Relationship between need and demand: The RUTF supply chain is a pull system, with all partners ultimately relying on good assessments of demand. There is insufficient capacity–both on the supply and programmatic sides–to reach all need for RUTF. Despite this, the relationship between need and demand for RUTF is complicated by a range of data quality concerns, including:
– Choosing descriptive statistics: Different nutrition statistics may yield a very different picture of need for RUTF, and surveys may count children under 6 months of age who are excluded from the clinical guidelines for treatment with RUTF.
– New growth standards: There is an ongoing transition to new WHO growth standards which may also impact assessments of need.
– Latent need versus actual demand: Using latent need data to predict demand is not a straightforward process. Demographic surveys assess prevalence whereas it is incidence that impacts admissions to nutrition programs, they often do not capture seasonal fluctuations in hunger that affect nutrition status, and they focus on national-level statistics, while districts may vary greatly in their nutritional status. Additionally, the relationship between need and demand, is strongly influenced by other flows in the supply chain, such as limits on funding, product supply and programmatic capacity that place a ceiling on how many children in need can actually be treated.
Trust in the supply chain impacts information flow: The RUTF supply chain experiences a lack of trust and buy-in for forecasting. Orders only materialize when there is sufficient funding and product, so the development of accurate forecasts can be seen as a waste of time and resources. This means that ordering behaviors are driven by factors outside of information flow. There is a spike in orders each year in September/October, corresponding with theend of donor fiscal years.
– Manual linkages between systems: There are new automated linkages between different information systems, but previously all data were manually coordinated–leading to manual entry errors, delays in data input, and a lack of transparency for partners outside of Supply Division.
– Information flow is passive: Although there are some information sharing mechanisms, these are not consistently utilized by all relevant UNICEF staff. Staff are extremely busy and may not prioritize the review of these data.
– No automated exceptions: It is particularly important to notify key partners when orders deviate from their expected timeline, but UNICEF does not have an automated exceptions handling system.
KPIs should be actionable: Lastly, KPIs on this supply chain may not help all stakeholders make well-informed decisions on ways to improve the delivery of RUTF. There are a number of existing KPIs but they do not always collect the most useful data. A survey of UNICEF staff found that UNICEF staff identified the highest-priority KPIs as:
– Orders delivered to UNICEF warehouses on-time and completely
– Orders delivered to consignee on-time
– Storage time at the UNICEF warehouse
– Order fulfillment time
Of these highest-priority KPIs, only one (Order fulfillment time) is tracked by a global UNICEF KPI. On-time order shipment is measured to port of arrival by UNICEF Supply Division, but all the other KPIs are monitored at the country level, which introduces variability and the potential for inconsistency. It also makes it hard for UNICEF to develop a good global view of the supply chain.