Members discussed their experiences and perspectives on as they collectively discussed an accurate and all-encompassing definition of a “public health supply chain.” This discussion was moderated by Kossivi Agbelenko Afanvi (Ministry of Health, Togo).
Original message: Some initial attempts were made to define supply chain in the health care system. According to Raja and Mohammad (1) , the term supply chain describes the links and the interrelationships among the many organizations, people, resources, and procedures involved in getting commodities to the customers (in this case, health care consumers). According to John Snow, Inc. (2) a public health supply chain is “a network of interconnected organizations or actors that ensures the availability of health commodities to the people who need them.” This idea of delivering health commodities to customers were also found in the definition provided by the World Bank (3). But these definitions seem to be reductionist, since they limit health system to the delivery of commodities (not health services). They occult the central role of health system information management, medical and surgical knowledge, behavior change interventions and organizational processes. According to the above, we propose this definition of public health supply chain: a system that integrates, coordinates and controls in a timely manner all resources and processes required to promote, restore or maintain health. So, I need your input for a common definition of public health supply chain that integrates a systems approach.
“Those working in public health supply chains view the supply chain as one among a number of different inter-dependent systems (for service delivery, for information, for human resources, for finances, for communication and behavior change, etc.) that together comprise an integrated health system. The supply chain is focused on delivering medicines and other supplies that enable the health worker to meet a client’s or patient’s health needs. It is not intended to deliver the health worker, nor the surveillance data, nor the behavior change messages and IEC materials that help inform and influence health seeking behaviors.” (Chris Wright, USA)
“I empathize with the perspective that the public health supply chain should be accountable to public health providers; however, I believe that the public health supply chain should be accountable to end users, and not only to clinicians. The needs of the end users should ultimately determine the characteristics of the supply chain, not only the current needs of public health providers.” (Safia Ahsan, USA)
“I propose this definition of public health supply chain: A system that integrates, coordinates and controls in a timely manner all resources and processes required to promote, restore or maintain health.” (Kossivi Afanvi, Togo)
“It is difficult to manage public health supply chains because there are so many stakeholders whose linkages to each other are convoluted. Supply-side participants means those who provide goods and/or services to the “Supply Chain” for profit/pay. Then the Demand-side participants are those who enable payments to be made to the Supply Side participants in return for the services or goods provided. Where are public health officials then? They are both Supply-side and Demand side participants.” (Karen Ampeh, USA)
References: (1) Raja S and Mohammad N. A Handbook on Supply Chain Management for HIV/AIDS Medical Commodities. Washington, D.C.: Health, Nutrition, and Population – The World Bank, 2005.
(2) John Snow Inc. Getting Products to People. The JSI Framework for Integrated Supply Chain Management in Public Health. Arlington: John Snow Inc., 2012.
(3) The World Bank. Public Sector Healthcare Supply Chain Strategic Network Design for Kemsa. Driving Service Improvements through Supply Chain Excellence. Washington, D.C.: The World Bank, 2009.