Supply Chain Management
Presenter
C.Nkaka
OVERVIEW OF SUPPLY CHAIN MANAGEMENT
• Prior to the 1980s, business firms were using
terms such as, “logistics”, and “operations
management” instead of supply Chain
Management.
• The term was coined by a British logistician
and consultant by the name of, Keith Oliver in
the 1980s.
OVERVIEW OF SUPPLY CHAIN MANAGEMENT
• The term was first used in public in an
interview with Arnold Kransdorff of the
Financial Times on 4 June 1982
• The term Supply Chain Management
came into widespread use in the 1990s
OVERVIEW OF SUPPLY CHAIN MANAGEMENT
Continuous evolution of the supply chain and of
the techniques to manage it effectively were
motivated by the following:
• Fierce competition in today’s global markets,
• Introduction of products with shorter life
cycles
OVERVIEW OF SUPPLY CHAIN MANAGEMENT
• The heightened expectations of customers,
• New rules of competition and the downward
pressure on prices,
• Continuing advances in communications and
transportation technologies (e.g., mobile
communication, Internet, and overnight
delivery),
OVERVIEW OF SUPPLY CHAIN MANAGEMENT
• Supply chain management builds upon the
concept of logistics and seeks to achieve
linkage and coordination between the
processes of other entities in the pipeline
( suppliers and customers).
According to the council of Supply Chain
Management Professionals ( CSCMP,2011)
• “Supply Chain Management encompasses the
planning and management of all activities
involved in sourcing, procurement ,and all
logistics management activities
Definition of Supply Chain Management
Definition of Logistics
The CSCMPP also define Logistics – “The part
of supply chain management that
plans ,implements, and controls the
efficient ,effective forward and reverse flow
and storage of goods ,services and related
information between the point of origin and
point of consumption in order to meet
customers requirements...
Definition of Logistics
• Logistics management is an integrating
function ,which coordinates and optimizes all
logistics activities, as well as integrates
logistics activities with other functions
including marketing , sales,
manufacturing ,finance, and information
technology”
Comparison of logistics and supply
chain management:
• Logistics typically refers to activities that occur
within the boundaries of a single organization
such as procurement, distribution, storage,
and inventory management.
• Supply Chain Management (SCM)
acknowledges all of traditional logistics and
also includes activities such as marketing, new
product development, finance, and customer
service.
Comparison of logistics and supply chain
management:
BASIS FOR COMPARISON LOGISTICS SUPPLY CHAIN
MANAGEMENT
Objective Customer satisfaction; to
ensure the six rights
right product
with the right quality
In the right quantity
at the right time in
the right place at the right
price to the ultimate
customer)
Competitive advantage
How Many Organisations
are involved
One Multiple
Evolution A long time ago Modern concept
Purpose of Logistics
The purpose of a logistics system is to ensure
the six rights:
• The right drugs and medical supplies
• in the right quantities
• in the right condition
• are delivered to the right place
• at the right time
• for the right price.
The logistics cycle
Policy/ legal
Frame work
adaptability
SERVING CUSTOMER
PRODUCT
SELECTION
FORECASTING AND
PROCUREMENT
INVENTORY
MANGEMENT
Logistics management
information system
Organization and
staffing, financing and
budgeting, supervision
evaluation
Major Activities of the Logistics Cycle
• Serving Customers:Everyone working in logistics
must remember that their job is to select,
procure, store, or distribute products to meet
customer needs
• Product selection: In a health logistics system, a
national formulary and therapeutics committee,
pharmaceutical board, board of physicians, or
other government-appointed group select
products to meet the needs of patients.
Major Activities of the Logistics Cycle
• Quantification :After products are selected,
managers must determine the quantity
needed for each product, for a specific time
period—this is called quantification.
Quantification depends on accurate
forecasting
Procurement: Procurement plans are based on
requirements estimates that are determined
mathematically for each product.
Major Activities of the Logistics Cycle
• Inventory management: A program’s
inventory control strategy specifies how much
stock to store and where to store it. Enough
stock should be available to meet customer
needs until a new order is received; but not so
much that stocks expire or are wasted or that
you exceed storage capacity.
Major Activities of the Logistics Cycle
• Quality monitoring:Quality monitoring
appears between each activity of the logistics
cycle and ensures that the quality of all the
activities in the cycle are monitored.
Management Information Systems:
Information drives the logistics cycle; without
it, the logistics system cannot run smoothly.
Managers gather information about each
activity in the system and then analyze that
information to make decisions.
Major Activities of the Logistics Cycle
Organization and Staffing:A logistics system can
only work when the staff are well-trained and
operate in a supportive environment. They
must have the right tools to do their jobs,
whether they place orders, coordinate
shipments, oversee deliveries, or keep a
warehouse functioning effectively to ensure
that the right product, in the right quantity, is
shipped to the client.
