Unpacking the impact of integrating the Neglected Tropical Diseases supply chain into the national supply chain system: Illustrative evidence from Liberia

Effective supply chain management is a critical pillar of a well-functioning health system to ensure that medical commodities reach all those in need on time. In Liberia, the national NTD programme is supporting health systems strengthening for the case management of NTDs. Integration of NTD commodities into the national health system supply chain, is central to the integrated approach, however, there is minimal evidence on enablers and barriers to supply chain integration. Drawing on qualitative evaluation data, we illustrate that perceived benefits and strengths to integrating NTDs commodities in the national supply chain include leveraged storage and management capacities which are capitalised at lower systems (county) levels; the political will to integrate based on cost-saving and capacity strengthening potential; positive progress in integrating paper-based reporting tools. However, challenges remain, specifically: the risk of reliance on donor funding for the supply chain; difficulty in accessing commodities due to bureaucratic bottlenecks; lack of inclusion of NTD commodities within electronic data tools; poor coordination leading to an inability to meet medicine and commodity demand. Collectively, the negative consequences of ineffective integration of NTD commodities in the supply chain has a detrimental impact on health workers (including community health workers’) who feel unable to deliver the quality of care to patients. Trust between affected populations and the health system is compromised when treatments are unavailable.