We checked the quality and classification of the data during the manual review of interview guides and during computerized data processing: creating a template and entering data (questionnaire, observation grid, and review) into Excel.

Table 1. Summary of data collection techniques and tools by target for evaluating the performance of MRC SGCA in the public and private sectors in Benin in 2025.

Then, the data analysis was done using STATA.11 and Excel according to our needs. Next, the assessment of the performance of the SGCA of the MRCs in the public and private sectors was carried out by component and sub-component to generate the overall result (using Excel software).

The total score for the criteria for each sub-component was expressed as a percentage of the total expected score to serve as a basis for evaluating the sub-component. Similarly, the component score was also expressed as a percentage of the total expected score for its assessment.

The assessment of the SGCA of the MRCs in the public and private sectors was done by starting from the percentage of the score obtained for the components “Management Support,” “SCOR,” and “Performance Indicators” compared to the total expected. For each sub-component of the system, the following ratings are assigned based on the scores for the different criteria, according to the measurement scale adapted to the SCOR model [8]. 1) If the total score of the sub-component’s criteria is between 90% - 100%, it means that almost all evaluation criteria are satisfactory. A grade of A will be given to this score. The corresponding assessment of the performance of the MRC’s SGCA is “Excellent.” 2) If the total score of the sub-component’s criteria is between 75% - 89%, it means that almost all evaluation criteria are satisfactory. A grade of B will be given to this score. The corresponding assessment of the performance of the MRC’s SGCA is “Good.” 3) If the total score of the sub-component’s criteria is between 60% - 74%, it means that almost all the evaluation criteria are acceptable. A score of C will be assigned for this. The corresponding assessment of the MRC SGCA performance is “Acceptable.” 4) If the total score for the sub-component criteria is between 45% - 59%, it means that most of the evaluation criteria are low. A score of D is assigned for this. The corresponding assessment of the MRC SGCA performance is “Low.” 5) When the total criteria for the sub-component are below 45%, it will mean that very few of the evaluation variables are satisfactory; a score of is assigned for this. The corresponding assessment of the MRC SGCA performance is “Critical.”

The targets of our study were warehouses, stores, and cold rooms where MRC management is carried out, as well as the people involved in managing MRC who had been working for at least six (06) months before data collection.

Warehouses/Stores and Cold Rooms

We collected our data in four (04) public and private structures that have stores and cold rooms where MRC are stored.

Figure 1 shows the different stores and cold rooms of the public and private structures where the data collection was carried out.

Healthcare Workers Involved in Managing NCDs

Figure 1. Distribution of the stores and cold rooms of public and private facilities where the collection was carried out.

- Stock managers who are health logisticians (one at SoBAPS and the second at BGL-SYSMET): 02

- Logisticians of the person responsible for public markets and procurement (PRM-PA) SoBAPS: 03

- Storekeepers: 12

- Pharmacists: 03

- Transport officers: 04

- Delivery people: 04

- Laboratory technicians: 03 (Table 2)

Table 2. Summary of the total number of eligible staff members who participated in the study evaluating the performance of the MRC supply chain management system in the public and private sectors in Benin in 2025.

3.2.1. Management Support

HumanResources

Availability and qualification of staff at every management level

Figure 2 shows that 40% of the surveyed staff are warehouse workers, followed by logisticians (14%), delivery personnel, and transport officers (13% each). The least represented are pharmacists and laboratory technicians (10% each). Most staff at each management level (warehouse workers) were not qualified for their positions.

Figure 2. Characteristics of the socio-professional profile of agents involved in the management of surveyed MRCs.

Staff training and continuous education at each management level

All surveyed personnel (100%) received training on RRM management, except CNHU-HKM staff, who did not receive ongoing training.

Supervision of staff

All surveyed staff reported being supervised on RRM management (100%) over the past six months by their hierarchy. However, no warehouse had a supervision logbook. Supervision teams came from partners, namely PNLP, PNT, and PSLS, or were sometimes joint teams for SoBAPS and ARC. Regarding CNHU-HKM and the company BGL-SYSMET, we had joint teams or auditors coming from the Ministry of Health who came from outside. The number of years of experience of the staff in warehouse management ranged from 3 to 16 years.

• Availability of organizational chart and job descriptions

Organizational charts and job description sheets were available in all warehouses and cold rooms of (100%) of SoBAPS, ARC, CNHU-HKM, and BGL-SYSMET, but were not posted; all warehouse managers had a job description, which is 100%.

3.2.2. Management Tools

All warehouses and cold rooms had 100% of stock management sheets, inventory sheets, and daily consumption registers for MRC. All structures had the document of national guidelines, the document of national pharmaceutical policy, the document of national procedures, and the annual work plan. Only SoBAPS and the company BGL-SYSMET had customs clearance and shipping procedures for the MRCs. Figure 3 shows the results from the analysis of this subcomponent.

