Evaluation of End-to-End Supply Chain

BACKGROUND

As a medical humanitarian organization, ensuring the timely and cost-effective provision of quality goods and services to the projects is a fundamental prerequisite for MSF Operational Centre Brussels (OCB) to achieve its medical operational ambitions, both in responding to sudden onset emergencies and in the routine programming.

Making this happen, is the OCB Supply Chain, comprised of a Supply Chain Department, Supply Centers in Belgium and Nairobi (MSF Supply and Kenya Supply Unit) and numerous project and mission level supply teams in the field. At any given moment, the Supply Chain engages approximately 600 personnel, oversees, and manages approximately 240 warehouses and storage locations. The direct spending in the supply chain (goods) represents €62 million, the indirect spending (services) €68 million, totaling approximately €130 million annually.

The OCB Supply Chain is an End-to-End and demand driven supply chain, meaning that for every item supplied there is a clearly identifiable authority who has requested the item and who will in turn receive the item at the point of use. Requests can be made, either through the project planning such as at the start of a project, through periodic ordering, such as to replenish stock or ad-hoc if a new item is needed. From the point of request, responsibility is shifted to the OCB Supply Chain which is responsible for a series of activities including the purchase of goods and services, transport to final location, warehousing, customs clearance, and physical stock management. The OCB Supply Chain responsibility ends when the item is received and both the item, and responsibility, is transferred back to the requesting authority in the different departments (e.g., Logistics, Medical) and goes into, for example, the end user units, like pharmacies, houses, or logistics workshops.

In addition to the sheer size, the supply chain must deal with numerous complexities inherent in the operational environment. Medical items and drugs can have short and variable shelf-life and frequently require cold-chain storage or maximum storage temperatures over prolonged periods. Strict quality assurances need to be in place for drug procurement and as the organization pushes the envelope on its medical ambitions, the range of drugs and medical supplies required keeps on growing – and the complexity to manage them as well.

On top of the medical complexities and challenges traditional to a supply chain, the operational environments MSF works in have their own challenges and are arguably becoming more diverse. Extreme weather patterns (heat, flooding) are becoming more normal and the remote, often conflict-ravaged, places MSF works provide challenges for the transportation and storage of items. As there are increases in the state legislation and control, new obstacles in the procurement and importation regulations emerge.

The apparent linear simplicity of the supply ‘chain’, a series of interconnected links, perhaps masks some of the interdependencies of what might better be described as a supply system. Along the supply chain there are numerous touchpoints where technical input is required from technical referents and departments. For example, the Supply Chain needs to work closely with medical and logistical personnel at both the point of request, to ensure accurate data is available to guarantee appropriate identification of needs (forecasting), at the point of procurement (ordering), and to ensure quality control. Forecasting and ordering remains under the accountability of medical and logistical teams. The specifics related to the handling and handover of items from the warehouse to different end points can vary according to different projects and subsequently transit times can vary. With long transit times, medical input can be needed to monitor stock levels and expiry dates etc. Good supply monitoring, which is the backbone of a supply chain, needs to happen across multiple storage points and requires a collaborative approach at project level to avoid shortages and ruptures which can in turn impact on program effectiveness.

While the OCB Supply Chain has been developed to meet the needs of OCB medical humanitarian ambitions it also has to operate with some prescriptive elements and initiatives from MSF International and incorporate those into its design. OCB Supply Chain strives to operate in line with industry standards, and it is very important that the supply chain is optimized around the unique and specific requirements of MSF’s operations. This is referred to in its mission statement and strategic ambitions, where it aims “to provide flexible solutions fitting the needs of Operations” (OCB Supply Chain Strategy Document 2020-2023). The OCB Supply Chain has a Framework for Action, operationalizing the strategic document, based on four points: reliability, proactivity, rapidity, and reactivity (in order of importance).

ORGANIZATIONAL CHANGES
Starting in 2012, OCB initiated the End-to-End Reform amounting to a series of significant investments to optimize and improve the supply chain’s capabilities in terms of service level, cost and quality of products and services. Investments were made specifically to the organizational set-up (including human resources and governance), and to develop and implement a series of tools that would help optimize at the process level, requiring particularly significant investment into elements including hardware, software, and human resources. It also aimed to achieve a better oversight of the Supply Chain by bringing together different supply entities and incorporating both the international supply and local supply under the same system.

A number of changes were made to the resourcing and governance of OCB Supply Chain, including increasing capacity and expertise with dedicated supply positions in the missions (2012), dedicated supply people in the operational cells (2014), and creation of the Supply Chain Department, integrated into the Comité des Directeurs (CoDir, ENG. Committee of OCB Directors of departments) (2016) and finally, with the handover of all supply related activities from logistics to the new Supply Chain department.

