How to Transform Your Public Health Supply Chain, Part 2

Read time -7 min 44 sec

Author: Ramatu Abdulkadir 

In part 1 of this write-up, we looked at the new CEO, preparing to transform a public health supply chain in a developing country to make medicines available.

I also shared a puzzle which I hope you have attempted to answer. I know it’s complicated but also very easy to solve if you think outside the box.


You have 15 tree stumps around your warehouse, and you have loads of trash to dispose of and some probably friendly snakes roaming around. You’re also short on cash, as a Supply Chain rebel, how will you solve this problem.

Answer to puzzle

You will invite a lumberjack, Carpenter, Snake charmers and waste management company. Get the lumberjack to uproot the 15 tree stumps and cut into economic pieces. Sell the wood to the carpenter at a reasonable price, pay the logger, pay the snake charmers to catch the friendly snakes. Note that by now, the unfriendly snakes are far gone. Pay for your waste disposal. Don’t forget to get some pictures for accountability and show the other snakes that you mean business. You also have to figure out the payment terms, pay per snake, or pay per hour? How do you measure performance?

Finally, you have a snake-free, stump-free, clean work environment which is critical for employee performance.

Schedule a non-workday for the clean-up; you don’t want people to freak out!

Pictures below and a video treat! CLICK…….

See! They don’t bite!

Caution – Don’t try this at home.

The supply chain complexity of Malaria, HIV, Tuberculosis, Nutrition, Maternal, and Child Health interventions is a handful. Then enters COVID-19, a pandemic which has led to shut down of global economies. This pandemic brings complexity to a whole new level as you will need the same supplies as everyone else on the face of the earth. It makes a mockery of all your projections, strategies, and business plans. You will need new skills to stay ahead of the curve. The single most crucial ability is to keep connected with your patients and your team to ride out COVID-19.

Can we ever be prepared for another pandemic? Yes, we can, by building resilient and sustainable supply chains that are socially, economically, and environmentally responsible business models. Don’t get products you don’t need as demand gets amplified during this pandemic, or else you will be dealing with huge expiries after. Trust me on this one! You will be getting advice from all quarters on what do, the only information I have for you is stick with what works for you.

Remember that dealing with the impact of your decisions in this period might be worse than the pandemic. Stay calm, focused and don’t make rash decisions. Review your processes and strategies with your team ahead of time. Inventory management strategy is key to ensuring the continuous supply of products to your patients. Follow your plan and review it as you go along.

These additional rules will improve your chances of a successful transformation beyond the pandemic.

Rule #6: Challenge The Status Quo

In your first three months, you will hear bizarre narratives like uncompleted projects for eight years, every officer holding on to their office for dear life, senior management not talking to operations staff. Crumbling buildings, everyone working to achieve a personal objective and other unhealthy organizational behaviors.

Listen, learn, empathize, and reject the status quo. Not every problem needs money, how much does it cost to clean your warehouse? We found out after scrubbing the floors for over one month to behold a decorative concrete coating. How much does it cost to fix the light bulbs? How much to service office vehicles? What about running tap water?

You see, the problem is not a lack of funds so much as they will want you to believe but rather a wrong attitude. We reached out to the program manager and completed all projects in 3 months. The security man is happy because the security lightings are now working, and that makes his job more manageable. Even the gardener now has enough water for the flowers.

Adopt this rule, and it will guide you throughout your journey. You will always seek better and more efficient ways of doing things.

When we wanted to reduce the time to deliver products from warehouses to facilities, the team got together to review our process. There’s this bunch of papers that the warehouse team had to fill all the time, and it took a sizable chunk of the processing time. I asked the group why they had to fill the forms; they filled out the documents to get medicines to the patients. Fine, so what do you do with the papers? Everybody went blank. We were able to trace the filled forms to a trash pile.

We cut out the filling of forms and other time-wasting activities, reduced lead time from 35 days to 2 hours. Now that was epic! It gave the needed boost to try new ways of working. This practice could be addictive; you have to manage it.

Rule #7: Ask Questions, It Never Hurts Anyone

The key to unlocking the thought process is to ask questions. In public health supply chains, people don’t ask too many questions. You don’t have to fill 100 papers before you send medicines to the facility. Ask questions, and you will discover that most times, people don’t have a deeper understanding of their work. The most vital question and difficult to answer is the WHY? If you and your team understand the WHY? of your business, then you have a chance of making better choices.

Your business is to save lives and get the medicines to the hospitals to achieve that. It doesn’t make sense to continue filling out those forms when every second count. It freed the team to think of better ways to achieve the goal. We discovered the warehouse management software does a far better job than the hand-filled forms. It can be analyzed and used for decisions making.

