I recently spent some time in Tanzania looking at the “last mile” of logistics of medical supplies in the country. The project focused on assessing the challenges with reaching health clinics and dispensaries, particular in rural areas. Below are some issues to consider when drafting your “last mile” strategy:
Territory and road infrastructure – Gain a clear understanding of the road conditions and travel time required for delivery. Also, consider seasonality and how the rainy reason will affect your distribution. Not all roads are passable during the rainy season and your mode of transport, e.g. four wheel drive, may also change. Road infrastructure and seasonality will also impact your network design, e.g. designing routes.
Service delivery point growth – In a number of African markets there are aggressive plans to expand and increase the footprint of health facilities. It is important to understand what impact this will have on the supply chain or pipeline.
Distribution centers (DCs) or cross docking – In Africa, distribution distances tend to be large and DCs limited. Overnight routes and driver per diems can increase costs and reduce truck utilization. Evaluate the need for more DCs and the role cross docking can play in streamlining distribution processes and reducing cost.
Demand planning – Tanzania has moved from a push system (demand determined at central level) to a pull system (demand determined at health facility level). Health workers at health facilities are responsible for submitting demand requirements (or R&R forms). Common problems include delays in submitting forms and limited capacity or capability to complete forms. It is important to identify and understand bottlenecks. Determine what can be done to simplify the process, e.g. limit the pull to certain Stock Keeping Units, and help reduce the workload for health workers, e.g. introduce regional demand coordinators.
Ordering cycle – Review the ordering cycle (or frequency) and order groupings, if any. Assess unplanned orders and volume per drop for each segment, e.g. health facilities versus dispensaries.
Scheduling – Ad hoc deliveries need to be evaluated, especially at the “last mile” level. Ensure that documented scheduling is in place.
Delivery process– Determine how long on average the delivery process takes (time) and review the written guidelines for delivery. For example, in Tanzania all goods received in villages need to be checked by the Village Health Committee. It is a good system to ensure checks and balances, but has the potential to create delays due to committee members not being available.
Use the right vehicles – The Landcruiser is widely used but not always the right vehicle for the job. A number of African countries have poor infrastructure but Landcruisers, with high capital costs, are not always required. See my previous post on this issue.
Distribution incentives –Review how incentivizing employees can drive efficiencies. Incentives could focus on truck turn around time, loading and dispatching.
The use of 3rd party distributors – 3rd party distributors (3PLs) can play an important role in distribution. Local operators allow you to tap into a lower cost structure and can also provide greater flexibility.
Fourth party logistics (4PL) or transport agents – A 4PL is defined as an organization that assembles resources, capabilities, and technology of its own organization and other organizations to design supply chain solutions. In Africa, health facilities tend to have limited capacity and capability to identify and manage 3rd party distributors. 4PLs or agents have the potential to play an important role here and help reduce the workload for health workers. Local operators or 4PLs are also in a much better position to negotiate better transport rates and manage scheduling.