Major Activities of the Logistics Cycle
Organization and Staffing:A logistics system can
only work when the staff are well-trained and
operate in a supportive environment. They
must have the right tools to do their jobs,
whether they place orders, coordinate
shipments, oversee deliveries, or keep a
warehouse functioning effectively to ensure
that the right product, in the right quantity, is
shipped to the client.
Major Activities of the Logistics Cycle
• Supervision:If the logistics system is carefully
watched, it will run smoothly and staff will
anticipate any needed changes. The effective
supervision of logistics activities minimizes
problems and/or resolves them quickly before
any one problem becomes a crisis.
Major Activities of the Logistics Cycle
• Budgeting : affects the product selection,
quantity of products procured, amount of
storage space available, transport, and
number of staff working in logistics. To have
the entire system operating effectively,
logistics activities must be included in
operational planning and receive sufficient
funds.
Use of standard operating procedure
manual
• The manual is intended to simplify and
standardise the work required for logistics
management in order to allow health workers
more time for client focused activities. The
manual guides health care workers in
completing the following tasks with the help
of Job aids.
Use of standard operating procedure
manual
• Maintaining adequate supplies of
commodities
• Reporting essential logistics data and ordering
of commodities from MSl
• Receiving and storing
• Recording and reporting issues
• Monitoring logistics activities throughout the
system
Supply chain pipeline
• The pipeline includes the entire chain of
storage facilities and transportation links that
move supplies from the manufacturer to the
consumer, including port facilities, central
warehouses, regional warehouses, district
and sub district stores, service delivery points,
and transportation vehicles.
Supply chain pipeline
• A supply chain consists of activities and
organisations that materials move through on
their journey from initial suppliers to the final
customer.
Supply chain pipeline
• A supply chain consists of activities and
organisations that materials move through on
their journey from initial suppliers to the final
customer.
Supply chain pipeline
• The pipeline includes the entire chain of
storage facilities and transportation links that
move supplies from the manufacturer to the
consumer, including port facilities, central
warehouses, regional warehouses, district
and sub district stores, service delivery points,
and transportation vehicles
Logistics management information system
( LMIS)
• The basic purpose of an LMIS is to collect and
report information to other levels in the
system in order to make decisions regarding
the quantity and time to distribute drugs and
medical supplies.
Essential logistics data
• STOCK ON HAND: quantity of usable stock at a particular level of
the system at a particular point in time
• CONSUMPTION DATA: quantity of drugs dispensed to clients
during a particular period of time
• DATA ON LOSSES AND ADJUSTMENTS : quantity of drugs no
longer available for distribution, which have not been dispensed,
but are damaged or expired are called losses and additions and
subtractions to the available drug supply, which were not received
through the normal mechanism of receipt are called adjustments.
These are either transfers, drugs loaned to (-)/from (+) another
facility, or drugs “found” (+) as a result of a previous miscount
Records and Reports used in the management
of ARV ,EMLIP and HIV test kits logistics system
• Stock Control Card
• Stock Control book
• GRN
• Supply voucher
• Requisition form
Stock Keeping Records
Description Type of data collected
on the Transaction
record
•Stock Control Card
•Inventory Control Card
•Stores Ledger
•Stock On Hand
•Losses and
adjustments
•Quantity to Order
•Quantity On Order
Transaction Records
Description Type of data collected
on the Transaction
record
•Requisition and issue
voucher
•Issue voucher
•Packing Slip
•Delivery note
Quantity of product
being
• Ordered
•Shipped,
• Received
Consumption Records
Description Type of data collected
on the Transaction
record
•Dilly Usage Register
•Log book
•Tick sheet
•Test Register
Product used or
dispensed to the end
user at the service
delivery point
Forms used in managing drugs
Form name Purpose activity
Stock control card To account for drugs in the
storeroom
Issuing
Storing
Receiving
Reporting and ordering
Physical inventory
ART daily activity register To record and track the
number of ARV drugs
dispensed to patients
Dispensing
Reporting and ordering
Drug log book Collect information on
amounts of drugs
dispensed
Dispensing
Reporting and ordering
Report and requisition To provide logistics data to
MOH-LMU
To report on stock status
To order drugs
Reporting and ordering
Forms used in managing drugs
Form name Purpose activity
Supply voucher To request for drugs form
the health center to the
district
To request for drugs from
the ward to the hospital
pharmacy
Ordering
Receiving
Issuing
Dispatch note To account for receipts
from MSL
receiving
Report for returning
products
To track products returned
to MSL from health facility
level
storing
Dangerous drugs register To record and track the
number of dangerous
drugs dispensed to
patients
Dispensing
Reporting and ordering
Recording transactions in the stock control
card
• Complete one SCC for each product
• Enter the code, the name and form of the
drug, unit, strength ,maximum level and the
minimum level
• Enter the date of the transaction
• Enter the reference number
Recording transactions in the stock control
card
• In the issued to or received from column enter
Balance brought forward if this is the first line
of a new stock control
Physical count if you have done a physical
count
MSL or Pharmacy in red if receiving
Loss or adjustment
Recording transactions in the stock control
card
• In the remarks column provide a brief
explanation for any loss or adjustment or add
any other comment.
