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The Role of Impact Approach in Minimizing Wastage During TLE-TLD Transition: A Case of Geita Region

Received: 29 September 2022    Accepted: 17 October 2022    Published: 28 October 2022
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Abstract

The Tanzanian government, in its quest to improve the health care supply chain and the availability of essential health commodities, has taken several measures over the years, including the development of robust electronic systems to improve data transparency. However, the use of available data for informed decision-making was still very low. This prompted the introduction of IMPACT (Information Mobilized for Performance Analysis and Continuous Transformation) in 23 regions, including Geita Region, to compensate for the underutilization of data. Following the introduction of TLD, which replaced TLE as the standard drug of choice for HIV/AIDS care and treatment in Tanzania, Geita Region faced a higher risk of wasting about 40 000 tins of TLE through expiry, at a cost of 615 million Tanzanian shillings. To mitigate this huge risk, the Geita regional IMPACT team implemented data-driven interventions under the IMPACT team approach. Therefore, this study aimed at assessing the impact of the implemented data-driven IMPACT processes on minimizing TLE wastage during the TLE-TLD transition in the region. Among the notable methods employed by the regional IMPACT team in Geita to mitigate the risks of TLE wastage, were the development of a standardized tool to collect various logistics and service data from all health facilities and then conducting two phases of data analysis to identify the risks of TLE wastage before developing interventions to prevent wastage. Finally, all councils in the region took the agreed data-driven actions to save the available TLEs. The region's collective efforts through the IMPACT teams resulted in the salvage of approximately 1.2 million tabs of TLE valued at US$263,918 by July 2021, representing 99.95% of the stock available in August 2020, the start of the intervention period. These results suggest that the IMPACT approach is very vital in enhancing data-driven decision-making in identifying supply chain issues and finding innovative and appropriate solutions. In addition, effective data use, strong team spirit and leadership support were found to be critical in solving health supply chain problems. Therefore, it is recommended that the IMPACT approach be strengthened and transferred to lower levels of the supply chain to improve data use and supply chain performance.

Published in International Journal of Health Economics and Policy (Volume 7, Issue 4)
DOI 10.11648/j.hep.20220704.11
Page(s) 78-83
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

IMPACT Approach, TLE, TLD, Supply Chain Management, Shelf Life, Stock Status, Overstocked, No Demand

References
[1] Technical Assistance - Tanzania. Creating a Demand Driven-Supply Chain : Aligning Stakeholders and Priorities. 2018;(October).
[2] Printz N, Amenyah J, Serumaga B, Van Wyk D, USAID, DELIVER. Tanzania: Strategic Review of the National Supply Chain for Health Commodities. Minist Heal Soc Welf [Internet]. 2013; (April): 111. Available from: http://deliver.jsi.com/dlvr_content/resources/allpubs/countryreports/TZ_StraRevi_SC.pdf%5Cnfile:///C:/Users/GHFP/Documents/Realist Review/Original Docs/Eval Assessment Docs/TZ_StraRevi_SC.pdf
[3] Mboera LEG, Rumisha SF, Mbata D, Mremi IR, Lyimo EP, Joachim C. Data utilisation and factors influencing the performance of the health management information system in Tanzania. BMC Health Serv Res. 2021; 21 (1): 4–11.
[4] Lamphere B, Machagge M, Adane TD. IMPACT Team Approach to Supply Chain Management. Reprod Heal supplies coaltion [Internet]. 2019; 39. Available from: https://www.rhsupplies.org/
[5] MoHCDGEC. Data Management for improving health commodities supply chain (IMPACT Team approach). 2021.
[6] MoHCDGEC. National Guidelines on Quality Improvement of the HIV and AIDS Services, United Republic of Tanzania. Popul Policy Compend. 2017; (January): 46.
[7] MoHCDGEC. Medicines and therapeutic committee guideline. Dar es salaam; 2012. p. 27.
[8] MoHSW. Implementation Guidelines for 5S-KAIZEN-TQM Approaches in Tanzania. 3rd Editio. Dar es salaam; 2013. 116 p.
[9] MoHCDGEC. THE UNITED REPUBLIC OF TANZANIA Essential Health Commodities Quantification Guideline. 2018; 44.
[10] Kagashe GA, Makenya FB, Buma D. Medicines wastage at a tertiary hospital in Dar es salaam Tanzania. J Appl Pharm Sci. 2014; 4 (6): 098–102.
[11] Hakuzimana T. Assessment of Factors Contributing to Medicine Expiry in Rwanda : Case of the Medical Procurement and Production Division. 2021; 4 (2): 281–91.
[12] Tadesse GE, Teshome GD, Gedif FT. Factors contributing to medicines wastage in public health facilities of South West Shoa Zone, Oromia Regional State, Ethiopia: a qualitative study. Aust N Z J Public Health. 2012; 36 (2): 106–8.
[13] USAID Deliver. The Logistics Handbook: A Practical Guide for the Supply Chain Management of Health Commodities. USAID | Deliv Proj Task Order 1 [Internet]. 2011; 174. Available from: http://deliver.jsi.com/dlvr_content/resources/allpubs/guidelines/LogiHand.pdf
[14] Mori AT, Owenya J. Stock-outs of antiretroviral drugs and coping strategies used to prevent changes in treatment regimens in Kinondoni District, Tanzania: A cross-sectional study. J Pharm Policy Pract. 2014; 7 (1): 3–8.
[15] Dugdale CM, Ciaranello AL, Bekker LG, Stern ME, Myer L, Wood R, et al. Risks and benefits of dolutegravir- And efavirenz-based strategies for South African women with HIV of child-bearing potential. Ann Intern Med. 2019; 170 (9): 614–25.
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  • APA Style