PURPOSE AND INTENDED USE

This evaluation comes at the request of the office of OCB’s General Director to inform discussions to be held by the CoDir. The evaluation should inform these discussions by assessing the extent to which the objectives of the supply chain are being met and identify areas working well and the critical issues that still need to be addressed.

To achieve this, the evaluation needs to provide a descriptive analysis (“What?”) of the supply chain, its strategy and design as well as its implementation and results. The evaluation also needs to assess (“So what?”) the overall performance of the supply chain with respect to delivering on the medical humanitarian ambitions of the organization and considering the different contexts of operation and with the intention of identifying what works, when, for who and under what circumstances. The evaluation should conclude (“Now what?”) with recommendations or scenarios that can be used by the CoDir to inform future strategic decisions and choices. The formulation of recommendations or scenarios should be done as part of a consultative process.

It should be noted that, although significant investments have been made during the End-to-End Reform, it is not the intention to compare the now against the ‘before’ but rather to compare against today’s available standards, guidelines, and ideal types.

The evaluation should only consider the supply chain’s efforts vis-à-vis supplying goods (services are not to be included in the scope).

EVALUATION CRITERIA AND QUESTIONS

EQ1: What elements of the supply chain design (set-up), strategy and governance could be adapted to better optimize the capacity to deliver on the objectives?
• Describe the internal and external operational environment and how the supply chain design (set-up), strategy and governance is adapted to this?
• How well adapted is the supply chain, its design (set-up), strategy and governance, to the operational ambitions of OCB and the internal and external operational environment?

EQ2: What are the main limitations and opportunities in the supply chain functioning and how do these relate to different operational contexts?
• Describe the supply chain functioning with regards to the effective and efficient delivery of quality goods to the project locations?
• How well is the supply chain functioning against the objective to provide timely and efficient supply of goods to project locations at the required quality?

EQ3: In what ways could the organization limit the negative consequences and build on the positive outcomes of the supply chain functioning?
• What is the effect of the supply chain’s functioning when considering the positive and negative, intentional, and unintentional, impact on the OCB operational ambitions both globally and at the local level?
• How significant are these effects when considering the operational ambitions of the organization and the projects’ objectives?

EXPECTED DELIVERABLES

1. Evaluability exercise
   To ensure a common vision of the evaluand.

2. Inception Report
   As per SEU standards, after conducting initial document review and preliminary interviews. It will include a detailed evaluation proposal, including methodology.

3. Draft Evaluation Report
   As per SEU standards. It will answer to the evaluation questions and will include conclusions, lessons learned and recommendations.

4. Working Session
   As part of the report writing process, a meeting with the commissioner, consultation group members and SEU evaluation manager. The evaluator will present the findings, collect attendances´ feedbacks and will facilitate discussion on lessons learned or recommendations.

5. Final Evaluation Report
   After addressing feedback received during the working session and written inputs.

6. Presentation of the Final Evaluation Report
   An online presentation of the final report for OCB and possible other stakeholders of interest.

TOOLS AND METHODOLOGY PROPOSED

In addition to the initial evaluation proposal submitted as a part of the application (see requirement chapter), a detailed evaluation protocol should be prepared by the evaluators during the inception phase. It will include a detailed explanation of proposed methods and its justification based on validated theories. It will be reviewed and validated as a part of the inception phase in coordination with the SEU.

It is anticipated that the evaluation team will need to visit a range of projects and the methodology will need to include appropriate sampling strategies to identify the number and location of the projects to be visited.

RECOMMENDED DOCUMENTATION

 Plans, monitoring data and reporting, from both the OCB Supply Chain and projects
 Previous assessments and audits conducted
 Strategic documents and plans
 Internal presentations
 Reporting
 Existing guidelines

PRACTICAL IMPLEMENTATION OF THE EVALUATION

Number of evaluator(s): Flexible
Timing of the evaluation: June-October

PROFILE/REQUIREMENTS FOR EVALUATOR(S)

Requirements:
 Specific evaluation competencies related to evaluation of complex systems,
 Significant knowledge and understanding of supply chains systems in the medical and or humanitarian contexts,
 Excellent communication and diplomacy skills and ability to negotiate sensitive information with a range of stakeholders,
 Fluency in English, spoken and written, and
 Willingness and ability to travel to the selected field sites (TBD), alternatively identify partners to work with in those locations.

Assets:
 Experience with MSF either directly or through evaluations,
 Supply chain related expertise in areas of specific relevance to MSF operations, i.e., pharmaceutical goods, transport mechanics,
 Professional fluency in French language, spoken and written, and/or
 Good knowledge of organizational development and strategic planning.