), and provided direct procurement services. TO1 works in a wide range of country settings and health systems, including countries that focus primarily on family planning; those that work on family planning in an integrated health service delivery context; countries that work with a variety of essential health medicines; and programs that specialize in HIV/AIDS.
Numerous TO1 achievements, including some key accomplishments and activities, are highlighted below. Further details and highlights are available in the TO1 Annual Report.
Launched the new USAID | DELIVER PROJECT and transitioned from the previous DELIVER project to the new activities, centrally and in the field.
Determined and aligned the project’s workplans, staffing, structures, budgets, and processes with USAID’s priorities and the new business model.
Established a direct procurement capacity and issued contracts for the purchase of $10.4 million in commodities on behalf of USAID.
Supported the distribution of USAID contraceptives and increased on-time deliveries of USAID-procured commodities during a period of transition and change.
Provided technical assistance to 21 countries, with a resident presence in 15 of those countries, including fulfilling 32 requests for short-term technical assistance.
Implemented the DTTU system in Zimbabwe, which ensured that 99 percent of the service delivery points (SDPs) were being supplied with family planning, and now HIV/AIDS, commodities, despite the difficult economic circumstances.
Provided in-country support to the entire supply chain, including strengthening condom forecasts in Uganda; identifying and meeting family planning commodity financing needs in Ghana; continuing support to procurement in Bangladesh, including alerting government and donors to impending procurement delays; and improving warehouses in Ethiopia and last mile distribution in Nepal, Zambia, and Zimbabwe.
Strengthened global contraceptive security efforts by collaborating with the Reproductive Health Supplies Coalition and the Reproductive Health Interchange, as well as through a revised CPT reporting format.
Strengthened local and regional capacity by creating the International Association of Public Health Logisticians (IAPHL). Within three months of launching the association, its website membership grew to more than 115 members from 44 countries and 52 organizations.
Awarded a regional training contract to PRISMA in Peru to increase a local organization’s capacity in supply chain management training. This contract supports PRISMA’s efforts to conduct high-quality supply chain management training courses in the Latin American region and to improve their knowledge of supply chain management of health commodities.
Provided field-funded supply chain management training to over 3,200 health workers and program staff, as well as two core-funded training events for 41 participants from 11 countries.
Promoted databased decision making by enhancing the monthly Procurement Planning and Monitoring Report (PPMR, formerly the CPT Status Report). This new format integrates qualitative information on contraceptive security with up-to-date stock levels in the project’s presence countries; it is used by the Reproductive Health Supplies Coalition Countries at Risk (CAR) group to avert stockouts and expiries of products around the world.
Continued to produce and serve as a repository of useful data and information on supply chain best practices. The project’s website traffic increased by nearly 300 percent; there were more than 430,000 visits to the website and 92,000 publication downloads; and requests for publications came from 54 countries.
Developed monitoring and evaluation tools and mechanisms to monitor and report on project progress overall and on country progress in contraceptive security.
Supported the rapid roll-out of the newly designed National ARV Logistics System in Zambia. In only six weeks, a national team of trainers conducted 23 competency-based workshops for more than 282 service delivery and supervisory personnel.
Conducted a train-the-trainer (TOT) workshop in El Salvador, with 14 technical personnel at the regional level and SIBASI participating. These 14 trainers then held 11 training events with approximately 420 regional and SIBASI technicians, hospital personnel, and secondary-level service providers. Health promoters took part in trainings on various supply chain management issues, including the use of computerized logistics systems, inventory management, quality control and use of an LMIS, and community-based distribution system.
Ensured reliable financing and supply after donor support was withdrawn in Nicaragua. The project worked closely with the contraceptive security committee to ensure that an MOH budget line item for contraceptives and commitment of funds was included. The MOH has allocated $100,000 to procure condoms.
Identified gaps and, drawing on multiple partners to address them, ensured financing for the short- and long-term in Ghana. Under TO1, the project helped USAID/Accra address an impending shortage of condoms by providing 21 million no-logo condoms to fill the gap.
Ensured that condoms reached high risk groups/areas in Uganda. The project moved the system for condom requisition and distribution from a push to a pull system; they also collaborated with the MOH condom coordination unit to train 30 district condom focal persons on condom logistics and the new national condom distribution plan. The districts are now able to determine their order quantities and order condoms based on existing stock.
Researched several new innovations, including adapting technology, such as PDA devices for SDP-level data entry; collaborated with the MIT-Zaragoza program on international logistics to adapt logistics segmentation techniques to help system design; and developed virtual leadership tools with USAID’s Leadership Management and Sustainability (LMS) program.
Task Order 2- Outbreak Response Supply Chain Management From its beginning in March 2007, the USAID | DELIVER PROJECT's Task Order 2 has made unprecedented progress in creating new systems and delivering avian influenza commodities and other outbreak response commodities to the most-at-risk countries worldwide. USAID can now state with confidence that commodities for containment and response to emerging and exisiting pandemic threats can be delivered to requesting countries, on demand, in a very short time. Project achievements are summarized below. Further details and highlights are available in the TO2 Annual Report.
Successfully transferred 95 percent of the inherited Avian Influenza International Stockpile (AIIS) to the new MAP Savannah warehouse within two months. This transfer involved 110 50-foot semi-trailers—almost a mile of commodities.
