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Picture of drug delivery in Mozambique courtesy of VillageReach Picture of drug delivery in Mozambique courtesy of VillageReach Photo credit: VillageReach

Improving visibility in humanitarian supply chains

by Natalie Privett
24 February 2014

Humanitarian supply chains must function in the most challenging environments and, consequently, supply chain visibility – information and data, for instance regarding products in transit and availability and stock levels at storage and distribution points – can often be poor. Increasing supply chain visibility has the potential to greatly improve humanitarian operations by providing data to inform more effective and accurate decisions, enabling evidence-based interventions and management, exposing issues for effective remedy and increasing accountability. This article identifies a core set of visibility needs for humanitarian supply chains, discusses technology and pilot projects aimed at providing increased visibility and compares and analyses current approaches.

Visibility needs

A common set of visibility needs can be identified for both disaster response settings and prolonged crises.

  1. Be robust to the contextual challenges of humanitarian settings, including compromised infrastructure (e.g. roads, electricity and mobile networks), remoteness, lack of human resources and environmental conditions.
  2. Track the location of products. Such information can greatly aid in management and ordering decisions, increase shipment security and reduce loss and theft.
  3. Track inventory levels, especially as inventory discrepancies are a persistent problem. Inventory information can be used to balance inventory across the system, facilitate transshipment, inform inventory allocation and ultimately improve inventory management and system performance.
  4. Share information – especially important in a fragmented and uncoordinated system – to enhance visibility and coordination.
  5. Support decision-making because information alone is insufficient. Information technology and software are possible solutions to improve visibility, responsiveness, monitoring and reporting.

Non-technology-based products

Modest projects avoiding technology are independent of infrastructure and have proved effective for even remote facilities. However, they require training and reporting, making them labour- and time-intensive. Furthermore, they can be prone to data inaccuracy.

VillageReach
VillageReach is a non-profit organisation focusing on last-mile distribution and logistics, with particular emphasis on health delivery. In this project a ‘small number of specialized workers visit each health center once a month to deliver vaccines and supplies, repair equipment, facilitate an information system and provide supportive supervision’.[1] In these visits, field coordinators use a paper form to record information about inventory levels, equipment status and services provided. At a district office, the data is entered and sent via the Internet to headquarters. The project was intended to improve access, increase vaccine coverage rates and reduce stockouts, as well as increasing understanding of demand patterns. Under the pilot, average coverage rates increased from 69% to 95%, and the number of health posts reporting a stockout each month fell from 80% to less than 1%.[2] The project was piloted in the rural province of Cabo Delgado in Mozambique and has now been deployed in Niassa and Nampula provinces as well.

Curatio Franchised Pharmacies
These pharmacies in Ghana were intended to create new private sector distribution and supply channels for pharmaceutical products. In this system of pharmacies, a second person rides with the delivery truck to collect information and replenish drugs for half of their time.[3] This process is designed to collect information, reduce costs, ensure quality and improve access and availability.

Mature technologies

Several mature technologies dominate tracking and tracing in global supply chains.

1Dand 2D Barcodes
1D and 2D barcodes are optical machine-readable representations of data about the item to which they are attached (2D barcodes have notably higher data capacity). Information cannot be updated or changed. Readers are needed to read the data, though software can enable reading capabilities on other devices (e.g. PDAs).

Radio Frequency Identification (RFID)
These tags, which consist of a microchip and antenna, attach directly to products or packaging. In-place readers are required, which emit, receive and convert electromagnetic waves to communicate with tags. Thus, RFID tags do not have to pass by a physical reader like barcodes do; instead, they can be read whenever they are within a reader’s coverage area. There are two main types of RFID tags, passive and active. An important difference is that information on active tags can be updated and changed.

Global Positioning System (GPS)
GPS typically reports time, location and relative movement using an in-place standard satellite positioning service. As such, it is relatively independent of infrastructure and able to operate even in the most remote and distressed regions. GPS is mainly used for vehicle tracking, though other uses are clearly possible. GPS can also be used in collaboration with geographic information systems (GIS), which manage, analyse, manipulate and visually display location data. However, such advanced tools can require more expertise and human resources.

Mobile phone projects and technologies

Mobile technology and connectivity are booming. Worldwide, 79 out of every 100 people – more than five billion – are mobile phone subscribers. In developing countries the figure is 77 per 100, or more than 2.2bn. Using this technology, data collection can be significantly boosted, even in remote regions.

SMS for Life
This public–private collaboration between Roll Back Malaria, Novartis, Google, IBM, Vodaphone and local cell phone providers was a 21-week pilot project in 2009–2010 involving 129 health facilities serving 1.2 million people in Tanzania.[4] In this project, health workers sent messages containing stock level information and a central website allowed stock level reports in on-line, paper and map formats. The project was intended to collect accurate stockout and inventory information at health facilities, and it did provide reliable weekly data. Data accuracy improved, achieving 94% in the pilot. Aims also included increased availability and reduced stockouts. This scalable approach requires training, personal cell phones and a collaboration structure between multiple public and private partners.

UNICEF Rapid SMS
This open-source, customisable initiative was developed by UNICEF’s Innovation Division with Dimagi and the Open Mobile Consortium. Customisable SMS forms allowed collection of both quantitative and qualitative data. The web interface allowed multiple users around the world to simultaneously access real-time data and SMS users in the field. So far, the approach has been piloted and/or implemented in Malawi, Ethiopia, Senegal, Nigeria, Somalia and Kenya.