    Japhet Simeo, Eddom Silabi, Martha Kikwale, Hemedi Mahamudu, Charles Mateso, et al. (2022). The Role of Impact Approach in Minimizing Wastage During TLE-TLD Transition: A Case of Geita Region. International Journal of Health Economics and Policy, 7(4), 78-83. https://doi.org/10.11648/j.hep.20220704.11

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    ACS Style

    Japhet Simeo; Eddom Silabi; Martha Kikwale; Hemedi Mahamudu; Charles Mateso, et al. The Role of Impact Approach in Minimizing Wastage During TLE-TLD Transition: A Case of Geita Region. Int. J. Health Econ. Policy 2022, 7(4), 78-83. doi: 10.11648/j.hep.20220704.11

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    AMA Style

    Japhet Simeo, Eddom Silabi, Martha Kikwale, Hemedi Mahamudu, Charles Mateso, et al. The Role of Impact Approach in Minimizing Wastage During TLE-TLD Transition: A Case of Geita Region. Int J Health Econ Policy. 2022;7(4):78-83. doi: 10.11648/j.hep.20220704.11

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  • @article{10.11648/j.hep.20220704.11,
      author = {Japhet Simeo and Eddom Silabi and Martha Kikwale and Hemedi Mahamudu and Charles Mateso and Ondo Baraka and Lynne Nuru Mshamu and Salum Ndimu and Athanas Ntaganyamba and Projestus Tehingisa and Furaha Kibaba and Mathew Mganga and Lameck Yohana},
      title = {The Role of Impact Approach in Minimizing Wastage During TLE-TLD Transition: A Case of Geita Region},
      journal = {International Journal of Health Economics and Policy},
      volume = {7},
      number = {4},
      pages = {78-83},
      doi = {10.11648/j.hep.20220704.11},
      url = {https://doi.org/10.11648/j.hep.20220704.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.hep.20220704.11},
      abstract = {The Tanzanian government, in its quest to improve the health care supply chain and the availability of essential health commodities, has taken several measures over the years, including the development of robust electronic systems to improve data transparency. However, the use of available data for informed decision-making was still very low. This prompted the introduction of IMPACT (Information Mobilized for Performance Analysis and Continuous Transformation) in 23 regions, including Geita Region, to compensate for the underutilization of data. Following the introduction of TLD, which replaced TLE as the standard drug of choice for HIV/AIDS care and treatment in Tanzania, Geita Region faced a higher risk of wasting about 40 000 tins of TLE through expiry, at a cost of 615 million Tanzanian shillings. To mitigate this huge risk, the Geita regional IMPACT team implemented data-driven interventions under the IMPACT team approach. Therefore, this study aimed at assessing the impact of the implemented data-driven IMPACT processes on minimizing TLE wastage during the TLE-TLD transition in the region. Among the notable methods employed by the regional IMPACT team in Geita to mitigate the risks of TLE wastage, were the development of a standardized tool to collect various logistics and service data from all health facilities and then conducting two phases of data analysis to identify the risks of TLE wastage before developing interventions to prevent wastage. Finally, all councils in the region took the agreed data-driven actions to save the available TLEs. The region's collective efforts through the IMPACT teams resulted in the salvage of approximately 1.2 million tabs of TLE valued at US$263,918 by July 2021, representing 99.95% of the stock available in August 2020, the start of the intervention period. These results suggest that the IMPACT approach is very vital in enhancing data-driven decision-making in identifying supply chain issues and finding innovative and appropriate solutions. In addition, effective data use, strong team spirit and leadership support were found to be critical in solving health supply chain problems. Therefore, it is recommended that the IMPACT approach be strengthened and transferred to lower levels of the supply chain to improve data use and supply chain performance.},
     year = {2022}
    }
    

