Situation

Nigeria’s complex decentralized health system gives significant importance to the role and responsibilities of the states, especially in the supply chain management and logistics for health commodities. Each state manages its own supply chain system, requiring significant coordination and collaboration with multiple local stakeholders. In addition, certain regions in the country, including the North, have remotely located populations with limited access to treatment and drugs.

On entering Nigeria in 2004 as supply chain partner in FHI’s USAID-funded GHAIN project, Akesis Health Nigeria quickly recognized the inefficiencies of the multiple vertical, disease specific supply chain systems that existed there, and the deficiencies of an overly centralized, top-down approach to strengthening these supply chains.

In response, Akesis Health Nigeria pioneered a range of innovations to address these issues in Nigeria, bringing the latest thinking and technology to bear on addressing root causes and improving integration and efficiencies at all levels of the supply chain.

Solution

Akesis Health Nigeria has been the logistics partner for a number of major projects in Nigeria and has managed warehousing, inventory, and distribution of health commodities, as well as strengthening supply chain systems, particularly at the State, LGA, and health facility levels.

These projects have included GHAIN (USAID/ FHI), its successor, SIDHAS (USAID/ FHI360), ACTION (CDC/UMD), ProACT (USAID/ MSH), PATHS2 (DFID/Abt Associates), and MNCH2 (DFID/Palladium), as well as NACA and NMEP, to which Akesis Health Nigeria has provided system strengthening and distribution services:

• Key partner for SCMS, and more recently for GHSC-PSM, managing the 4 regional (“Axial”) warehouses in Awka, Calabar, Gombe and Sokoto that form the backbone of Nigeria’s current supply chain for PEPFAR and Global Fund commodities. Akesis Health Nigeriea also manages Last-Mile Distribution services for PSM.

• Supported the GHSC-PSM National Integrated Specimen Referral Network (NiRSN) in Nigeria, with Laboratory Advisors in 11 states monitoring and overseeing the entire national network, ensuring secure, reliable delivery and tracking of specimens from health facilities throughout the country to Nigeria’s network of PCR laboratories, and timely and accurate delivery of diagnostic results back to health facilities.  

• Led and implemented the CDC National EQA project, which included the establishment of an EQA Center for PEPFAR laboratories in Nigeria and a reference laboratory in Zaria.

Under these programs, Akesis Health Nigeria partnered with multiple state governments and implementing partners (IPs) and has worked in all 36 states in Nigeria, playing a key role in the establishment of MOU’s with state governments in order to facilitate state government engagement in national supply chain systems.

Akesis Health Nigeria has implemented health systems strengthening activities to enhance supply chains at the lower levels of the health system. Many of these initiatives involve innovations led by Akesis through the aforementioned projects.

• Establishment of a network of 20 state-level advisors, located throughout Nigeria, to provide capacity building, technical assistance, and other support services to pharmacy and other relevant personnel at health facility level. This was the first such decentralized systems strengthening structure for supply chains (Via GHAIN project).

• Through its engagement with state governments, Akeis Health Nigeria conceived and pioneered the concept of State Logistics Technical Working Groups. This proved to be highly successful, and later evolved into to the current national network of State LMCUs.

• Ensured end-to-end visibility within the supply chain using the Akesis Delivery System (ADS), a proprietary and validated Electronic Proof of Delivery (ePOD) System developed by Akesis Health Nigeria.

Results

Akesis Health Nigeria’s activities in the country are now supporting supply chains for HIV/AIDS, TB, malaria, RMNCH, family planning, essential medicines, and laboratory commodities.

By designing, implementing and utilizing versatile systems that can serve multiple donors and disease programs in Nigeria, Akesis is continuing to provide its donors and stakeholders with efficiencies and savings in the supply chain.