Completed Research

Reaching the Last Mile:
Tanzania’s Medical Supply Chain

University of Toronto

Tanzania has gradually and purposefully improved its system for distributing medical commodities. The use of GPS technologies and geo-mapping software to optimize delivery routes has made logistics and information management platforms more precise and efficient. Today, the Medical Stores Department is responsible for delivering all medical commodities directly to over 7,500 public and faith-based health facilities across the country.

The Hard to Reach

Patients of public, and some faith-based, health facilities, regardless of geographic location or socioeconomic demographics of the health facility’s district.

Key Takeaways

The modernization and improvement of Tanzania’s medical supply chain system has been an evolutionary process over the past thirty years. What we see today does not resemble how medicines were distributed (or not distributed) during the 1990s. In the past, medical commodities were shipped to district-level drop-off points. Today, medical commodities are delivered directly to every public health facility (and some private facilities) in the country, regardless of where the facilities are, how poor the district is, or how distant the facility may be from a central warehouse. The Medical Stores Department has improved overall system performance so much that it is now a center of excellence and the regional procurement hub for the Southern Africa Development Community. Many lessons can be learned from this extraordinary case.

  1. Modernizing the country’s medical supply chain system required patience, resources, and a long-term commitment from a variety of stakeholders and political will on the government’s part.
  2. From the start of the supply-chain-modernization process, the government embraced participation and advice from private-sector actors. Many of the process improvements — from information management, route optimization, and computer modelling to human resource management and performance assessment — came from private sector insights.
  3. Despite the tendency to seek a one-size-fits-all solution to complex supply chain challenges, the Medical Stores Department  and its local partners have had to adapt to local conditions, maintaining a strong commitment to standardized supply chain processes while accommodating local adaptations so that the system can work throughout Tanzania.
  4. The Tanzanian case demonstrates the importance of good infrastructure in part because of the investments the government and the private sector have made and in part because of gaps in infrastructure, both hard and soft, in the medical supply chain system.

Acknowledgements

This research was made possible through the Reach Alliance, a partnership between the University of Toronto’s Munk School of Global Affairs & Public Policy and the Mastercard Center for Inclusive Growth. Research was also funded by the Canada Research Chairs program and the Ralph and Roz Halbert Professorship of Innovation at the Munk School of Global Affairs & Public Policy. The authors of this report express our gratitude and appreciation to those we met and interviewed in Tanzania, including program administrators, government officials, front-line social service professionals, civil society activists, and scholars. Your work and dedication are inspiring.

This research was vetted and received approval from the Ethics Review Board at the University of Toronto.