A stewardship approach to shaping the future of public health supply chain systems

Bornbusch, Alan H.; Dickens, Todd; Hart, Carolyn; Wright, Chris F.

doi:10.9745/ghsp-d-14-00123

Cited by 9 publications

(7 citation statements)

References 2 publications

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“…Commodities required for BNC and resuscitation should be available everywhere births occur; however, many LMIC health facilities lack these commodities and the prerequisites for hygienic practices such as clean water, soap, gloves and alcohol rub. Effective logistic information systems that monitor local and national uptake of commodities and transparent procurement procedures could address some of the perceived barriers [ 54 ].…”

Section: Discussionmentioning

confidence: 99%

Basic newborn care and neonatal resuscitation: a multi-country analysis of health system bottlenecks and potential solutions

Enweronu‐Laryea

Dickson

Moxon

et al. 2015

BMC Pregnancy Childbirth

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BackgroundAn estimated two-thirds of the world's 2.7 million newborn deaths could be prevented with quality care at birth and during the postnatal period. Basic Newborn Care (BNC) is part of the solution and includes hygienic birth and newborn care practices including cord care, thermal care, and early and exclusive breastfeeding. Timely provision of resuscitation if needed is also critical to newborn survival. This paper describes health system barriers to BNC and neonatal resuscitation and proposes solutions to scale up evidence-based strategies.MethodsThe maternal and newborn bottleneck analysis tool was applied by 12 countries in Africa and Asia as part of the Every Newborn Action Plan process. Country workshops engaged technical experts to complete the survey tool, which is designed to synthesise and grade health system "bottlenecks" that hinder the scale up of maternal-newborn intervention packages. We used quantitative and qualitative methods to analyse the bottleneck data, combined with literature review, to present priority bottlenecks and actions relevant to different health system building blocks for BNC and neonatal resuscitation.ResultsEleven of the 12 countries provided grading data. Overall, bottlenecks were graded more severely for resuscitation. The most severely graded bottlenecks for BNC were health workforce (8 of 11 countries), health financing (9 out of 11) and service delivery (7 out of 9); and for neonatal resuscitation, workforce (9 out of 10), essential commodities (9 out of 10) and service delivery (8 out of 10). Country teams from Africa graded bottlenecks overall more severely. Improving workforce performance, availability of essential commodities, and well-integrated health service delivery were the key solutions proposed.ConclusionsBNC was perceived to have the least health system challenges among the seven maternal and newborn intervention packages assessed. Although neonatal resuscitation bottlenecks were graded more severe than for BNC, similarities particularly in the workforce and service delivery building blocks highlight the inextricable link between the two interventions and the need to equip birth attendants with requisite skills and commodities to assess and care for every newborn. Solutions highlighted by country teams include ensuring more investment to improve workforce performance and distribution, especially numbers of skilled birth attendants, incentives for placement in challenging settings, and skills-based training particularly for neonatal resuscitation.

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Section: Discussionmentioning

confidence: 99%

Basic newborn care and neonatal resuscitation: a multi-country analysis of health system bottlenecks and potential solutions

Enweronu‐Laryea

Dickson

Moxon

et al. 2015

BMC Pregnancy Childbirth

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“…Unfortunately, doing so does not tap the benefits that multiplicity offers in reducing the risk of dependency on a single logistics pipeline and the benefits that competition offers in reducing the number of societal resources spent on ensuring health commodity security. 2 However, in moving from the ad hoc to the extended phase of the roadmap, one may ask: What institutional arrangements should be present at that stage of the roadmap, and how can they be developed? A detailed answer to this question should consider all the constituent functions of logistics systems and supply chains.…”

Section: Introductionmentioning

confidence: 99%

Transforming Supply Logistics for Health Commodity Security in Africa

Tetteh

2024

Glob Health Sci Pract

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To resolve problems of ensuring secure supplies of all health commodities, health planners in African countries must first identify arrangements that best serve the public interests of promoting choice and competition in ensuring health commodity security.n Investments in inventory management should not be viewed as a one-off exercise but rather as a continuous search for the optimal scale and scope of operations that ensure the availability of essential health commodities most of the time.n Without competing alternatives to manage inventory, public-sector logistics monopolies lack adequate incentives to devise ways of reducing costs and improving output. Further, these monopolies make it more difficult to minimize the impact and duration of catastrophic supply disruptions.n Current efforts to improve public-sector supply logistics must be extended to include the transformation of existing public and private logistics infrastructure for inventory management into a state of prudent multiplicity-one in which there are at least 2 full-line national logistics institutions competing to serve all government, nongovernmental, and private health facilities.n Health planners should consider creating a state of prudent multiplicity in their roadmaps, master plans, and health system strengthening initiatives.

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“…One of the most telling takeaways from these proceedings came from the committee's chair, Tara O'Toole, vice president of In‐Q‐Tel, who noted: “obsession with cost and profit has now infiltrated our sense of public health and how we are going to take care of each other in the most dire circumstances.” 10 (p44) This is especially important, since one assessment of the public health supply chain has been that in public health, “the bottom line is saving and improving lives, which should be as powerful a motivator for rethinking supply systems as profit is in the commercial sector.” 8 …”

Section: Introductionmentioning

confidence: 99%

“…Stewardship does not require the direct control of services and facilities; rather, stewards are responsible for engaging and orchestrating different partners to achieve common development goals 8 . And as is increasingly recognized by public health and has become evident in the initial months of the COVID‐19 pandemic in the United States, the private sector has an important role, and government can learn from the commercial sector 8 . (p408)…”

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confidence: 99%

A Commons for a Supply Chain in the Post‐COVID‐19 Era: The Case for a Reformed Strategic National Stockpile

et al. 2020

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Reflecting on current response deficiencies, we offer a model for a national contingency supply chain cell (NCSCC) construct to manage the medical materials supply chain in support of emergencies, such as COVID-19. We develop the following: r a framework for governance and response to enable a globally independent supply chain; r a flexible structure to accommodate the requirements of state and county health systems for receiving and distributing materials; and r a national material "control tower" to improve transparency and realtime access to material status and location. Context: Much of the discussion about the failure of the COVID-19 supply chain has centered on personal protective equipment (PPE) and the degree of vulnerability of care. Prior research on supply chain risks have focused on mitigating the risk of disruptions of specific purchased materials within a bounded region or on the shifting status of cross-border export restrictions. But COVID-19 has impacted every purchase category, region, and border. This paper is responsive to the National Academies of Sciences, Engineering and

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A stewardship approach to shaping the future of public health supply chain systems

Cited by 9 publications

References 2 publications

Basic newborn care and neonatal resuscitation: a multi-country analysis of health system bottlenecks and potential solutions

Basic newborn care and neonatal resuscitation: a multi-country analysis of health system bottlenecks and potential solutions

Transforming Supply Logistics for Health Commodity Security in Africa

A Commons for a Supply Chain in the Post‐COVID‐19 Era: The Case for a Reformed Strategic National Stockpile

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