Providing reliable last miles access to contraceptives and other essentials medicines :The Informed Push Model with third party logistics providers in Senegal

The use of contraception is recognized as one of the most cost-e ective ways to lower maternal mortality rates – potentially averting one-third of maternal deaths by reducing the overall number of pregnancies and helping women plan and space their pregnancies.1 The modern contraceptive prevalence rate (mCPR) among women of reproductive age in Senegal, though increasing, is among the lowest in the world due in part to product stock-outs at public health facilities.2,3

To solve the stock-out problem, and to increase access to these potentially lifesaving products, the government of Senegal, led by the Ministry of Health and Social Action (MoHSA) and National Supply Pharmacy (PNA), in partnership with IntraHealth International (IntraHealth) and with support from Merck for Mothers* and the Bill & Melinda Gates Foundation, designed, piloted and scaled up the Informed Push Model with third party logistics providers (IPM-3PL).

IPM-3PL is a last mile direct delivery model that has strengthened commodity, data, and nancial ows across the public health supply chain.

  • Through this model, 3PLs deliver commodities directly to health facilities, making real-time stocking decisions based on inventory and consumption data. 3PL logisticians perform forecasting, logistics, and data management on behalf of facility sta .
  • 3PLs enter data into a tablet-based electronic logistics management information system (eLMIS), which feeds data in real time to authorities at the district, regional and national levels, and facilitates health program monitoring.
  • Health facilities pay for commodities after they are purchased by customers, ensuring availability of a broad range of commodities, and adequate cash collection to cover the supplied commodities.

Beginning in 2015, the model was scaled nationally and has reduced contraceptive stock-outs to an average of 2% of all health facilities nationwide4, improving access to contraceptives for an estimated 3.2 million women. Moreover, consumption data from more than 1,400 health facilities are now electronically captured and available for procurement and programmatic decision- making.

Given these results, the MoHSA and PNA have expanded IPM-3PL to include other essential commodities beyond contraception, as a part of a broader supply chain transformation called “Yeski Naa” (“I have arrived”). By late 2017, management of the model has been transitioned to the government of Senegal.

Lessons learned in Senegal are applicable to other low-resource settings. IPM-3PL is a model for integrating private sector logistics providers into public health supply chains, streamlining supply chains across multiple commodities, providing real- time data for decision-making, and creating mechanisms to nance and sustain supply chain reforms over time.

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