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May 2, 2017

Benin: A Success Story in Malaria Supply Chain Management



In Benin, three major challenges impact the health system's capacity to implement an effective national program for malaria control: limited capacity, the unreliability of the health information system, and weaknesses in supply chain management - resulting in pilfering, stock-outs, and the expiration of medicines. To resolve this situation, USAID and MCDI's Accelerating the Reduction of Malaria Morbidity and Mortality (ARM3) Project, jointly with the National Malaria Control Program (NMCP), developed two strategies to improve stock management, supply chain management and case management.

Given the challenge of fragmented forecasting and stock management practices, in 2015, the Ministry of Health established a national pooled mechanism, which involves the pooling of different stocks of commodities acquired or received as donations by all actors involved in the fight against malaria (such as USAID, the Global Fund, etc.) without requiring the pooling of funds. The pooled mechanism is positioned to promote national local ownership of all malaria forecasting and management of commodities and to improve the overall integration of supply chains across all malaria products and donors, ultimately reducing the risk of stock-outs.

To adhere to the monitoring and storage condition requirements necessary for success, a strong monitoring mechanism is essential. In 2015, Benin introduced "100% supervision" at the district level. This on-the-job capacity building approach is based on frequent, focused supervision at every health center (public and registered private sector) on a monthly basis. The objectives of 100% supervision are to prevent stock-outs at the facility and district warehouse levels, and improve the timeliness, completeness, and coherence of the logistics management information system (LMIS) reports. The two innovations operate in synergistic, top-down (pooled management) and bottom-up (100% supervision) directions, positively impacting stock management, LMIS data, and, ultimately, malaria case management.

"Monthly 100% supervision has brought a clear improvement in the rational management of malaria commodities based on the information system and logistics management, the adherence to the national policy of malaria management and a good filling-out of the management tools" says Warehouse Manager Daniel Agodou.

Good coordination and communication practices between donors and the NMCP facilitated by the pooled malaria commodity management mechanism improved pharmaceutical management practices, including: appropriate procurement plans, first-expired/first-out, commodity storage, development of risk assessments, and led to early identification and management of overstock and stock-outs to avoid wasted resources. The improvement in the supply chain metrics and indicators achieved through the 100% supervision, as part of the effort to strengthen the local health level, is evident. The approach was extended to two low performing districts in 2016 and is planned to be scaled up to 12 more districts in 2017.

Dr. Adjibabi, head of the NMCP pharmacy and pharmaco-vigilance (SPPV) service, USAID Benin Commodity & Logistics Specialist Mr. Ricardo Missihoun and ARM3’s Supply Chain Management Manager Dr. Gbaguidi presented the findings from the pilot of these programs at the 2016 Global Health Supply Chain Summit held in Dar es Salaam, Tanzania. The team received the second place prize for the innovative approach.





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