Improving nutrition supply chains for children

Malnutrition is both preventable and treatable; however, supply chain inefficiencies may hinder access to the therapeutic food needed to treat severe cases. The Supply Chain Maturity Scorecard is a simple tool that can help identify gaps and target investments to strengthen supply chains. 

In the Central African Republic (CAR), years of conflict and displacement of populations have created a crisis for children. Acute food insecurity has led to increasing rates of malnutrition among children. In 2019, more than 43,000 children under five years of age were projected to suffer from severe acute malnutrition (SAM), a life-threatening condition requiring urgent treatment.

With the nutrition crisis in CAR escalating, ensuring that children had access to ready-to-use therapeutic food (RUTF) – a primary treatment for children with SAM – was critical. However, there were gaps in availability of RUTF at health facilities. End user monitoring assessments indicated that stock-out management was one of the main challenges to ensuring continued availability of RUTF. 

Supply Chain Maturity Scorecard

To better understand why the stock-outs were occurring, UNICEF supported the Government of CAR to undertake a USAID Food for Peace-funded review using the tool known as the Supply Chain Maturity Scorecard. 

Developed by UNICEF in 2018, the Supply Chain Maturity Scorecard assesses the maturity level of a country’s supply chain and helps measure progress and target investments. The tool provides a comprehensive approach to address issues affecting supply chain performance, by monitoring and tracking fundamentals – the main operation elements – such as procurement, budgeting and planning; and the enablers, such as policy and system design. As of 2019, UNICEF has supported 21 countries to undertake this supply chain assessment in different areas such as essential medicines, immunization and nutrition. 

In CAR, the Maturity Scorecard helped to determine that a main reason for the stock-outs was the inefficient flow of stocks from the national to the health facility level. The Government of CAR, together with UNICEF and other supply chain stakeholders, established a comprehensive roadmap to address these barriers, such as strengthening warehouse capacity and transportation mechanisms. 

UNICEF supported the implementation of the Government-led plan by leveraging the momentum created around the nationally-led roadmap to advocate for funding and match the national supply chain needs identified by the Supply Chain Maturity Model with resources. Once put in place, these targeted and coordinated supply chain strengthening efforts had a significant impact on expanding the distribution coverage and accessibility of RUTF products at the last mile.