Background
The Ghana Integrated Logistics Management Information System (GhiLMIS) is designed tosupport supply chain decision making, inventory visibility and operations throughout the entire supply chain. It is currently implemented in over 1500 facilities. The system implementation is funded by the Global Fund and its successful implem9entation is based on a patient centric driven approach, ensuring quality data production and use, while improving and optimizing operational performance and reducing overall supply chain costs. The shifting of the paradigm, from the mundane reporting driven systems, and focusing on usage of data for informed decisions, led to significant impacts within the shortest period. This transformational approach enabled full utilization of the system in meeting and addressing covid-19 supply chain needs. It facilitated the adoption of an agile approach in addressing the disruptions caused by the pandemic and provided critical data that facilitated effective decision making and responsiveness.
The response
The Government of Ghana (GoG) commitment to the COVID-19 pandemic response has been exceedingly high. As evidenced in the Ministry of Health National Strategic Covid-19 Response Plan, the GoG adopted an approach that was consultative and reliant on evidence from data and science for informed decision making.
Key to this plan was to procure and distribute the appropriate medicines and supplies for treatment of cases to enable early initiation of treatment to reduce morbidity and mortality. One of the key systems used to achieve this objective was the GhiLMIS. The system was used to capture and process all covid-19 related items transactions through the entire value chain. Transactions included capturing item receipt data in real time, inventory transactions like issues, consumption and transfers, stock status updates including available stock, stocked according to plan, and stock outs. Further to transactional processing, the system was used to track and trace all Covid-19 items throughout the supply chain. Additionally, data derived from the system was leveraged to inform decisions including demand and supply planning and scenario modeling leading to distribution segmentation and demand prioritization.
The availability of this critical data was instrumental in helping the Ghana Ministry of Health (MoH) and Ghana Health Services (GHS) in planning and decision making to address the country Covid-19 needs and mitigate and addressing pandemic disruptions to the entire supply chain. The data was instrumental in the execution of both supply and demand planning activities through intelligent demand, using the replenishment sensing engine. This enabled, development and implementation of an effective supply chain plan, that was agile and responsive to all the disruptions brought by Covid-19. It informed which items and sites needs were to be prioritized, enabling the strategic moving of inventory and repurposing stocking and distribution of items to sites with high demand.
Additionally, leveraging workflow management capabilities, GhiLMIS facilitated end to end collaboration between multiple tiers and ensured responsiveness that addressed customer needs in real time. By using the order management module, multiple tiered vendors and customers managed to collaborate in addressing site needs in real time, while offering alternatives to commodities that were not in stock at the time of the request. This established efficiencies, significantly reducing cycle time and providing both agility and responsiveness that were needed to address the new demands.
As part of inventory projection and forecasts, the GhiLMIS analytic engine was used to provide multiple scenarios to addressing any perceived and real demands. In addition to the GhiLMIS transaction analysis capabilities, the team leveraged power BI to conduct both predictive and prescriptive analytics to model multiple scenarios. This enabled establishment of a resilient and risk management supply chain, that was leveraged to address any disruptions in the supply chain, making it responsive to any variations and creating responsive capabilities to address any challenges. By using GhiLMIS data driven supply chain decision, the Ghana MoH effectively managed the disruptions created by the pandemic and provided a foundation for future growth.
The approach:
To effectively utilize the system and address the challenges created by the pandemic,
Systems For Development (S4D) GhiLMIS team supported the Ghana Health Service and Temporary Medical Central Stores (TCMS) to develop a 5 phased agile approach. The approach was instrumental in creating an agile and responsive strategy that successfully contributed to the fight against Covid-19, while minimizing the disruption impacts on other commodities supply chains
- Critical Covid Agile Response Team
An agile MoH/GHS team supported by the S4D GhiLMIS team was setup to develop strategies that can address the Covid-19 supply chain needs, identify disruption challenges, and align the supply chain capability outputs with customer needs. The team also, focused on achieving better outcomes and creation an agile supply chain management framework to address the pandemic challenges.
