Providing quality assurance services in fragile and conflict affected states

Posted: 27/10/2020

Since October 2018, MannionDaniels has been the in-country Local Fund Agent (LFA) for The Global Fund, working to fight against Tuberculosis (TB), AIDS, and Malaria (GFATM) in Somalia. While Somalia has PricewaterhouseCoopers (PWC) as the LFA, we were appointed the in-country LFA because of our previous experience working in fragile and conflict affected states and our ability to access most parts of the country including the sites where the Global Fund grants are being implemented.

Our role as the in-country LFA, works toward improving implementation of the HIV Aids, Tuberculosis and Malaria grants so as to reduce the impact of these diseases on the Somali people. We do this by conducting in-depth reviews of the grants through spot checks, data quality reviews, ad hoc procurement reviews, reviews of programme management tools and assessments of District Health Information Systems (DHIS2). We analyse the data collected and then feedback our findings to The Global Fund giving them recommendations on how to improve grant implementation.

As in-country LFA we access the health facilities and sites where the Global Fund grants are being implemented. This requires collaboration and engagement at all levels, from the community, Regional, sub-National, and National level with local and national health authorities, implementing partners and bilateral partners.

Our knowledge and understanding of the country context, together with the existing relationships with most of the stakeholders working in health has allowed us to successfully carry out role successfully. For example, in June 2019 we conducted a spot-check of the long-lasting insecticide nets (LLIN) distribution, which found that many recipients were using the distributed LLINs in the wrong way, as fishing nets or placing them on top of their homes rather than inside. This was reported to the Global Fund with recommendations and they communicated to the Implementing partners through the Principle Recipients to address the issue.

Assessment of Somali Procurement & Supply Chain

In February 2020 we carried out the first ever Assessment of Somali Procurement & Supply Chain Management for HIV Aids, TB, and Malaria health commodities. This included looking at and understanding some of the root causes of supply chain challenges and documenting baseline indicators in the management of TB, HIV, and Malaria supply chains.

Smaller assessments had previously been carried out, but none had gone in-depth in looking at the procurement and supply chain issues. Before our assessment was completed a Ministry of Health official in Puntland told us:

"It is concerning that lots of assessments, evaluations, and workshops have previously been done but the very slow implementation of the recommendations and feedback to the Government undertaken for the health supply chain, we need to change this.  I hope this supply chain assessment will be different."

During our assessment, a total of 28 facilities (16 non-government organisations, 11 government and one private facility) were selected and assessed in South Central, Somaliland, and Puntland. The sample included 14 TB Management Units, nine HIV/AIDS sites, and five Malaria facilities.

The findings of the assessment focus on the results from the Logistics Indicator Assessment Tool (LIAT), a tool which is used in many countries to collect data and information to assess healthcare supply chains. The findings from the LIAT have allowed the Global Fund and other stakeholders to have a better picture of the performance of the current supply chain systems in place in Somali and has helped to identify strengths and areas of improvement in order to have a well-performing and functioning system. This in turn will help the entire health commodities supply chain in Somalia and Somaliland.

MannionDaniels Team Piloting the Logistics Indicator Assessment Tool tool in Hargeisa TB Hospital

MannionDaniels team piloting the Logistics Indicator Assessment Tool tool in Hargeisa TB Hospital

MannionDaniels Senior Procurement and Supply Chain Management (PSM Expert Dr. Chris Masilla in the Hargeisa Central Warehouse