The document summarizes the results of a baseline assessment of supply chain management practices for common childhood illnesses in Malawi, Ethiopia and Rwanda. It found that while product availability at resupply points was linked to availability at the community health worker (CHW) level, other factors also influenced availability. Barriers identified included inadequate CHW storage, transportation challenges, and lack of motivation. Proposed interventions focused on improving training, data visibility, transportation, and collaborative problem-solving to enhance motivation and address supply chain issues.

1. Supply Chains for CCM: Preliminary Baseline Results & SC Intervention Areas

4. SC4CCM Theory of Change

5. GOAL LEVEL OBJECTIVES Sick children receive appropriate treatment for common childhood illnesses Main Country Level Objective: CHWs have usable and quality medicines available when needed for appropriate treatment of common childhood illnesses Precondition 1 : Necessary, usable, quality CCM products are available at CHW resupply point/s Precondition 2: CHWs, or person responsible for CHW resupply, know how, where, what, when and how much of each product to requisition or resupply and act as needed Precondition 3: CHWs have adequate storage: correct conditions, security and adequate space. Precondition 4: Goods are routinely transported between resupply points and CHWs Precondition 5: CHWs are motivated to perform their roles in the CCM product supply chain SC4CCM Core Indicators Derived from the main country level objective and immediate preconditions

6. Analysis of Product Availability Results by Precondition Malawi, Ethiopia & Rwanda

8. Main Country Level Objective: CHWs have usable and quality medicines available when needed for appropriate treatment of common childhood illnesses

10. Product availability at the resupply point appears to be strongly linked to product availability at the CHW, but is not the only predictor PRECONDITION 1: Necessary, usable, quality CCM products are available at CHW resupply point/s

11. Product Availability at the Resupply Point & CHW Malawi Ethiopia Rwanda

12. RP fully stocked CHWs stocked out or not fully stocked RP not fully stocked CHWs have stock Malawi

18. Main Country Level Objective: CHWs have usable and quality medicines available when needed for appropriate treatment of common childhood illnesses Precondition 1 : Necessary, usable, quality CCM products are available at CHW resupply point/s Precondition 4: Goods are routinely transported between resupply points and CHWs Preliminary Conclusions Most significant drivers of product availability at CHW level Precondition 2: CHWs, or person responsible for CHW resupply, know how, where, what, when and how much of each product to requisition or resupply and act as needed Precondition 5: CHWs are motivated to perform their roles in the CCM product supply chain Training appears to be necessary but not sufficient to significantly improve product availability CHWs receive frequent supervision in all countries, but content can be improved to target SC problems; motivation for SC tasks was not high 13. CHWs routinely collect and report timely, accurate logistics data

21. Ethiopia Proposed Intervention Strategies GROUP A: “Ready Lessons” for SC knowledge and skills GROUP B: Collaborative SC problem solving. “Finding local solutions together!” GROUP C: Supply chain segmentation for improved transportation. “No product left behind!”

23. Standardize Resupply Procedures SMS System: Data-Driven Advance-Orders, Simplified Engaging CHWs to Prioritize SC Activities Rwanda Proposed Intervention Strategy

24. Thank You! Sarah Andersson, sandersson@jsi.com sc4ccm.jsi.com