- Identify system functionality and enable data visibility capabilities
Key system functionality to support supply chain agility and responsiveness were identified and utilized. This included enabling both transactional and analytic capabilities, like receipts, issues, transfers, consumption, replenishment planning, demand sensing technologies, Key Performance Indicators (KPIs) and projected inventory views. These capabilities provided the MoH/GHS with a more accurate picture of the current transactions in real time, and future demand while enabling scenario modeling to address any real and perceived disruptions. Additionally, availability of critical data in real time contributed to improvement in efficiency, visibility, flexibility, responsiveness, and transparency along the entire supply chain.
- Establish data use mechanisms to support decision making
The data in GhiLMIS was used by the team and key stakeholders like the presidential task force on covid-19 to support decision making and planning. Data was critical in informing leadership on which items needed urgent replenishment, highlighted consumption trend, and when triangulated with patient data and infection rates, it guided the procurement decision and mitigations to perceived challenges. It was established that gaining quicker access to data helped MoH/GHS respond intelligently, increased product availability, and improved agile supply chain management.
- Segmentation Definition and Demand Prioritization
Using both pandemic and supply chain data, the team managed to create distribution and demand segmentation. Critical items and high demand sites which required items urgently were prioritized. Segmentation also helped in identifying inventory norms, capacity allocations, planning frequency and where exception-based planning like Covid-19 isolation centers should be used.
- Evaluated Supply Chain Scenarios
Leveraging the GhiLMIS inventory projection capabilities and using power BI analytics, the team run multiple scenarios to predict when and where excesses and shortages were likely to occur. Additionally, end-to-end scenarios were also run to have actionable insights that will optimize the operational metrics and help MoH/GHS navigate the pandemic as effectively as possible. The availability of real-time data enabled abilities to see and predict demand shifts by product and regions. Finally, the GhiLMIS data provided capability to prioritize or repurpose new and critical in-demand products, such as PPEs and treatment protocols.
Lessons Learned and Next Steps
The interruptions caused by the pandemic created a critical need to redesign the Ghana public health supply chain. It emphasized the need to establish an agile and responsive supply chain management system, that is both effective and efficient in fighting any disruptions future and current. It highlighted how data plays a critical role in addressing supply chain needs, creates agile opportunities and facilitates resilience.
As such, it will be prudent to leverage lessons learned to establish mechanisms that will facilitate the capture of pandemic related supply chain transactions:
- Build mechanisms that support generation of critical supply chain information in real time
- Support development and establishment of supply and demand planning tools to assist in quantification and multiple impact scenarios and mitigations
- Leverage service data to build system mechanisms that mitigates disruptions to patient treatment regimens e.g., multi month dispensing.
Additionally, we will need to develop a framework that will facilitate addressing similar scenarios and create a sustainable infrastructure that can sustain the supply chains, establish mechanisms for post market surveillance, conduct monitoring and evaluation activities, strengthen
supply chain systems to address current and post covid challenges.
The COVID-19 pandemic has radically affected every share of life around the world, more specifically, public health and socio-economic aspects. Within the framework of whole-of-government’ and ‘whole-of-society, the GoG activated the National Emergency Preparedness Plan to mitigate the effects of the disease on public health and socio-economic development. It was established that the availability of real time and accurate data plays a critical role in planning mitigations. Today available data indicates that the National Emergency Preparedness Plan has yielded some appreciable success since its implementation, although some challenges continue to persist.
By Philip Lule, Bernard Asamany and Cyril Dan Lardy
Bernard Asamany is the Deputy Director for Ghana Health Services, Supplies, Stores and Drug Management Division with additional responsibility as The Head for Ghana Ministry of Health’s Temporary Central Medical Stores.
Philip Lule is the GhiLMIS implementation project lead and CEO for Systems For Development (S4D) Consulting.
Cyril Dan Lardy is the systems engineer at S4D Consulting LLC and a member of the GhiLMIS Implementation Team
