Full Text Available
Note: Clicking the button above will open the full text document at the original institutional repository in a new window.
Supply chain analysis : a case study of differentiated physical distribution for chronic medicines in the public health sector of South Africa
Thesis (MCom)--Stellenbosch University, 2023.
Saved in:
| Main Author: | |
|---|---|
| Other Authors: | |
| Format: | Thesis |
| Language: | en_ZA |
| Published: |
Stellenbosch : Stellenbosch University
2023
|
| Subjects: | |
| Tags: |
No Tags, Be the first to tag this record!
|
| _version_ | 1867613969339908096 |
|---|---|
| access_status_str | Open Access |
| author | Enoos, Bashier |
| author2 | Louw, Johannes Jacobus |
| author_browse | Enoos, Bashier Louw, Johannes Jacobus |
| author_facet | Louw, Johannes Jacobus Enoos, Bashier |
| author_sort | Enoos, Bashier |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (MCom)--Stellenbosch University, 2023. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/127211 |
| institution | Stellenbosch University (South Africa) |
| language | en_ZA |
| last_indexed | 2026-06-10T12:44:35.400Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2023 |
| publishDateRange | 2023 |
| publishDateSort | 2023 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/127211 Supply chain analysis : a case study of differentiated physical distribution for chronic medicines in the public health sector of South Africa Enoos, Bashier Louw, Johannes Jacobus Pillay, Anban Stellenbosch University. Faculty of Economic and Management Sciences. Dept. of Logistics. Drugs -- Prescribing -- South Africa Medicine -- Formulae, receipts, prescriptions -- South Africa Medical care -- Prescriptions -- South Africa UCTD Thesis (MCom)--Stellenbosch University, 2023. ENGLISH SUMMARY: Timely, predictable, and sustained access to essential medicines is critical for ensuring long-term treatment adherence for chronic stable clients. In South Africa, ineffective and inefficient distribution processes compounded by a sizable and increasing burden of chronic diseases and shortages of health care professionals further strain the functioning of the public health supply chain. The Central Chronic Medicine Dispensing and Distribution (CCMDD) programme is an alternative supply chain dispensing and physical distribution model for chronic medicines and long-term therapies in South Africa, which leverages the dispensing, warehousing, and distribution infrastructure of private sector service providers. Although some studies have evaluated the performance of the CCMDD programme from a public health perspective, no study to date has specifically evaluated the programme through a supply chain lens. Six focused research questions provided insights into CCMDD programme indicators, defined the CCMDD segmented supply chain and illuminated opportunities toward continuous improvement. The purpose of this descriptive case study was to analyse the CCMDD programme and its contracting mechanism from a supply chain perspective. The analysis period spanned from July 2019 to September 2021. Quantitative secondary data from the South African National Department of Health (NDoH) were used for retrospective descriptive data analysis. Qualitative data, publicly available or provided by the NDoH, relevant to CCMDD programme contracting, segmentation and physical distribution were used to analyse the supply chain, supplemented by widely recognised models, tools, and frameworks. Six public health medicines supply chains were identified in South Africa using the SCOR model. Eight of 1 171 products on contracted supply agreements across all defined supply chains (by volume) were long-term therapy products, and equated to 22% of the total volume of all contracts. The CCMDD supply chain was defined as high-volume products with predictable demand for long-term chronic therapies. Reliability was identified as the CCMDD strategic driver with perfect order fulfilment as the key performance indicator. Further, by using a recognised “Supply Chain Dynamic Alignment Framework”, differences in the supply-side and demand-side, related to desired behaviour, were identified, with a transactional, lean approach on the supply-side opposed to a collaborative approach on the demand-side. Findings from this research also indicated that the CCMDD programme’s supply contracts and indicators did not comprehensively include all aspects of a balanced scorecard approach. By analysing the CCMDD programme indicators showed that: 1) client medicines parcels were delivered to 2917 external pick-up points outside of traditional internal public health medication distribution sites, 2) chronic stable clients were decanted to alternative external pick-up points outside of traditional internal public health medication distribution sites (1 449 644 active clients (59%)), 3) 52% of total registered clients were actively using the programme, 4) the highest demand for the programme came from antiretroviral therapy clients with 66% of active clients, followed by noncommunicable diseases with 20% and antiretroviral therapy with co-morbidities at 15%. The contracting of private sector service providers allowed the public health system to leverage private sector dispensing, warehousing, and distribution infrastructure for the CCMDD programme. The study concludes with recommendations for further research into client satisfaction, active client retention, increased enrolment of noncommunicable diseases client type, phase two of the SCOR roadmap, national centralisation of high-volume product lines, and CCMDD benchmarking toward a balanced scorecard approach. AFRIKAANSE OPSOMMING: Tydige, voorspelbare en volgehoue toegang tot noodsaaklike medisyne is van kritieke belang om te verseker dat langtermyn-behandeling vir chroniese stabiele kliente volg. In Suid-Afrika