title: Assessing "First Mile" Supply Chain Factors Affecting Timeliness of School-Based Deworming Interventions: Supply and Logistics Performance Indicators.
abstract: BACKGROUND
  Between 2007 and 2012, Children Without Worms (CWW) oversaw the Johnson & Johnson (J&J) donation of Vermox (mebendazole) for treatment of school-age children to control soil-transmitted helminthiasis (STH). To identify factors associated with on-time, delayed, or missed mass drug administration (MDA) interventions, and explore possible indicators for supply chain performance for drug donation programs, we reviewed program data for the 14 STH-endemic countries CWW supported during 2007-2012.
  
  
  METHODS
  Data from drug applications, shipping records, and annual treatment reports were tracked using Microsoft Excel. Qualitative data from interviews with key personnel were used to provide additional context on the causes of delayed or missed MDAs. Four possible contributory factors to delayed or missed MDAs were considered: production, shipping, customs clearance, and miscellaneous in-country issues. Coverage rates were calculated by dividing the number of treatments administered by the number of children targeted during the MDA.
  
  
  RESULTS
  Of the approved requests for 78 MDAs, 54 MDAs (69%) were successfully implemented during or before the scheduled month. Ten MDAs (13%) were classified as delayed; seven of these were delayed by one month or less. An additional 14 MDAs (18%) were classified as missed. For the 64 on-time or delayed MDAs, the mean coverage was approximately 88%.
  
  
  CONCLUSIONS
  To continue to assess the supply chain processes and identify areas for improvement, we identified four indicators or metrics for supply chain performance that can be applied across all neglected tropical disease (NTD) drug donation programs: (1) donor having available inventory to satisfy the country request for donation; (2) donor shipping the approved number of doses; (3) shipment arriving at the Central Medical Stores one month in advance of the scheduled MDA date; and (4) country programs implementing the MDA as scheduled.
authors.affiliation: Children Without Worms, Task Force for Global Health, Decatur, Georgia, United States of America.
authors.forename: Kimberly M
authors.initials: KM
authors.lastname: Koporc
authors.affiliation: Children Without Worms, Task Force for Global Health, Decatur, Georgia, United States of America.
authors.forename: Eric
authors.initials: E
authors.lastname: Strunz
authors.affiliation: Children Without Worms, Task Force for Global Health, Decatur, Georgia, United States of America.
authors.forename: Cassandra
authors.initials: C
authors.lastname: Holloway
authors.affiliation: Children Without Worms, Task Force for Global Health, Decatur, Georgia, United States of America.
authors.forename: David G
authors.initials: DG
authors.lastname: Addiss
authors.affiliation: Johnson & Johnson, New Brunswick, New Jersey, United States of America.
authors.forename: William
authors.initials: W
authors.lastname: Lin
mesh_terms: D000871:Anthelmintics / Q000008:administration & dosage* / Q000600:supply & distribution*; D004358:Drug Therapy / Q000379:methods; D006373:Helminthiasis / Q000188:drug therapy* / Q000517:prevention & control; D006801:Humans; D007411:Intestinal Diseases, Parasitic / Q000188:drug therapy* / Q000517:prevention & control; D009934:Organization and Administration; D012574:Schools; D013334:Students
chemical_list: D000871:Anthelmintics