zambian moh essential drug logistics system november 2009
TRANSCRIPT
Zambian MOH Essential Zambian MOH Essential Drug Logistics System Drug Logistics System
November November 20092009
s
HIV test 2006-8
Laboratories 2007-9
OI
MalariaED/OI/Malaria/FP 2009-2011
Zambian people
ARVs 2006
Zambian MOH Essential Drug Logistics Zambian MOH Essential Drug Logistics System System
Test two different logistics system models to Test two different logistics system models to select one (or a combination/variation) that can select one (or a combination/variation) that can be rolled out nationally, in order to significantly be rolled out nationally, in order to significantly
improve the availability of essential drugs at improve the availability of essential drugs at service delivery sites.service delivery sites.
GoalGoal of the Pilot of the Pilot
JSI
TO1 – PEPFARTO1 – Family Planning
TO1 – MCHTO3
World Bank
Crown Agents
World Bank
Pilot Funding SourcesPilot Funding Sources
The Pilot Logistics System -The Pilot Logistics System -Similarities with Earlier SystemsSimilarities with Earlier Systems• Uses a Max/Min Inventory Control System
(pull system)• Collects dispensed to user data, stock on
hand, and losses/adjustments from every site in the system, and sends the data to the Logistics Management Unit at MSL
• Follows a monthly reporting/ordering period• Distribution of products is integrated with
other products on the MSL trucks going to the districts and hospitals
The Pilot ModelsThe Pilot Models
System A
• District Store remains as stockholding point
• MSL supplies a consolidated order every month to district stores
System B
• District Store converted to cross-docking point
• MSL supplies goods packed for individual facilities to districts
VSVS
Key Pilot ActivitiesKey Pilot Activities
J09 F M A M J J A S O N D J10 F M J09 F M A M J J A S O N D J10 F M
Baseline study
Adapting
central level
software
37 workshops to train 668 participants
Hiring of commodity planners,
supervisors,and data
specialists
MoH-led stakeholders
System Design
Workshop
Training Training of of
trainerstrainers
Implementation with monitoring & supervision
Final Evaluati
on
Stock OutsStock Outs DHOs vs Health Facilities DHOs vs Health Facilities
Baseline January 2009
Pilot trainings through Sept 2009 37 trainings and 668 participants
An estimated 170 trainings for 3,400 An estimated 170 trainings for 3,400 participants participants
will be needed for national roll outwill be needed for national roll out
Reporting RatesReporting Rates
The 73.9% reporting rate at the The 73.9% reporting rate at the beginning of the pilot was mainly beginning of the pilot was mainly due to the due to the intensive training intensive training given given to facility staff.to facility staff.
The improved reporting rates are The improved reporting rates are helped by continuous helped by continuous monitoring, monitoring, supervision & follow up of facilities supervision & follow up of facilities in the pilot.in the pilot.
AmoxicillinAmoxicillin
CondomsCondoms
BenzylpenicylinBenzylpenicylin
Depo-ProveraDepo-Provera
Selected products reportedSelected products reportedstock out trendsstock out trends
CTXCTX
AL 4*6AL 4*6
Key ChallengesKey Challenges
• Full supply principal: ensure timely, Full supply principal: ensure timely, reliable, sufficient & quality productsreliable, sufficient & quality products
• Sufficient, quality storage spaceSufficient, quality storage space• Dedicated logistics vehiclesDedicated logistics vehicles• Funding & availability of fuelFunding & availability of fuel• Dedicated district pharmacist Dedicated district pharmacist
technicians (use of commodity planners) technicians (use of commodity planners) • Availability of candidates for training Availability of candidates for training
with the minimum skills required at with the minimum skills required at HC/HP levelHC/HP level
• Attrition rate of trained staffAttrition rate of trained staff
Cost Scenarios (estimated)Cost Scenarios (estimated)
• Current costs to sustain the 16 pilot districts July to December 2010: USD 300,000
• MSL additional costs to sustain MSL only activities for all districts: (4% current +)– Version A = 0,5% of stock throughput– Version B = 1% of stock throughput
• Cost of CP’s and vehicles all districts– 2% of stock throughput
• Other countries in region range from 7 to 12% of stock throughput for logistics activities (district level only)
Expected BenefitsExpected Benefits
Addresses 2 key priorities in the Fifth National Development plan (FNDP) on essential drugs:
• To ensure availability of adequate, quality, efficacious, safe and affordable essential drugs & medical supplies at all levels, and
•To significantly improve availability, distribution & condition of essential infrastructure & equipment so as to improve equity of accessto essential health services.