Save the Children ‘McAID’
As part of Save the Children USA’s Jibon o Jibika development assistance programme, an integrated information management system, ‘McAid’, was developed for Maternal and Child Aid, and became fully functional in January 2009. Its original objectives included facilitating quick and easy look-up of beneficiary information, improving data accuracy, real-time information availability, nutritional status tracking and facilitating donor reporting. Distribution workers carry portable, long-life PDAs to scan patients’ individual barcode ration cards when a distribution is made in order to enter information into the database. This reduces data entry and reporting burdens while achieving high data accuracy. However, PDA devices must be rugged and users must be trained in their use. Finally, the McAid system auto-synchronises to transfer data from the field to a central repository using Wi-Fi, USB or broadband connectivity.

Satellite-based technologies

A few approaches have employed satellite-based technologies to improve humanitarian supply chains, though most are aimed at fleet tracking and management. Although satellite-based technologies have the potential to be effective, they also may involve satellite usage costs.

ARGOS Early Warning System
This system, a joint collaboration between The Mentor Initiative and Comic Relief, was built to identify and respond to malaria epidemics quickly, as well as collect real-time stock information. As part of the system, workers travel to a long-life, inexpensive data collection station that uses graphic icons to collect information, namely the number of diagnosed and treated patients and stocks of essential drugs at the individual health facility level. The platform, an in-place system, relays this via a satellite to a central computer, which automatically analyses and displays data on a secure website.

Software technologies

Even when data exists, lack of decision-making support continues to be a source of frustration at both the global and field levels. Information is fragmented, inconsistent, inaccurate and inadequately represented graphically. Humanitarian-specific software technologies seek to provide decision-making support through open-source, customisable products as independent of infrastructure as possible.

HELIOS
This supply chain management software was specifically designed for humanitarian organisations by the Fritz Institute, Blue Star Infotech and Iris Logic. HELIOS aims to create a community of humanitarian users and, thereby, improve supply chain coordination, efficiency, optimisation and visibility. It is also intended to improve donor communications and accountability by tracing donations. It consists of a database, five optional modules and an interface. The database can be hosted externally by a data centre (for a cost), or internally by an organisation’s server. Where connectivity is limited, HELIOS can be deployed to servers in the field.

Eden
This open-source information management system by the Sahana Software Foundation is for use in all phases of disaster management – mitigation, preparation, response and recovery. Eden has been used by the International Federation of the Red Cross and the Disaster Risk Reduction Project. Eden is intended to improve the coordination, management and operations of organisations, people, projects, inventory, assets, data collection and assessments. Eden consists of a free software platform and optional modules, which can be run from a local flash drive, server or host (for a cost). Like HELIOS, it can be run independently of internet connectivity. It supports databases, messaging and data export.

Resource Map
InStedd’s Cambodia innovation lab developed Resource Map technology with a Mapping Tool for map creation, sharing, online information updates, data export, alerts and queries. Data collection and query are enabled via internet and SMS. The main objective of the tool is to enable visualisation of information geospatially to improve decision-making, monitoring, evaluation and response. It also aspires to create a collaborative environment and enable information sharing. Operationally, it intends to track resources and report to funders. It is currently being piloted in a beta version; the Clinton Health Foundation has used it to map stock situations for the National Center for Malaria Control.

Conclusion

Increased visibility has the potential to greatly improve humanitarian operations, and current efforts are diverse and unique to their challenging settings. While they each make strides in visibility by resolving different problems, as summarised in Table 1, none satisfies all. Thus, more complete visibility must be achieved through patchwork solutions of multifaceted and disjoined mechanisms.

privett-table privett-figure

All of these technologies and projects suffer from a set of key limitations, as illustrated in Figure 1. While much has been achieved in adapting initiatives and approaches to challenging operating environments, reliance on infrastructure such as electricity, computers, internet connectivity and cellular networks remains a limitation. Typically, as a product or system moves away from being infrastructure dependent it becomes more dependent on human resources. As such, many are labour-intensive, dependent on reporting and require extensive training. Some data is still not real-time, and affordability is another limitation. Most importantly, for this information to be beneficial information and response systems must be synchronised. Only actionable information is valuable. Thus, the greatest limitations are the lack of systems, procedures and training to enable meaningful and appropriate responses to the information provided.

Natalie Privett is Assistant Professor of Management and Policy at the Robert F. Wagner Graduate School of Public Service, New York University.

This is an article in HPN’s Online Exchange. To read other Exchange articles, please visit http://www.odihpn.org/humanitarian-exchange-magazine.


[1] VillageReach, ‘Mozambique: National Expansion of the Dedicated Logistics System’, VillageReach, 2011, http://villagereach.org/where-we-work/mozambique/.

[2] Ibid.

[3] S. Conesa and L. Kopczak, ‘Positioning Paper and Lessons Learned: Coordination & Development of SMS Project. UNICEF Supply Division Innovation Initiative’, 2009.

[4] J. Barrington, O. Wereko-Brobby and R. Ziegler, ‘SMS for Life: Tanzania Pilot Project Report’, Roll Back Malaria, 2010.

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