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    T1  - The Role of Impact Approach in Minimizing Wastage During TLE-TLD Transition: A Case of Geita Region
    AU  - Japhet Simeo
    AU  - Eddom Silabi
    AU  - Martha Kikwale
    AU  - Hemedi Mahamudu
    AU  - Charles Mateso
    AU  - Ondo Baraka
    AU  - Lynne Nuru Mshamu
    AU  - Salum Ndimu
    AU  - Athanas Ntaganyamba
    AU  - Projestus Tehingisa
    AU  - Furaha Kibaba
    AU  - Mathew Mganga
    AU  - Lameck Yohana
    Y1  - 2022/10/28
    PY  - 2022
    N1  - https://doi.org/10.11648/j.hep.20220704.11
    DO  - 10.11648/j.hep.20220704.11
    T2  - International Journal of Health Economics and Policy
    JF  - International Journal of Health Economics and Policy
    JO  - International Journal of Health Economics and Policy
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    EP  - 83
    PB  - Science Publishing Group
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    AB  - The Tanzanian government, in its quest to improve the health care supply chain and the availability of essential health commodities, has taken several measures over the years, including the development of robust electronic systems to improve data transparency. However, the use of available data for informed decision-making was still very low. This prompted the introduction of IMPACT (Information Mobilized for Performance Analysis and Continuous Transformation) in 23 regions, including Geita Region, to compensate for the underutilization of data. Following the introduction of TLD, which replaced TLE as the standard drug of choice for HIV/AIDS care and treatment in Tanzania, Geita Region faced a higher risk of wasting about 40 000 tins of TLE through expiry, at a cost of 615 million Tanzanian shillings. To mitigate this huge risk, the Geita regional IMPACT team implemented data-driven interventions under the IMPACT team approach. Therefore, this study aimed at assessing the impact of the implemented data-driven IMPACT processes on minimizing TLE wastage during the TLE-TLD transition in the region. Among the notable methods employed by the regional IMPACT team in Geita to mitigate the risks of TLE wastage, were the development of a standardized tool to collect various logistics and service data from all health facilities and then conducting two phases of data analysis to identify the risks of TLE wastage before developing interventions to prevent wastage. Finally, all councils in the region took the agreed data-driven actions to save the available TLEs. The region's collective efforts through the IMPACT teams resulted in the salvage of approximately 1.2 million tabs of TLE valued at US$263,918 by July 2021, representing 99.95% of the stock available in August 2020, the start of the intervention period. These results suggest that the IMPACT approach is very vital in enhancing data-driven decision-making in identifying supply chain issues and finding innovative and appropriate solutions. In addition, effective data use, strong team spirit and leadership support were found to be critical in solving health supply chain problems. Therefore, it is recommended that the IMPACT approach be strengthened and transferred to lower levels of the supply chain to improve data use and supply chain performance.
    VL  - 7
    IS  - 4
    ER  - 

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Author Information
  • Regional Health Management Team, Regional Administrative Office, Geita, Tanzania

  • Capacity Building and Data Use, USAID Global Health Supply Chain-Technical Assistance-Tanzania, Dodoma, Tanzania