Unpacking the impact of integrating the neglected tropical disease supply chain into the national supply chain system: illustrative evidence from Liberia

Abstract

Effective supply chain management is a critical pillar of well-functioning health systems ensuring that medical commodities reach those in need. In Liberia, the national neglected tropical disease (NTD) programme supports health systems strengthening for case management of NTDs. Integration of NTD commodities into the national health system supply chain is central to the integrated approach; however, there is minimal evidence on enablers and barriers. Drawing on qualitative evaluation data, we illustrate that perceived benefits and strengths to integrating NTD commodities into the supply chain include leveraged storage and management capacities capitalized at lower system levels; the political will to integrate based on cost-saving and capacity strengthening potential and positive progress integrating paper-based reporting tools. Challenges remain, specifically the risk of reliance on donor funding; difficulty in accessing commodities due to bureaucratic bottlenecks; lack of inclusion of NTD commodities within electronic data tools and poor coordination leading to an inability to meet demand. Collectively, the negative consequences of ineffective integration of NTD commodities into the supply chain has a detrimental impact on health workers (including community health workers) unable to deliver the quality of care to patients. Trust between affected populations and the health system is compromised when treatments are unavailable.

Multimethod evaluation of health services integration for neglected tropical diseases requiring case management in Liberia

“…Several other factors, including supportive supervision, mentoring and a sufficient supply of medicine and supplies, have enhanced access and scaled up the process. However, key barriers remain, such as weakness in the availability of medicine, uncertainty about the sustainability of medical supplies through the national supply chain system26 and the need for continuous in-service training. While our findings confirmed the importance of training for the success of the integrated approach as suggested by Barogui et al and Means et al .,20 22 training as an isolated intervention, as recommended by Barogui et al cannot achieve the level of success without other inputs and can be counterproductive to strengthening health systems if increased demand is not met with increased supply 22.…”