The RUTF Supply Chain Analysis involved field visits, both to the Horn of Africa and to Copenhagen. Each field visit afforded the opportunity to meet with different circles of stakeholders. In Nairobi, those involved in the regional and local planning of nutrition programs, the delivery of RUTF from port to warehouse to NGOs and district health centers, and the funding of these operations all were among those interviewed. Similarly in Copenhagen, Nutriset, Kuehne+Nagel, and UNICEF’s Supply Division all contributed to discussions with the core research team.
The focus group discussions with a range of stakeholders also served a useful purpose in each field visit. These field visits timed with the completion of different phases of the supply chain analysis. This allowed not only useful inputs into the data collection process, but the opportunity to share preliminary findings and to receive useful feedback on potential recommendations emerging from these results. This process can be very rewarding, and growing out of the field visit to Nairobi, the core research team was asked by the regional UNICEF program and supply/logistics staff to prepare a poster presentation for a meeting of UNICEF Country Representatives on the RUTF Supply Chain analysis’ preliminary findings.
Field visits also helped to fill in the gaps in the quantitative data analysis and the stories behind these analyses. Sometimes e-mail and phone calls fall short of a firsthand exchange over missing data needed for the study of the supply chain. Other times, the data do not tell the full story. For example, in studying the variability in order volume and production lead time, the core research team learned that the data provided had to be parsed further into non-emergency and emergency orders to analyze accurately the delays and congestion in the supply chain.
Strategic issues in stakeholder feedback were mirrored also in the RUTF Supply Chain Analysis.
- Triangulation of perspectives. UNICEF’s NGO implementing partners in Kenya expressed concerns over occasional stockouts in treating severely malnourished children. However, the UNICEF country office there did not flag such problems in the workings of the RUTF Supply Chain.
- Corroboration with quantitative data. Delays in RUTF delivery were thought to relate, in part, to the port strike at LeHavre and the civil unrest in Kenya, both potential sources of disruption in the transport of RUTF. However, quantitative data analyses suggest that neither incident accounted for the variability in order volume and production lead time either within or outside that period of time.
- Risk mapping. Implementing partners for UNICEF voiced concerns over delays in the delivery of RUTF supplies. They also noted that a RUTF order size depended on immediate prior demand. However, seasonal peaks in the hunger gap made anchoring this month’s supply on last month’s demand precarious. The rainy season also washed out roads and slowed the distribution of RUTF during some of these times. Bearing the risks of stockouts, but less directly the responsibility and the means for fixing them, NGOs expressed some frustration with the situation. Occasional stockouts resulted, and this erosion of trust in the supply chain prompted some NGOs to fund separately their own buffer stocks to cover such shortfalls.
- Handling non-transparency of data. Some data proved difficult to track down. For example, though country-level patent registrations should be publicly known, Nutriset treated such information as proprietary and did not share such information with the core research team. In the end, non-transparency of data limited the report’s findings. As a consequence, the report could not clear concerns expressed by those in the field that Nutriset’s broad patent claims over product and process or its approach to licensing might adversely impact local supply and innovation for RUTF.