Operationalized a functioning 62,000 square foot warehouse in the first two months.
Due to unexpected logistics problems, reprocessed and handled almost every carton of supplies from the inherited stockpile—over 1.2 million.
Processed and delivered the first emergency shipment to Ghana in five days.
Made 363 shipments to 91 countries, with a total value of $14,035,587. Established a comprehensive management information system to provide current information about all aspects of the global distribution mechanism for outbreak response commodities.
Held the first-ever commodity coordination meetings with USAID, CDC, HHS, the State Department, USDA, WHO, and FAO. To review outbreak response kits and other related supplies.
In Nigeria, began USAID AI partner collaboration with the first joint in-country technical mission and designed and implemented a logistics management information system to support the Ministry of Agriculture response to avian influenza outbreaks.
Developed and implemented Operational Research in Indonesia for More Effective Control of Highly Pathogenic Avian Influenza (OR); a study that evaluated the feasibility and effectiveness of several HPAI control strategies, such as vaccination and depopulation
Provided critical technical assistance in the design and implementation of the cold chain and supply chain operations, ensuring that each Indonesia district participating in the study was prepared to receive and administer the vaccine to the poultry population. The cold chain system has become a model for the Ministry of Agriculture Animal Health Division and an example of best practices for vaccination programs.
In response to an emergency request from the Office of Foreign Disaster Assistance task force managing the USG response to the H1N1 influenza outbreak, mobilized an emergency shipment to the Government of Mexico, delivering 100,000 PPE within 36 hours of the request.
In September 2009, the task order mandate was expanded to include the procurement, management, and distribution of commodities for existing and emerging pandemic threats. In the coming months, the project will be providing commodities and assistance, on behalf of USAID, as part of USAID’s support to WHO’s response to the global H1N1 pandemic. TO2 is providing ancillary vaccine, laboratory, and surveillance equipment to complement WHO’s donation of H1N1 vaccine to 54 developing countries.
TO3 has seen a steady growth in activities since it was awarded; a large increase in focus countries is expected in the coming year. Key achievements include managing project start up and mobilizing a new team, including the recruitment of several new staff. The new TO3 team has been integrated into both the overall IQC management structure, as well as the wider project culture, with support from staff at several different levels. This has ensured that the IQC and TO3 team have been able to provide a rapid response for both requests for forecasting and system assessment STTA, as well as the procurement and in-country distribution of malaria commodities.
Recent key task order accomplishments are highlighted below. Further details and highlights are available in the IQC Semi-Annual Report.
Procured commodities worth $21,307, 644 for Angola, Benin, Liberia, Malawi, Mali, Mozambique, Nigeria, Rwanda, Senegal, Tanzania, Uganda, and Zambia.
Delivered 6,340,240 treatments of malaria pharmaceuticals to five countries; 460, 115 LLINs to two countries; and 1,129,000 RDTs to two countries.
In Liberia, contributed technical assistance for door-to-door distribution of LLINs during the country's PMI launch, covering nearly 100 percent of the targeted population.
In Angola, coordinated emergency room in-country ACT distributions to avert pending stockouts.
In Ghana, assessed the malaria commodities supply system and planned the implementation of those PMI-funded activities that the project and SPS will carry out from 2008 to 2010.
In Mozambique, piloted a type of cool box in Maputo, Tete, and Quelimane provinces to store malaria commodities, developed training materials on new protocol for malaria treatment for MOH staff, and participated in a malaria working group to produce a three-year plan for addressing malaria.
Developed wholesaler and manufacturer questionnaires that helped identify and ensure quality malaria and commodity procurement.
Conducted several joint assessments with MSH's project, Strengthening Pharmaceutical Systems, including productive joint missions to Madagascar and Ghana.
Participated in a number of international malaria meetings to address and improve the global supply of malaria commodities.
In the coming year, as the volume of work increases, we will recruit additional technical, management, and administrative staff. We will also rerun expressions of interest for key product categories and continue to refine our QA procedures to ensure that we are buying the best quality products on behalf of the U,S, Government and national malaria control programs. The first TO3-specific field office will open in Liberia in the next quarter; we anticipate a growing demand for STTA to support in-country supply chain strengthening.
Supply chain improvements benefit public health programs in three important ways: more clients receive the commodities they need; health care providers can offer higher quality care to their clients; and health programs become more effective and cost-efficient.
A strong supply chain for health products in developing countries contributes to improved cost-effectiveness in all parts of a program; it can stretch limited resources by reducing loss due to overstock, waste, expiry, damage, pilferage, and inefficiency.
Without the necessary supplies, reproductive health programs cannot provide services. By giving women in the developing world access to the full range of contraceptives, it is possible to prevent approximately one of every four pregnancy-related deaths.
Women without access to reproductive health care and commodities face an increased risk of birth complications, unintended or mistimed pregnancies, infectious diseases, and death.
Reproductive health commodity security (RHCS) exists when every person is able to choose, obtain, and use quality contraceptives and other essential reproductive health products whenever she or he needs them.
Programs can achieve security for contraceptives and other essential products by—
estimating their product needs accurately
identifying adequate financing
conducting timely procurement
delivering the goods reliably to all customers at every type of service outlet.