Infrastructure andEquipment

All warehouses and cold rooms were secure and protected (90% respectively), except for CNHU-HKM, which did not have a cold room but rather refrigerators; the warehouse roofs were all in good condition and ventilated; the warehouses

Figure 3. Availability and completion of MRC management tools.

and cold rooms were lit; the infrastructure and equipment were of good quality. Regarding the warehouses surveyed, only CNHU-HKM and BGL-SYSMET stores did not have all the equipment, such as pallet jacks and fire extinguishers, but offices were available in all the warehouses surveyed.

- Technology and Logistics Management Information System (LMIS)

The management software, SAGE 100 CLOUD version, was available, functional, and used for stock management at SoBAPS. All warehouse managers/storekeepers surveyed were trained in its use (100%). It was functional and used for stock management; similarly, at 3.3. Within the private company BGL-SYSMET, we had the ERP (Enterprise Resource Planning) software, which in French means Progiciel de gestion intégré, and all warehouse managers/investigated storekeepers were trained to use it (100%); it was also functional and used for inventory management. All the warehouses from SoBAPS and ARC that were investigated had electronic SIGL reporting support. All ten investigated warehouses (10/10) had submitted reports for the past 6 months on time and regularly (promptly). There was consistency between the report data and the physical inventory. As for CNHU, it does not have such a system since it does not have software; everything is done manually and on Excel. The staff in charge of managing MRCs at SoBAPS and ARC had received training on filling out SIGL tools. The warehouse managers at SoBAPS and ARC are transmitting the management activity reports of the MRCs to the management. Regarding the company BGL-SYSMET, the activity reports are sent to management. All these managers stated that they received written feedback on their reports.

-FinancialResourcesandService Operations

SoBAPS and the ARC had no debts related to the purchase of the MRCs; for them, the acquisition of the MRCs was done through a prepayment mechanism before delivery from international suppliers and a deposit-with-payment-after-sale (DPAV) contract with national suppliers. According to them, despite significant efforts from the development partners, the government’s contribution still needs to improve to cover all needs. Concerning CNHU-HKM and the company BGL-SYSMET, they are in debt; CNHU-HKM, being a client, owes BGL-SYSMET; the latter, in turn, owes its suppliers like Sysmex, Biomérieux, etc. CNHU-HKM sources from ARC and BGL-SYSMET (thanks to a call for tenders); as for the ARC, it sends its needs every three months (03) to SoBAPS for its supply; SoBAPS, in turn, gets its supply from BGL-SYSMET, which is one of its national suppliers, also thanks to a call for tenders.

Supply Chain OperationReference(SCOR)

Planning andForecasting

All four (04) surveyed facilities had the national policy document on essential medicines (MRC), the list of essential medicines, and the list of tracer products (100%). The facilities themselves quantified their needs using management parameters (average monthly consumption, available usable stock, etc.).

Procurement andInventory Management

In all surveyed facilities, MRC stored on pallets or shelves is protected, separated, and well arranged. Expired and/or damaged products are separated from good products and removed from stock. A physical inventory of stocks is carried out twice a year, once in June and once in December at SoBAPS, ARC, and BGL-SYSMET, while at CNHU-HKM, the inventory is carried out once a year, at the end of the year. Of the four surveyed facilities, only CNHU-HKM had refrigerators for the storage of health products. The storage temperature is between +2 and +8˚.

Production and Quality Control

In all the facilities surveyed, the verification of the ordered quantity of MRC is checked against what is received upon delivery (100%); the expiration date, the integrity of product packaging, and compliance with proper storage conditions are all verified. The MRC packaging is not covered with dust or other dirt and is properly stored.

Distribution and Transport

Regarding distribution, there is the company BGL-SYSMET, which is a local supplier for SoBAPS; then SoBAPS delivers to the ARC quarterly; as for CNHU, it receives deliveries at the ARC. 100% of orders had been delivered within the deadlines stipulated in the contract with suppliers. An MRC distribution plan is operational; a fleet of vehicles for MRC delivery is available. All delivery notes included information about the sender, expiration dates, and batch numbers of all delivered MRCs. Vehicles in good working condition were available with the necessary drivers to meet the distribution plan.

Returns andWaste Management

All warehouses followed the rules for storing expired items by separating them from good products and removing them from stock. There was a procedure for destroying expired and spoiled products. All warehouses had trash bins to manage waste from logistics activities. To reduce waste, redistribution strategies for stocks were carried out before the MRCs expired.

