Forecasting and Supply Planning: Despite Success in Overcoming Many Challenges, Countries May Prefer to Return to the Pre-COVID Model with International Advisors

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Date
May 10, 2021
Lead Paragraph/Summary

COVID-19 began to impact the USAID Global Health Supply Chain Program-Procurement and Supply Management (GHSC-PSM) project by March, 2020, with travel restrictions and other public health measures greatly limiting in-person training and other capacity-building activities.

The impact of COVID-19 was perhaps greatest for activities like forecasting and supply planning (FASP). Training and implementation for FASP activities require extensive stakeholder engagement, training, data review, negotiations and decision-making. Before COVID-19, support for FASP would typically include one or two weeks of travel by an international advisor to lead an in-person event with participants representing many local partners.

Because of the COVID-19 pandemic, GHSC-PSM shifted to remote support to ensure countries meet their planned FASP objectives, including technical assistance to multiple countries on quantification of HIV/AIDS, malaria, family planning/reproductive health, maternal, newborn and child health, and COVID-19 commodities.

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Overcoming Many Challenges in Remote Facilitation
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However, FASP advisors encountered many challenges while facilitating FASP activities remotely, including more time and effort required for planning. Remote facilitation prevented or hindered facilitators from doing basic administrative tasks that are easily done during in-person sessions, such as verifying that participants had downloaded software to their computers in advance, noting body language and verifying that participants are fully engaged, and pairing up participants who are doing well with those who are struggling.

To overcome these challenges related to online facilitation, GHSC-PSM is developing a training tracker tool for self-assessment to better monitor the progress of FASP participants, limiting the number of participants in online activities, and spending more time on advance planning. To limit screen fatigue and account for the fact that some participants were caring for children at home, the project also adapted to online by breaking FASP activities into smaller bits of time but over an extended schedule.

Time differences meant needing to be online at odd hours, including as early as 3:00 am on the East Coast of the United States to lead FASP activities in Asia. Online facilitation required a more structured approach; facilitators found it much more difficult to adapt and go with the flow' as they would at times do during in-person sessions. Some basic technology challenges also remain, including predictable connectivity issues and the need for participants to learn to use new online platforms to participate, share screens and more.

Other challenges arose regarding client expectations. Prior to COVID, planning for international travel and in-person support had involved a standard scope of work that USAID was familiar with and could readily approve. Switching to remote support required a redesign of activities and negotiations with the client for approval. Despite travel restrictions and facilitators' concerns about COVID transmission and quarantining, some countries still requested in-person support that required travel, even though various technology platforms are available. The project uses Microsoft Teams for internal activities and had to negotiate with partners the technology to use for sessions with outside participants. For new platforms, licenses may be required, and facilitators at times struggled to utilize new features like breakout rooms.

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For the Long-term, Promoting Local Ownership
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The long-term implications of COVID may be difficult to predict for FASP activities. To encourage country ownership and sustainability for quantification (one piece of the overall FASP program), GHSC-PSM is working to reduce international advisors' involvement and encourage local leadership. FASP advisors would prefer to play an advisory role after each daily session, allowing local staff to lead. Local staff often already have the skills and knowledge to lead, but they often prefer having an outside facilitator because of the challenges of balancing the demands of regular duties with planning and implementing a large event.

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COVID Article Mali Screenshot
COVID Article Mali Screenshot
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Case in Point: Mali
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In Mali, the annual health commodity quantification workshop took place under local leadership (no international support) and in line with COVID-19 safety measures. To keep the number of participants under the maximum of 50 allowed by the government, the four technical working groups (TWGs) for HIV/AIDS, malaria, FPRH and MNCH selected ten representatives each to attend. Before the event, through multiple consultations and conference calls, each of the TWGs conducted weeks of advance work and data review to prepare their representatives. At the event in June 2020, participants received two masks every day, and supplies of disinfectant gel, soap and water promoted hand washing. Breakout group leaders monitored compliance with COVID-19 social distancing measures.

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A Question of Cost
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The cost implications of remote support vary greatly. Where international advisors lead the activity, the total cost can be more – despite the savings in international travel – because of the increased level of effort to plan and coordinate online sessions and potential costs for licensing fees and more. Where local staff can lead, the cost can be less. 

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Case in Point: South Sudan
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For South Sudan, an international trip planned for April 2020 transitioned to remote support, with the international advisor leading the United States' activity. The activity's cost was nevertheless the same, with an additional level of effort in planning to double from that originally budgeted and costing the same as the savings related to canceled travel, hotel and danger pay.

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All Things Being Equal?
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Because the accuracy of commodity forecasts requires time to assess, it is too soon to know that the quality of outputs from remote support is the same quality as in-person. In the meantime, participants report that they prefer in-person FASP activities for various reasons, including the enjoyment of social interactions, the preference for an independent, outside facilitator, and the benefit of a time-constrained, focused activity. Because of this, FASP advisors predict that countries will likely prefer to return to the 'old way' of doing things, but adapting to COVID-19 has added a new tool to the toolbox that can be used when international travel is not possible or practical.