plaas oneffektiewe en ondoeltreffende verspreidingsprosesse, vererger deur 'n aansienlike en toenemende las van chroniese siektes en ’n tekort van professionele gesondheidswerkers, bykomende druk op die funksionering van die openbare gesondheidsvoorsieningsketting. Die Central Chronic Medicine Dispensing and Distribution (CCMDD)-program is 'n alternatiewe voorsieningskettingreseptering- en fisiese verspreidingsmodel vir chroniese medisyne en langtermyn-terapiee in Suid-Afrika, wat die reseptering-, verpakking- en verspreidingsinfrastruktuur van diensverskaffers in die privaatsektor hefboom. Alhoewel sommige studies die prestasie van die CCMDD-program vanuit 'n publieke gesondheidsperspektief geevalueer het, het geen studie tot op hede die program spesifiek deur die lens van 'n voorsieningsketting geevalueer nie. Ses gefokusde navorsingsvrae het insig in CCMDD-programaanwysers verskaf, die CCMDD-gesegmenteerde voorsieningsketting gedefinieer en geleenthede vir voortgesette verbetering verhelder. Die doel van hierdie beskrywende gevallestudie was om die CCMDD-program en sy kontrakteringsmeganisme vanuit 'n voorsieningskettingperspektief te ontleed. Die studietydperk het gestrek van Julie 2019 tot September 2021. Kwantitatiewe sekondere data van die Suid-Afrikaanse Nasionale Departement van Gesondheid (NDoH) is vir retrospektiewe beskrywende data-analise gebruik. Kwalitatiewe data, wat in die openbaar beskikbaar is of wat deur die NDoH verskaf is en wat relevant is vir CCMDD-programkontraktering, segmentering en fisiese verspreiding, is gebruik om die voorsieningsketting te ontleed, aangevul deur wyd-erkende modelle, gereedskap en raamwerke. Ses voorsieningskettings vir openbare gesondheidsmedisyne is in Suid-Afrika geidentifiseer deur van die SCOR-model gebruik te maak. Agt van die 1 171 produkte wat op kontrak oor alle voorsieningskettings verskaf is, gebaseer op volume langtermynterapieprodukte, was gelykstaande aan 22% van die totale volume van alle kontrakte. Die CCMDD-voorsieningsketting is gedefinieer as hoe-volume produkte met voorspelbare vraag vir langtermyn chroniese terapiee. Betroubaarheid is geidentifiseer as die strategiese drywer van die CCMDD, met perfekte bestellingvervulling as die sleutel prestasie-aanwyser. Deur gebruik te maak van ’n erkende Supply Chain Dynamic Alignment Framework is verskille in die aanbod- en vraagkant wat verband hou met gewenste gedrag, geidentifiseer, met 'n transaksionele skraal benadering aan die aanbodkant en 'n samewerkende benadering aan die vraagkant. Bevindinge van hierdie navorsing het aangedui dat CCMDD-programdiensverskafferskontrakte en -aanwysers nie alle aspekte van 'n gebalanseerde telkaartbenadering volledig insluit nie. ’n Analise van die CCMDD-programaanwysers het aan die lig gebring dat: 1) kliente se medisyne-pakkies by 2 917 eksterne optelpunte buite tradisionele interne openbare medisyneverspreidingsterreine afgelewer is, 2) chroniese stabiele kliente na alternatiewe eksterne afhaalpunte buite tradisionele interne openbare gesondheidspunte geskuif is (1 449 644 aktiewe kliente (59%)), 3) 52% van die totale geregistreerde kliente die program aktief gebruik het, 4) die grootste vraag na die program kom vanaf antiretrovirale terapie-kliente kom, met 66% aktiewe kliente, gevolg deur nie-oordraagbare siektes, met 20%, en antiretrovirale terapie met komorbiditeite, teen 15%. Die kontraktering van diensverskaffers in die privaatsektor het die openbare gesondheidstelsel in staat gestel om die private sektor reseptering-, verpakking- en verspreidingsinfrastruktuur deur die CCMDD-program te benut. Die studie sluit af met aanbevelings vir verdere navorsing oor klienttevredenheid, aktiewe klientbehoud, verhoogde inskrywing van kliente met nie-oordraagbare siektes, fase twee van die SCOR-padkaart, nasionale sentralisasie van hoevolume-produklyne, en CCMDD-benchmarking na 'n gebalanseerde telkaartbenadering. Masters 2023-03-06T16:07:33Z 2023-05-18T07:10:02Z 2023-03-06T16:07:33Z 2023-05-18T07:10:02Z 2023-03 Thesis http://hdl.handle.net/10019.1/127211 en_ZA Stellenbosch University xv, 171 pages : illustrations (some color), maps, includes annexures application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Drugs -- Prescribing -- South Africa Medicine -- Formulae, receipts, prescriptions -- South Africa Medical care -- Prescriptions -- South Africa UCTD Enoos, Bashier Supply chain analysis : a case study of differentiated physical distribution for chronic medicines in the public health sector of South Africa |
| title | Supply chain analysis : a case study of differentiated physical distribution for chronic medicines in the public health sector of South Africa |
| title_full | Supply chain analysis : a case study of differentiated physical distribution for chronic medicines in the public health sector of South Africa |
| title_fullStr | Supply chain analysis : a case study of differentiated physical distribution for chronic medicines in the public health sector of South Africa |
| title_full_unstemmed | Supply chain analysis : a case study of differentiated physical distribution for chronic medicines in the public health sector of South Africa |
| title_short | Supply chain analysis : a case study of differentiated physical distribution for chronic medicines in the public health sector of South Africa |
| title_sort | supply chain analysis a case study of differentiated physical distribution for chronic medicines in the public health sector of south africa |
| topic | Drugs -- Prescribing -- South Africa Medicine -- Formulae, receipts, prescriptions -- South Africa Medical care -- Prescriptions -- South Africa UCTD |
| url | http://hdl.handle.net/10019.1/127211 |
| work_keys_str_mv | AT enoosbashier supplychainanalysisacasestudyofdifferentiatedphysicaldistributionforchronicmedicinesinthepublichealthsectorofsouthafrica |