Independent, Washington DC, USA.
InSupply Health, Nairobi, Kenya.
Glob Health Sci Pract. 2022 Jun 29;10(3). doi: 10.9745/GHSP-D-21-00345.
Information Mobilized for Performance Analysis and Continuous Transformation (IMPACT) Teams routinely bring together data, people, processes, and technology, under the leadership of governments, to institute a change in culture that leads to sustained improvements in supply chain processes and outcomes. This mixed methods study examined whether IMPACT Teams were effective in improving reproductive health supply chain outcomes in Guinea, Indonesia, Kenya, and Myanmar and identified enablers and barriers to IMPACT Team success and sustainability in Indonesia and Kenya.The study design employed a pre-post intervention comparison panel design with a nonrandomized matched comparison group to examine the IMPACT Teams' effect on 2 supply chain outcomes: stocked according to plan and stock-outs. Additional key informant interviews conducted in Kenya and Indonesia explored enablers and barriers to IMPACT Team success and sustainability.For nearly all products across the 4 countries, an increase in products being stocked according to plan and a reduction in stock-outs can be attributed to the IMPACT Team intervention, demonstrating that IMPACT teams are an effective approach for improving contraceptive supply chain inventory management and availability. However, our findings do not demonstrate a clear causal pathway as theorized in our theory of change, namely that government leadership leads to the installation of a data use culture, which in turn leads to improved product availability. In both Indonesia and Kenya, though product availability improved, there was a lack of leadership and culture change. This suggests that improved product availability does not depend on establishing a data use culture or government leadership, but rather, that a data use culture-rather than product availability-is the outcome of interest for sustained change, and that understanding motivations and incentives for leadership participation may be more important for scaling, institutionalizing, and sustaining gains in supply chain outcomes.
信息动员以实现绩效分析和持续转型（IMPACT）团队通常在政府的领导下汇集数据、人员、流程和技术，以改变文化，从而持续改善供应链流程和结果。这项混合方法研究考察了 IMPACT 团队是否能够有效地改善几内亚、印度尼西亚、肯尼亚和缅甸的生殖健康供应链结果，并确定了在印度尼西亚和肯尼亚促进 IMPACT 团队成功和可持续性的因素和障碍。该研究设计采用了前后干预比较面板设计，并与非随机匹配对照组进行比较，以考察 IMPACT 团队对 2 个供应链结果的影响：按计划库存和缺货。在肯尼亚和印度尼西亚进行的额外关键信息提供者访谈探讨了促进 IMPACT 团队成功和可持续性的因素和障碍。在这 4 个国家的几乎所有产品中，按计划库存的产品增加和缺货减少都可以归因于 IMPACT 团队的干预，这表明 IMPACT 团队是改善避孕药具供应链库存管理和供应的有效方法。然而，我们的研究结果并没有像我们的变革理论所假设的那样，明确地展示出因果关系，即政府领导导致数据使用文化的建立，而这反过来又导致产品供应的改善。在印度尼西亚和肯尼亚，尽管产品供应得到了改善，但缺乏领导力和文化变革。这表明，提高产品供应并不取决于建立数据使用文化或政府领导，而是数据使用文化而不是产品供应是持续变革的结果，并且理解领导参与的动机和激励因素可能对扩大、制度化和维持供应链结果的收益更为重要。