Performance Indicators

The SCOR model (Supply Chain Operations Reference) is widely recognized as the most promising framework for strategic decision-making in supply chains, particularly in the pharmaceutical industry, which has a complex and complete supply chain. So, we had a composite scale with five (05) dimensions, including both quantitative and qualitative indicators:

Supply Chain Reliability

- Availability rate of medicines, consumables, and reagents

The availability of essential medicines (EM) over the six months prior to our visit ranged from 100% for medicines at SoBAPS and ARC to 50% - 74% at CNHU-HKM; for laboratory reagents and consumables, it ranged from 55% - 69% at SoBAPS, ARC, and the company BGL-SYSMET, and 38% at CNHU-HKM. The availability of EM at each facility, on the day of the survey and over the past six months, is summarized in Table 3.

Table 3. Availability of MRCs on the day of the survey and over the past 6 months in 2025.

- Stockout rate: number of days/year

The stockout rate for MRC within SoBAPS and ARC ranges from 1 to 10 days; within CNHU, the MRC stockout rate ranges from 1 to 30 days or more; at BGL-SYSMET, the rate ranges from 1 to 14 days at most.

Stockout rate = (Number of stockout days/365) × 100 for a one-year period, or = (Number of stockout days/Total number of days in the period) × 100 for a given period.

- Order accuracy (quantity/quality compliance): 0 - 100%

For this indicator, we followed a few criteria before calculating it: whether the quantity is correct (meaning the number ordered is what we received upon delivery), whether the MRCs are of good quality, the condition of the packaging, and whether the expiration date is near. The orders received at SoBAPS, ARC, CNHU, and BGL-SYSMET are compliant because upon receipt, the receiving committee checked the expiration date; if the expiration date was near, they returned the products or the storekeeper could take a bit depending on the MRC stock going out of their store; the committee also checked Also, the condition of the MRC packaging, whether it’s open, dusty, or faulty; the reception committee of these surveyed structures checked the quantity of MRCs and claimed if there was any shortage or not. To conclude, on the day of the survey, for each structure, the number of orders received was without error, and also the reception of orders received within these structures during the six months prior to the collection day was in compliance, so 100% for each structure.

System responsiveness

- Average delivery time (order-reception)

The delivery time from SoBAPS to ARC and from ARC to CNHU is under 7 days; the delivery time from BGL to SoBAPS ranges from 7 to 14 days; the delivery time from BGL to CNHU-HKM ranges from 7 to 14 days or 14 to 30 days; it all depends on the availability of MRCs.

Average delivery time = Σ(Receipt date − Order date)/number of orders received.

Efficiency and costs

- Stock turnover

Number of times the average stock is replenished over the course of a year at SoBAPS, CNHU, BGL-SYSMET, and ARC.

The MRC stocks of SoBAPS, CNHU, and BGL-SYSMET were renewed 6 to 12 times per year and more. As for ARC, they are renewed every quarter.

Loss percentage (expiration, breakage) < 2%

Measures the proportion of losses (expiry, breakage, deterioration, etc.) and the proportion of products lost relative to the total quantity managed over a given period.

If the loss percentage < 2%: good performance.If the loss percentage is 2% - 5%: average performance; corrective actions are required.If the loss percentage > 5%: poor performance, indicating problems with inventory management and storage.

The percentage of expired, broken, or spoiled MRCs within SoBAPS and ARC did not exceed 2%; the percentages at CNHU and BGL-SYSMET exceeded the 2% recommended by the standard.

Table 4 presents the MRCs that had expired as of the survey date in 2025. After determining the percentage of losses attributable to MRCs, an inventory was conducted to identify the expired MRCs actually observed during the survey.

Table 4. Expiration of MRC on the day of the survey in 2025.

Assessment of the performance level of the supply chain management system of MRCs in the public and private sectors in southern Benin in 2025.

The performance assessment was carried out based on the analysis of the different sub-components and components of the MRC supply chain management system in the public and private sectors in southern Benin, according to the scores obtained by each sub-component compared to the expected score, and the results were presented in Table 5 and Table 6.

Table 5. Assessment of the components “Management Support,” “SCOR,” and “KPI Indicators” as well as their sub-components for evaluating the performance of the SCM system of MRCs in the public and private sectors in southern Benin in 2025.

The components “Management Support,” “SCOR,” and “KPI Indicators” obtained respective percentages of 78%, 83%, and 65%. Therefore, the performance of the “Management Support” and “SCOR” components is good. That of the “KPI Indicators” is acceptable.

Table 6. Overall assessment of the performance components of SGCA of MRCs in the public and private sectors in southern Benin in 2025.

The performance of the MRCs’ supply chain management system scored 81%. So the system’s performance is good, but there are still a few points to fix in each component.