Barriers Description Promising Practice(s) that

Address the Barriers Competing priorities for

health center staff Health workers in low- and
middle-income countries are often overworked
and under-resourced. Health workers are often
responsible for multiple jobs, including clinical
care, reporting, ordering and managing
commodities, and cleaning and maintenance of
equipment and the facility.  Performance-
based financing at the SDP Difficulty accessing
hard-toreach communities For individuals living
in remote and rural areas, the time, money,
and effort it takes to reach the nearest health
facility may be prohibitive and limit access to
care.  Community-based distribution 
Subsidizing underutilized commodities Lack of
community engagement Inadequate
information provided to the community on
service delivery and product availability issues,
leading to low or nonexistent community
engagement and limited accountability. 
Increase community participation in service
delivery accountability Unfavorable pricing for
the private sector Private sector entities face
challenges when trying to supply products at a
price that is affordable for the consumer while
still profitable for the entity. This is sometimes
exacerbated in an environment where the
public sector secures donated commodities and
provides products at no cost.
Barriers Description Promising Practice(s) that
Address the Barriers: Delayed, inaccurate, and
incomplete data Data that are not accessible for
decision making within a reasonable timeframe
after collection will not reflect current levels of
need or supply. Inaccurate data may lead to under-
or overestimating commodity needs. Incomplete
data means that guesswork must be used to
determine the current level of need or supply. 
Focused data collection  Use information and
communications technology (ICT) tools for data
collection and management  System design to
improve data quality and use Insufficient use of
data for decision making Data are often collected,
but are rarely used to the fullest extent possible in
decision making. Exacerbating the problem is the
over-collection of unnecessary data. Not only does
this use up valuable personnel time, it makes it
difficult to see and understand the data that are
actually important for decision making. Streamlining
data collection activities to focus only on data that
will be used helps address this barrier.  Focused
data collection  Create and use a logistics
information portal  Use information and
communications technology (ICT) tools for data
collection and management Insufficient human
resource capacity for appropriate data collection
and use Human resource limitations at all levels of
the system significantly impact data management.
Inadequate training, incentives, and feedback result
in poor data collection quality and inadequate use
throughout the supply chain.  System design to
improve data quality  Incentivize data
completeness and accuracy Lack of easily accessible
and shareable information In many locations, there
is a wealth of data collected. Too often, data are
inaccessible because: they are paper-based;
decision makers are located far away; the data are
locked up in a secure setting; or the data are
located on a computer to which few people have
access.  Use ICT tools for data collection and
management  Create and use a logistics
information port

 Initial and recurring costs: Adoption of ICT

tools involves upfront costs to purchase and
install equipment, procure software licenses, as
needed, migrate data from the current system,
and provide user training. Ongoing operational
costs should also be taken into account,
including maintenance and repair of
equipment, support for applications, user help
desk, anti-malware software for computers,
recurring charges for communications services
(both wired and cellular), and refresher
training. The effort and cost needed to define
and apply an organizational policy regarding
misuse or loss of equipment should also be
considered.

Barriers Description Promising Practice(s)

that Address the Barriers Lack of training
and capacity in SCM Health personnel often
have inadequate training (or sometimes no
training) to prepare them for the logistics
tasks they are expected to perform. 
Dedicated logistics personnel  Increased
SCM capacity for health personnel at the
service delivery point Outdated or
nonexistent standard operating procedures
In many places, standard operating
procedures for SCM are outdated or non-
existent. This problem occurs at all level of
the health system. Furthermore, job
descriptions of health personnel often do
not include logistics tasks.  Create and use
systematic HR plans and policies to support
SCM  Performance management and
supportive supervision for supply chain
activities Lack of a systematic approach to
HR for SCM HRH and supply chain planning
often lie in separate silos, lacking a
coordinated, systematic approach to HR for
SCM.  Create and use systematic HR plans
and policies to support SCM Lack of
performance support and motivation for
logistics tasks Overburdened and under-
resourced staff are often unsupported and
unmotivated to perform logistics tasks.
Supervision methods that exist are often
performed sporadically and/or focus on
clinical duties only, ignoring SCM. 
Performance management and supportive
supervision for supply chain activities High
staff turnover and mobility High staff
turnover and mobility of health personnel
cause barriers to keeping staff trained and
experienced in required logistics tasks. 
Dedicated logistics personnel  Increased
SCM capacity for health personnel at the
service delivery point High workload among
health personnel Many countries have
human resources shortages among health
workers increasing the number of patients
each provider sees and their workload. 
Dedicated logistics personnel