What Would an Uninterrupted Supply of Medicine Mean for Health Outcomes?

Existence without access is meaningless. No matter how good a restaurant may look, it’s of no use to you if you can’t get the food you want when you want it. In the same way, great diagnoses need to be accompanied by the right treatment at the right time for comprehensive healthcare delivery to be a reality. Strong supply chain mechanisms— i.e. strong systems of organizations, people, activities, information, and resources — are critical to moving medications from suppliers to patients.

At Sanford World Clinics, a branch of the Sanford Health network where I work, we are focusing our efforts on improving supply chain mechanisms to provide better access to medicines for patients in Ghana. After identifying stockouts as the most common default in the global pharmacy supply chain, we have moved quickly to take steps to address this problem sustainably.

To end stockouts, we are working on making the systems user-friendly and increasing knowledge of the staff involved in the pharmacy supply chain process. We are also engaging our vendors to encourage them to commit to supplying medicines on time so that clinics are fully stocked at all times.

Andrews — SWC Pharmacist; Diallo — PSC Consultant and late Emmanuel — SWC Procurement Manager.

What steps did we take at Sanford World Clinics — Ghana?

1. Organize medicine stores. We prioritize having all the medication with the same identification in one place. We avoid duplications and aim to be able to identify all the medicines with zero error. This arrangement also respects the ‘first-to-expire-first-out’ rule.
2. Label everything. Every medicine has a card with both of its names on it. This card is brought to the bin when the stock gets to the par level to trigger the order for the next supply. The head of the pharmacy store is notified of the time to place the next order when the stock level shifts to the second color of the card. This system is known as the Kanban System.
3. Check and update the record. The record is a tool that allows worked to quickly locate medicines in the pharmacy store.
4. Set bin sizes. This allows decreases in the amount of medicine available in one location to trigger the use of the medicine in the other location. It keeps alternating back and forth without interruption, and relies on visual cues to raise the alert when inventory of one bin is running low so you can order to replenish and avoid stockouts.
5. Train staff. As we aim to build an integrated supply chain of medicines, the staff involved on the pharmacy supply chain — from the Procurement Manager to the members of the pharmacy team at the clinic — all get educated on the systems and everyone’s role at every step of the chain.

Pharmacy setup after labeling at Adenta Sanford World Clinic. Photo © Randy Merkle, Sanford Health.

This process was conceived, introduced, and led by Sanford Health’s Jason Wilson and Randy Merkle — two of the most talented and experienced Supply Chain experts with years of experience in this field. Special thanks to Lindsey Steffes for the continuous support and guidance to make the Pharmacy Supply Chain work a success. Thanks to the Clinic Directors, the Pharmacy teams, Andrews Oteng Jr., Henrietta Amoo-Ashie, Emmanuel Chartey-Annang (RIP) and everyone who contributed to make this work feasible.