The Global Health Supply Chain – Technical Assistance – Tanzania aims to improve the health status of Tanzanians by increasing access to health commodities, strengthening accountability, and promoting sustainable financing through the development of an agile, flexible and sustainable health supply chain in Tanzania. The project works to increase the ability of the Government of Tanzania (GOT) to deliver healthcare services through an improved health supply chain. JSI provides in-country logistics support to improve the delivery of health commodities to service sites and strengthen the enabling environment to improve supply chain performance. JSI focuses on the eLMIS, capacity building and data use, and system redesign components.
While Tanzania has made tremendous progress in improving product availability, challenges still remain: 70% of the population lives in rural areas where access to essential commodities is low. Suboptimal governance and ownership of the supply chain have limited transformational supply chain improvements. HIV, tuberculosis, and preventable and treatable diseases such as malaria, pneumonia and diarrhea remain public health challenges.
Global Health Supply Chain – Technical Assistance – Tanzania (GHSC-TA-TZ)
A well-functioning health system requires a strong supply chain to ensure health supplies reach those most in need in a secure, timely, and cost-efficient manner. GHSC TA-TZ provides specialized technical assistance to the Government of Tanzania (GoT) to strengthen country supply chain systems across priority public health programs such as malaria, HIV and AIDS, tuberculosis, family planning, and maternal, newborn and child health.
The project assists the government of Tanzania's health programs and stakeholders across four objectives by:
- providing strategic planning and implementation assistance to the government,
- improving delivery of health commodities in service sites,
- broadening stakeholders' understanding and engagement of the supply chain system, and
- creating an enabling environment to improve supply chain performance.
The project is applying leading industry approaches and practices and other health systems strengthening interventions to strengthen the Tanzania public health supply chain by fundamentally improving medicine availability.
Through GHSC-TA-TZ, we will mentor leaders from the Ministry of Health, Community, Development, Gender, Elderly and Children (MOHCDGEC), the President’s Office of Regional Administration and Local Government (PO-RALG) and Medical Stores Department (MSD), train and transfer capabilities to Logistics Management Unit (LMU), and identify opportunities to strengthen the public sector health supply chain to achieve the development objectives of the Tanzania Country Development Cooperation Strategy (CDCS): empower women and youth, improve democratic governance, and improve data driven decision-making, planning and implementation.
Through the capacity building of the LMU and effective use of the eLMIS, GHSC-TA-TZ will strengthen important verticals that rely on a strong supply chain, such as the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the President’s Malaria Initiative (PMI), and the Family Planning 2020 (FP2020) Women Deliver initiative that rely on the strong health supply chain to increase access for women, children and patients across the country have to life saving medications and contraceptives.
By focusing on quality of data—and the data value chain—the program aims to improve transparency and accountability, inform strategic planning, identify effective supply chain improvements, and provide value to all health supply chain stakeholders. In addition, by strengthening the enabling environment through health financing and governance and accountability, this will help to ensure sustainability of supply chain transformation activities.
The project works to align stakeholders on national supply chain objectives, hold them accountable for their contributions towards strategic plans, and promote deliberate and routine integration of costing and financing components into supply chain interventions and activities.
The Logistics Management Unit (LMU) is a structure that was established by the GoT, with support from USAID and the Global Fund, to coordinate supply chain activities of different programs under one unit. GHSC TA-TZ, in addition to providing technical assistance to the central level LMU, supported the operations of the LMU at the zonal level in mainland Tanzania and Zanzibar. JSI played an important role in facilitating the formal transition of the LMU from donor support into government structures, and continues to focus on building the capacity of government stakeholders to assume some of the tasks and responsibilities that the LMU has historically performed.
GHSC TA-TZ supports the implementation of the electronic logistics management information system (eLMIS), to improve data visibility, the quality of data collected through automated data validation, and use of information. Support for eLMIS is provided in the context of broader support to the Health Information System (HIS) architecture, and the project facilitates integration with Epicor9, DHIS2, the Government of Tanzania Hospital Management Information System (GoTHOMIS), and the Health Information Mediator (an interoperability layer). Technical assistance through JSI includes providing eLMIS help desk support, building capacity of GoT staff to provide user support, and in developing dashboards, visualizations, and analytics. The project has developed an eLMIS transition plan, which outlines steps to transition the management and ownership of the eLMIS to GoT counterparts.
The project places special emphasis on improving data quality, use, and analytics. JSI has supported efforts to improve data quality including rolling out Information Mobilized for Performance Analysis and Continuous Improvement (IMPACT) teams in selected regions with the objective of building the capacity of district pharmacists to oversee data quality in their review of reports and requisitions, automating data capture at the facility level by integrating facility management information systems with the eLMIS, supporting facilities to directly enter data into eLMIS, coordinating with PO-RALG to identify facilities and councils who consistently provide low quality data, conducting data quality assessments and supportive supervision activities, and routinely comparing supply chain data with service data.
Other areas of focus of the project include: providing technical assistance and building capacity in quantification, planning for and supporting transitions to optimal ART regimens, strengthening the laboratory supply chain, supporting the redesign and implementation of in-country logistics systems, and aiding the implementation of a results-based financing scheme.
Collaboration with in-country stakeholders is central to the project’s approach to supply chain strengthening, decision-making, and management. Coordination groups (such as commodity security meetings and technical working groups) provide a mechanism to share supply chain data, align objectives, and facilitate the effective management of commodity-related resources across stakeholders. The project provides quantitative and qualitative data on supply chain performance to these groups to promote information sharing and the use of data for decision making.
Finally, the project has worked to strengthen Tanzania’s capacity to prepare for and respond to unfolding public health emergencies including Ebola and cholera. The project, in collaboration with MOHCDGEC, developed the Tanzania Emergency Supply Chain Operations Guidelines, and then used these guidelines to conduct a series of simulation exercises. During the exercises, participants practiced decision-making during simulated Ebola and Cholera outbreaks. These simulated scenarios provided participants a low-stakes environment in which to learn and apply leading practices in communication and coordination.
JSI’s Tanzanian team brings deep technical experience in supply chain strengthening, as well as in-country presence in Tanzania, and collegial and productive relationships across stakeholders in the country, including GoT, implementing partners, and donors.
GHSC TA-TZ is a five-year project led by Guidehouse and includes John Snow, Inc. (JSI), Abt Associates,VillageReach, the University of Dar es Salaam, and Pharmaceutical Systems Africa.