In 2007, the Botswana Ministry of Health (MoH) opted to utilize the USAID awarded SCMS program to help transform Botswana's Central Medical Stores (CMS) into a world-class distributor of health commodities to Botswana's public health system. This included 700 health facilities across the country. Crown Agents is the subcontractor managing the SCMS Botswana country office for PFSCM, the awardee of the SCMS contract.
The Botswana Ministry of Health along with PFSCM mobilized a senior management team who would assume responsibility for CMS operations, initially for three years. In addition to management of the supply chain, the six member team which included Crown employees put in place rigorous human and institutional capacity building initiatives to improve all managerial, operational, and administrative practices. Focal areas included human resource management, performance and information sharing, procurement management, warehousing and distribution, and quality management systems.
Strengthening the organisation's capabilities
From the beginning, HR initiatives have been a fundamental part of strengthening the organization. The management team has introduced changes to working practices at CMS to improve efficiency and better utilisation of staff. To date, more than 300 delegates have received targeted training in response to specific needs identified in a skills audit, and a comprehensive training plan is now in place. New working practices have been implemented and responsibilities and accountability within CMS are clear.
A new performance measurement framework became the catalyst to a performance-oriented culture, with performance data visible and staff activiely analysing problems and designing solutions. Previously perceived as an opaque organisation, CMS now reguarly shares data with managers and program staff at the Ministry of Health headquarters and with its' customers: a very welcome change.
A review of the CMS procurement department showed that areas that could be strengthened in its documentation, training, management information, commodity lists, and overall procurement strategy among different product groups. The management team addressed these issues with a number of actions:
- A new suite of procurement documents were developed.
- A comprehensive procurement training programme covering tender, contract, and inventory management was put in place.
- The essential drugs and non-drug lists are being reviewed each year and a new strategy for 140 vital drugs has been successfully implemented under long-term framework agreements.
- In order to address expiry of products and reduce wastage, a new unit has been established to capture logistics data and strengthen commodity management at the district and facility levels.
Availability for all vital, essential, and non-essential drugs has increased significantly from 2010 to 2012.
Efficiency, quality and customer service
To improve customer service, all customers (District Health Management Teams, clinics and hospitals) now have a specific date each month for order submission, and CMS commits to a delivery date. A focus on inventory control has yielded impressive results. Accuracy of CMS inventory records is now in excess of 99 percent. To ensure procurement and ordering matches customer needs, a newly established unit analyses usage and inventory data and uses this to inform procurement activity.
The CMS is implementing a quality management system with ISO: 9001 accreditation through the Botswana Bureau of Standards. In February 2012, CMS passed the first stage of this accreditation - the second and final stage of the assessment is scheduled for June 2012.
Through an approach that combines organizational development, capacity building and improvements to supply chain systems, CMS is rapidly becoming a reliable and high-performing organisation. More information on SCMS work with CMS in Botswana can be found in the link at the bottom of the page:
About SCMS and PFSCM
Funded by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) through USAID, SCMS is implemented by the Partnership for Supply Chain Management (PFSCM), a non-profit entity, comprised of 13 private sector, non-governmental and faith-based organisations. With offices in 20 countries and more than 700 dedicated staff globally, SCMS is working to improve the lives of people living with and affected by HIV/AIDS through procuring essential medicines and supplies at affordable prices; strengthening and building reliable, secure and sustainable supply chain systems; and fostering coordination of key stakeholders.
The project focuses on improving forecasting (to determine what drugs are really needed), aggregating demand and negotiating lower prices, and bringing the delivery mechanism closer to the point of use through regional warehouses.
In 2010 the European Supply Chain and Logistics Summit recognised PFSCM's groundbreaking work with the Supply Chain Innovation Award and Best Value Supply Chain Provider Award.