After six years of relationship building in Tanzania following the initial Project Last Mile pilot, we officially launched Phase II of our work there in December 2017. The partnership between John Snow International (JSI), the Medical Stores Department (MSD), The Global Fund to Fight AIDS, Tuberculosis, and Malaria (TGF), and Coca-Cola Kwanza (CCK), a subsidiary of Coca-Cola Beverage Africa, is adapting proven private sector approaches for optimizing the performance of Tanzania’s public sector supply chain towards improved health outcomes. The project focused on optimizing medical supply delivery routes for health facilities in four zones (Iringa, Mbeya, Dodoma and Muleba) and building sustainable modeling capacity within MSD.

The three primary objectives were:

• Help MSD identify optimal center-to-customer distribution routes,
• Create optimal multi-stop delivery or pick-up routes, and determine the best use of assets through route optimization modeling, and
• Enhance MSD staff expertise and ability to operate these processes independently in the future.

Strong supply chains save lives

Where life-saving medicines do not reach the “last mile” in the supply chain, lives are at risk. JSI is supporting MSD to help make medicines available when and where they are needed. Using GIS mapping techniques and supply chain optimization techniques Project Last Mile is supporting MSD to optimize last-mile delivery routes and realize time and operational cost savings.

JSI began the process of identifying optimal route models with data collection. Calculating travel times and speeds is crucial to creating realistic and cost-saving vehicle delivery routes. However, in every zone, at least 10-15% of facilities had no geolocation data in the official Health Facility Registry. Without these locations, the team could not use software features to accurately estimate local travel times and speeds. Where data was missing, JSI was able to fill in these gaps with data collection from Google Maps and Car Track data from MSD distributions.

The next step was to provide training. In April 2018, Zonal and Central level MSD staff, along with representatives from CCK and Project Last Mile, attended a four-day route optimization workshop co-facilitated by JSI and Llamasoft. The workshop focused on training MSD staff on route optimization concepts; data processing, cleaning, and analysis; and hands-on practice with Llamasoft’s Supply Chain Guru software. Attendees also reviewed and validated the data collected. To get an understanding of how the private sector supply chain uses these skills, participants visited the CCK plant in Dar es Salaam and were introduced to various supply chain operations within Coca-Cola.

Nine MSD staff have been trained to:

• Simulate near-term cost and service improvements to existing supply chain operations
• Identify longer-term strategic improvements to the national transportation network and
• Run periodic or as-needed what-if analysis of new strategies, disruptions constraints and business challenges.

Finally, JSI completed ride-alongs in all four zones during MSD’s last-mile deliveries from zonal stores to health facilities. These trips allow the modeling team members to validate the designed routes and parameters, such as the number of cartons shipped to each facility, road conditions and average speeds, loading times, distance travelled between facilities, fuel consumption, and mobile warehouse locations. Additionally, team members collect data on hard-to-reach areas in dry and wet season during the rides.

JSI used the data collected to refine the route models in Supply Chain Guru and provide the final models and maps for a particular zone. Between Q1/Q2, 2,021 health facilities had been covered in route optimization activities including 532 health facilities in Iringa, 593 in Dodoma Zone and 896 in Mbeya and Muleba. The final optimized route models for all four zones are now complete.

Exchanging skills to improve last mile medicine delivery

Project Last Mile and CCK hosted MSD staff for a Skills Exchange Workshop in August 2018. Ten MSD staff attended and eleven CCK staff shared process and systems in route-to-market, logistics and transport. The Skills Exchange, held at the CCK plant in Mikocheni, gave MSD officers the opportunity to get advice from skilled CCK employees on supply chain challenges.

MSD officers had the opportunity to not only interact with CCK employees but also tour the CCK warehouse. The MSD staff included transport officers, customer service officers, sales officers, drivers and IT technicians. Over 10 CCK employees participated in leading sessions and tours.

The sessions included the following topics: order generation, route-to-market, warehouse operations, distribution and route optimization, fleet management, live demonstration of route optimization software, sales and customer service, and risk management and quality assurance.

The Skills Exchange sparked discussions between MSD officers and between CCK and MSD. The sessions ran longer than expected because MSD had so many questions for CCK. However, CCK employees reported that hosting the MSD officers also helped them think through their own processes and identify areas where CCK could improve.

Project Last Mile reminded all attendees that the intention is for the relationships and the knowledge sharing to continue beyond the two-day workshop.

Project Last Mile is exploring the potential for future work to support MSD to route-to-market and logistics.