Strengthening the Malawi health supply chain to improve access to health care for children

Health supply chains are the processes and operations that are necessary to get products and medicines from manufacturers and into the hands of health staff and their patients, at the right place, time and quantity.

Strong supply chains save lives. They are fundamental building blocks of national welfare systems and necessary for attaining the Sustainable Development Goals (SDGs). This was further highlighted by the COVID-19 pandemic which has underscored the importance of resilient and mature supply chains in national emergency response efforts.  

Recognizing these challenges, UNICEF has increased investments to support governments in strengthening their public supply chains, so that all children have equitable and timely access to health, nutrition, water, education, and sanitation and hygiene supplies, including in emergency situations when their needs are at the highest.  

Children at risk

Over the past 10 years, countries in the East-African region have experienced recurrent health and nutrition supply chain challenges, such as stockouts and interruption of immunization services, putting millions of children at risk¹.  

To address these barriers, UNICEF has developed a methodology called the Supply Chain Maturity Model,  to measure the performance of key supply chain functions across five levels, where level 1 brings evidence of minimum development while level 5 reflects best supply chain management and practices. The findings of such an assessment are critical to guide investments and highlight areas that require additional resources to bring the supply chain to a higher performing standard.

With funding and technical support from UNICEF, the Malawi Ministry of Health used the Maturity Model to assess the country’s supply chain. The assessment had the participation –among other development partners – of the Christian Health Association, the largest non-government healthcare provider who delivers close to 40 percent of Malawi’s healthcare services.  

The review evaluated progress, highlighted gaps and provided recommendations to improve the efficiency of the supply chain in bringing essential medicines and health commodities to districts and communities across the country. The assessment also brought to light major progresses made in recent years, including on vaccine procurement and financing practices, and on the integration of nutrition supplies into the national health supply chain which led to improved product visibility, increased storage and distribution capacity as well as immediate and long-term cost-saving. These successful interventions will also provide the basis for cross-learning opportunities and sharing of experience within the region.   

The outcome also helped to determine Malawi’s readiness level and management capacity for the deployment of COVID-19 tests, treatments and vaccines. All these findings are critical to build upon best practices and have supported the Government of Malawi in developing the National Supply Chain Transformational Master Plan (2021-2026), which will contribute to better health outcomes with clear and measurable targets. The plan will allow UNICEF and partners to lend their technical assistance and coordinate their support toward a shared vision for greater and sustainable impact.  

The Government of Malawi praised the importance of the UNICEF Maturity Model in collecting evidence to drive improvement plans, leveraging partner resources, and bridging the gap in access to healthcare.  

“Guaranteeing continuous availability of health commodities is central to the Government of Malawi’s commitment of ensuring that people in Malawi attain the highest possible level of health and quality of life.  The Maturity Model assessment was a timely exercise that has assisted the country to highlight key bottlenecks in the supply chain and to prioritize areas of improvement. We will continue to use the tool to evaluate progress made towards reaching our goal of ensuring availability of essential medicines at all times in Malawi.” says Godfrey Kadewele, Director of Health Technical Support Services in the Ministry of Health.  

“UNICEF is proud to serve as a trusted adviser on system strengthening to help the Government of Malawi move forward towards achieving its health-related SDGs. The National Supply Chain Transformational Master Plan lays the foundations for all partners to unite and leave no woman, no child and no adolescent behind”, says Rudolf Schwenk UNICEF representative in Malawi.

^{1 Joint UNICEF WHO Reporting Forms, 2015-2019}