This poster was presented by Hery Firdaus and Bethany Saad at the International Conference on Family Planning (ICFP) in Kigali, Rwanda in November 2018. Over the past decade, Indonesia’s contraceptive prevalence rate has remained stagnant, to reinvigorate family planning services in Indonesia The National Population & Family Planning Board (BKKBN) is working to ensure that women can choose from a variety of contraceptive methods as part of a “Right Method, Right Time, My Choice” strategy. One challenge to this strategy is inconsistent access to the full range of contraceptives, especially long acting contraceptives, at service delivery points (SDP). Having a reliable, responsive supply chain that delivers quality contraceptives to service delivery points when and where they are needed is critical to ensuring the success of this strategy. JSI Research & Training Institute, Inc. (JSI) as part of the My Choice Project has been working with BKKBN to address the supply chain challenges. Can contraceptive availability be improved by strengthening organizational supply chain capacity, multi-level collaboration, and data visibility and use? To achieve this the intervention package included 1) strengthening organizational capacity by redesigning standard processes and developing training tools such as video tutorials and mobile apps 2) improved multi-level collaboration through quality improvement techniques, mentorship, and on-the-job training and 3) improving data visibility, quality, and use through accurate logistics records and reports, creating an inventory management and monitoring tool that facilitates easy decision making, guides stock distribution to maintain adequate stock levels, and monitors overall performance of the supply chain. Preliminary end line evaluation results suggest that the intervention package has improved supply chain performance and reduced stock outs, especially in areas where the full package was implemented.

1. INTRODUCTION
Reliable, responsive supply chains deliver quality contraceptives when and where they are needed.
Through the ‘My Choice’ project, JSI is partnering with Indonesia’s National Population & Family Planning
Board (BKKBN) to strengthen family planning supply chain systems across four provinces in Indonesia,
ensuring women have consistent access to a range of contraceptive options.
Over the past decade, contraceptive prevalence rates in Indonesia have remained stagnant in part due to
inconsistent access to contraceptives at service delivery points. To address critical gaps in the system, JSI
collaborated with stakeholders at each level to design a comprehensive package of data centric
interventions to strengthen the supply chain workforce, empowering them with new tools, skills, and
information to enable holistic and continuous supply chain improvement.
SUPPLY CHAIN BOTTLENECKS
PROGRAM IMPLEMENTATION
Using an implementation research approach, JSI partnered with BKKBN to evaluate supply chain system
weaknesses, and design and test the intervention package in four provinces that comprised 11 districts with 650
service delivery points.
A baseline assessment, conducted in November 2015, used a mixed method approach: quantitative facility surveys
and qualitative group discussions. The results of the baseline were used to identify strengths and weaknesses in the
current supply chain, inform intervention design, and provide a baseline for measuring effectiveness.
The midterm review in January 2017 reviewed routine data and gathered qualitative feedback that informed
adjustments in design and approach.
The endline evaluation, completed in February 2018 was designed to measure changes in key supply chain
indicators against baseline. The analysis includes a longitudinal evaluation of progress between baseline and
endline with significance tests of outcomes at the two timepoints plus some trend analysis of the routine data.
Qualitative data is analyzed by themes to supplement the quantitative results.
GOAL
METHODOLOGY
IMPACT
Inventory Management
Use of service targets to make resupply
decisions and an inadequate inventory control
system resulting in stock imbalances.
Communication and Collaboration
Supply chain functions cut across multiple
divisions and levels with minimal communication
and coordination resulting in inefficiencies within
the supply chain.
Organizational Capacity
The FP program lacked standardized processes
and a mechanism for routine monitoring and
supervision of the supply chain. High staff
turnover made capacity building challenging.
Logistics Management Information Systems
BKKBN has a robust electronic LMIS but poor
record management at SDPs compromises
quality and limits use of the data.
A strong and dynamic supply chain system for the family planning program that enables all people to have
consistent access to a full range of contraceptive methods at all times.