Not understanding your ‘WHY’ can lead to duplication of effort and loss of time. I see someone mentally kicking himself for that folly. You will find this scenario in the entire supply chain, waste of time, materials, and resources. Cut it out, and you’ll be happier for it.

Rule #8: Supply Chain is Supply Chain, Learn from The Best

Hate to burst your bubble! The public health supply chain is the same as the Toyota supply chain. The only difference is the product. In public health, health supplies and services are the products while Toyota deals in cars and other services. The misconception in public health supply chains is the thinking that supply chain concepts and practices that work for Toyota will not work for public health supply chains. How will you know, if you never tried?

Learn from best-in-class supply chains and implement the lessons in your supply chain. This rule will cost you money because it is one of the barriers to achieving your goal, which in our case is ‘Universal Health Coverage.’

An end - to - end view of your supply chain is non-negotiable. We use process maps to connect the dots with my team and still paying to drive this point home. You have to know how the product flows through the system and get to the patient. You can’t buy medicines and keep, then start looking for someone to distribute it for you to the patient or carry out reverse logistics or expiry management on your behalf. Every activity is part of the total cost of ownership.

Visibility is especially crucial in this COVID-19 era. Don’t get the products unless you figure out how to get them to the patients. Organizations supporting public health supply chains should not only procure but ensure available lifesaving medicines get to the people who need them.

Integrate all your processes; procurement must flow into your distribution channels and get to the patients. Plan your entire supply chain for each product up to the patient and back. Collect and document information all through the supply chain for resupply.

Rule #9: Say What You Mean and Mean What You Say

You have to be consistent; stakeholders and team members want to know if you’re in for the long run. Some people will give you one year to crash. To prevent burn out, connect with your team on a deeper level. Be genuinely interested in their lives outside transformation. Are they having family, health, or financial issues? Be supportive and try to help out.

Arrange flexible schedules for your employees, have lunch out, talk over coffee or tea on non-work issues. Play games and share life-experiences, just be human.

At the same time, be firm. Give honest feedback, encourage openness. Communicate clearly, admit your weakness. Have your morning huddles, set the tone for the week. Follow through with action. Measure your performance and continuously improve your processes to get better.

December 2018, my team decided that we needed a time out to relax and refresh our minds before starting the new year. Time outs were unheard of in the past. We got down to planning together with the health facilities. We informed them of the end of year closure and delivered one hundred (100) orders before closing out! We made sure they had all their needs, so we can relax and recharge for the new year! Win-win! That will be impossible without adequate planning and seamless execution.

Rule #10: Think Sustainability

Scarce resources are as good a motivator for sustainability as consumerism. When we wanted to flag-off our pharma-grade warehouse, and we were on a tight budget. All of a sudden, I was wondering why we needed to print a new banner. I suggested to my team not to print banners, ‘let’s save the money for better things,’ after all, you can’t use the banner twice.

They looked at me like I had lost my mind, “we always do banners.” Those small harmless habits are usually the killers. A no-banner flag-off will look classy and work well without the cost. In public health supply chains, there’s waste in different dimensions. Identify all the areas of waste, develop and implement strategies to continuously improve and sustain best practices.

Benchmark your organization against other supply chains and measure performance frequently. Share learnings and peer reviews.

How do you know if your transformation is working and will stand the test of time? Transforming the minds of the people you work with is the most difficult. It’s an indicator that people can’t fake, not always!

# Litmus test

Tell a team member to carry out a status quo task. If he/she instinctively gives you an earful on how it will affect the organization negatively, Congratulations! Mission Accomplished!

Transforming your supply chain is a journey for you and your team, which will likely span decades because the rot also took decades. Don’t forget to catch some fun on this journey, and don’t be hard on yourself. You started it, but your team will finish it, and that in itself is the joy of fulfillment!


After reading part 1 and 2 of this write-up, what do you think about transforming public health supply chains? Is it an end in itself, or should we change minds instead? Which one comes first?

A transformed mind will then go ahead to transform supply chains and build a better world. If you agree with me about changing minds, then how do we go about it?

Stay with me as we explore the salient features of mind over matter in future supply chains.

  • To change minds, open communication is key. Let your team see where you want to go and start the journey with the few that buy in to your ideas…others will catch up or fall out.

  • Thank you very much ma. I believe by now a lot of CEOs and managers are buzzing your phone with calls and emails.
    I remember what you usually tell us about transformation.
    As you try to develop a solution to an existing problem another one surfaces, but that’s not a problem, because its a way of revealing hidden challenges you are not aware of.
    We are very grateful ma.

  • Thank you ma. These rules are really helping me to set my own supply chain in another field , like you said the only difference in the supply chain is the product.

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