Improving access to COVID-19 commodities in Uganda's remote districts

When COVID-19 hit Uganda, Margaret Bayoru worried about how patients in the country's remote facilities in the West Nile region would receive medicines. As the person responsible for inventory management at Arua regional emergency supply chain stores, Margaret knew that her colleagues in these health facilities not only needed the medicines to save patients' lives, but they also needed personal protective equipment to protect themselves from the coronavirus.

Today, Margaret does not have to worry. She proudly leads the way towards achieving her team's main objective—a fully stocked district health store that consistently delivers essential supplies where they are needed most. "We have plenty of medicines and supplies from the Government of Uganda and donations from partners," says Margaret.

A central warehouse typically supplies all health commodities to public health facilities across the country. The process of using third-party private logistics companies for last mile delivery to health facilities, takes two months in total. In response to the COVID-19 pandemic, the Ministry of Health shortened the process of delivery of commodities to facilities within one-to-two days. Eight regional stores were established in 2019 at district health offices to ensure timely delivery of lifesaving emergency commodities, including personal protective equipment, medicines, and oxygen supplies.

Regional stores, like the one run by Margaret, receive emergency commodities every two weeks from the central warehouse or partner stores and distribute them to districts within their catchment area. To promote client-centered care and ensure uninterrupted availability of medicines and supplies, the stores are regularly monitored and restocked with support from the USAID Uganda Strengthening Supply Chain Systems Activity led by Management Sciences for Health. The Activity provides technical support and training on the web-based electronic emergency Logistics Management Information Logistics System—eELMIS. Facilities place an order for supplies, which the district aggregates and send to the store through the eELMIS, allowing for same-day delivery of emergency commodities. 

Margaret prides herself in being able to offer a service where commodities are delivered on the same day they are ordered, anywhere across the 13 districts served by her store. "Handling and the timely transportation of these emergency commodities is key to a swift response. For an emergency, you need to expedite the process. Otherwise, life will be lost," says Margaret. On average, the longest it takes to process and deliver commodities is four hours.

Achieving this was not easy, it required securing buy-in from partners and the leadership across each district to secure vehicles to pick up commodities.  In eight months, the Arua store supplied 208 orders to its districts. At the country level, between March and December 2020, all the 135 districts made 500 bulk orders for COVID-19 commodities through the eELMIS with 97.5% of these orders fulfilled to the districts' specifications. The orders were delivered to 135 districts, 8 regional stores, 75 emergency border posts and 89 quarantine and makeshift centers.

Margaret attributes the sufficient supply of commodities to the weekly meetings held between the Arua store and partners. Through these meetings, partners, many of whom are humanitarian agencies that serve the refugee population in the region, pool resources and donate commodities.

Due to Margaret's leadership of the district stores and mentoring inventory staff, improvement was seen in commodity management and the availability of real-time data needed to make decisions throughout the supply chain system.  The partnership with the District Health Office and local partners was essential in setting up the store-based distribution model and creating same-day availability of COVID-19 commodities to remote districts.

The USAID Uganda Strengthening Supply Chain Systems Activity supports efforts to strengthen Uganda's health supply chain to increase availability and access to safe, quality-assured medicines and health supplies in public and private nonprofit health facilities.