National Population & Family Planning Board
CONCLUSION and WAY FORWARD
45%
15%
23%
30%
9%
14%
32%
6%
21%
2% 3%
17%
Any
Method
IUD Implant Injectable Pill Condom
Baseline (n=341) Endline (n=358)
47%
reduction in number
of SDPs stocked out *
*Average of All Methods
Percentage of SDPs stocked out
on the day of the assessment
235%
increase in number of
SDPs using stock cards
Stock card usage and
accuracy at SDPs
24%
34%
80%
64%
% of SDPs using stock cards % of accurate stock
cards(matching physical stock)
Baseline (n=341) Endline (n=358)
32%
37%
32%
27% 24%
49%
45%
50%
33%
28%
IUD Implant Injectable Pill Condom
Baseline (n=341) Endline (n=358)
Percentage of SDPs with adequate stock
(0.5 to 5 months) on the day of the assessment
37%
increase in number of
SDPs with adequate stock*
*Average of All Methods
A new min max inventory control system using
consumption data, combined with standardized
trigger points for emergency orders and
reallocation of overstocks has resulted in
providers becoming more pro active and the
system becoming more adaptive to changing
consumption patterns. This has reduced stock
imbalances across facilities with a greater number
of facilities maintaining adequate levels of stock.
The institutionalization of Quality Improvement
Teams has improved capacity of team members to
analyze performance indicators, empowering them
to develop local solutions and action plans. These
forums have been critical in inculcating a culture of
data use for decision making and have fostered
collaboration amongst various departments within
the family planning office to work towards a common
goal of improved supply chain performance.
The supply chain workforce has been strengthened
with the support of a routine mentorship and
on-the-job training program which has led managers
to use data to better understand the needs of health
facilities and provide appropriate support. In facilities
where routine mentorship and on-the-job training
has been conducted regularly there is improved
supply chain performance with every visit.
89%
increase in number of
accurate stock cards *
*matching physical stock
The customer-focused, and data centric approach ensured that stakeholders have become more comfortable with analyzing and using data to proactively identify problems and determine solutions. Equipping staff throughout
the system with the right tools and standard operating procedures has improved accountability and coordination at all levels. Better planning and the use of data for managing inventory and distribution has resulted in
reduced stock imbalances and better availability at resupply points and SDPs. Most importantly, the work done over the last two years has elevated the importance of supply chain management within the family planning
program and has provided the evidence needed to convince the central and local governments to increase investment and focus in strengthening family planning supply chain systems. Many of the lessons learned in the
project districts, especially with regards to the use of data to guide distribution and resupply and the implementation of other supply chain management best practices, is now influencing and changing the policies and
procedures at the national level. In addition, provincial and district stakeholders have recognized the value of adopting these interventions and have committed resources to scale up the interventions in 25 additional districts.
Data visibility and use has improved by equipping
users with user friendly tools that allow tracking of
key supply chain performance indicators. Capacity
building and on-the-job training with a strong
emphasis on strengthening stock keeping recording
and reporting has significantly improved data
quality for decision making.
2018-2019
FEBRUARY
2018
FEBRUARY
2016
NOVEMBER
2015
APRIL 2016 to
JANUARY 2018
Baseline assessment.
Identify bottlenecks and
needs
Design system
strengthening solutions
Scale up to other
districts
Impact evaluation; identify
successes for scale up
Implement, monitor
and make course
correction if needed
A DATA CENTRIC APPROACH TO DRIVING SUPPLY CHAIN EFFICIENCY IN INDONESIA
HERY FIRDAUS ⚫ BETHANY SAAD ⚫ SARAH ANDERSSON ⚫ NURFADLIAH ⚫ OMAR BALSARA
JSI RESEARCH & TRAINING INSTITUTE, INC.
www.jsi.com/mychoiceindonesia
jsi.idfp@gmail.com