• Keep the stock control card close to were
products are being stored and issued in the
pharmacy.
Recording transactions in the stock control
card
EXERCISE UPDATING A STOCK CONTROL CARD
FOR AMOXYCILLIN CAPSULES 250MG AT KASAMA
GENERAL HOSPITAL Unit 1000
• On 1/1/2012 conducted a physical count and
found 50 bottles.
• On 2/1/2012 issued to 5 bottles ward J
• On 3/1/2012 issued to3 bottles to ward B
• On 4/1/2012 issued 2 bottles to ward c
• 0n 5/1/2012 loaned 10 bottles to Kasama DHO
Recording transactions in the stock control
card
• On 6/1/2012 received 30 bottles from medical
stores limited
• On 7/1/2012 issued 5 bottles to ward G
• 0n 15/1/2012 issued 10 bottles to casualty
• On 20/1/2012 Kasama DHO returned 10 bottles
that was loaned
• On 30/1/2012 issued 10 bottles to ward A
• On 31/1/2012 conducted a physical count and
found 44 bottles
Recording transactions in the stock control
card
Exercise 2
You are opening a stock control card, at Kasama General Hospital .Use
the following information to update the stock control cards.
• Doxycycline tablets 100mg bottle of 100(MSL code 798)
• 1 January 2012 You open a new stock control card, bringing a balance
of 40 bottles
• 2 January 2012 You receive from Medical stores limited 50 bottles with
a reference number of 798
• 3 January 2012 You issue to outpatient 10 bottles on internal
requisition number 800
• 4 January 2012 You loan Kasama district 5 bottles on internal
requisition number 801
Recording transactions in the stock control
card
• 5 January 2012 You issue to ward G 5 bottles on internal requisition
number 818
• 6 January 2012 You issue to ward C 2 bottles on internal requisition
number 819
• 10 January 2012 You drop one bottle and the tablets are damaged
• 12 January 2012 You issue to ward J 10 bottles on internal requisition
820
• 16 January 2012 your receive from Kasama district 5 bottles on
internal requisition 450
• 20 January 2012 You issue to ward B 5 bottles on internal requisition
821
• 31 January 2012 You conduct a physical count and you find 58 bottles
Recording transactions in the stock control
card
• In the received column enter the quantity
received
• In the issued column enter the quantity
issued
• In the losses and adjustment column enter the
exact amount of the loss or adjustment
• In the balance column enter the calculated
balance
Ordering Drugs and Medical supplies from
the Pharmacy
• A supply voucher is used
• Health centres also use the supply voucher to
order supplies from the DHO
Supply Voucher
TO -------------------- ------------- From -------------
Requested By: ------------- Signature-------------------- Date----------------
Authorised By: --------- Signature-------------------- Date------------------
( A) ITEM
CODE
( B )
DESCRIPTI
ON,STREN
GTH
(C)
UNIT
( D)
BALANCE
AT HAND
(E)
QUANTITY
REQUESTE
D
(F)
QUANTITY
SUPPLIED
(G)
QUANTITY
RECEIVED
(I)
REMARKS
Approved By: ----Issued By: ----Delivered by-------- Received by:
Date----- Date----------------- Date---------------
Date---------
JOB AID FOR RECORDING TRANSACTIONS IN
THE SUPPLY VOUCHER
• Enter only one transaction in each line
• Use a blue or black pen to enter the transactions
• From: enter the name of your ward, clinic or
department
• To: enter the name of the store , pharmacy or
department to which the supplies will be
obtained from
• Name of requisitionist: enter your name
JOB AID FOR RECORDING TRANSACTIONS IN
THE SUPPLY VOUCHER
• Signature: sign
• Date: Enter the date of the transaction
• Item number: Enter the serial number for each drug
• Item description: Enter the name and the form of
the drug
• Strength: Enter the strength
• Unit: Write the individual unit for the drug
• Quantity in stock: Enter the stock on hand in your
storeroom
JOB AID FOR RECORDING TRANSACTIONS IN
THE SUPPLY VOUCHER
• Quantity ordered: Enter the quantity you are
ordered
• Quantity received: Enter the quantity received if
receiving
• Quantity issued: leave this blank
• Signature: print your name and then your
signature after checking.
• Remarks: provide a brief explanation for any loss
or adjustment
EXERCISE USING A SUPPLY VOUCHER
MSL CODE PRODUCT
DESCRIPTI
ON
UNIT STOCK ON
HAND
AVARAGE
MONTHLY
CONSUMPT
ION
MS 0079 Fluid Giving
Set
25 3 10
MS 005 Examination
Gloves ,Larg
e
100 3 12
EM 0032 Amoxicillin
Capsules
250mg
1000 2 8
EM 00348 Paracetamol
Tablets
500mg
1000 4 15
Completing the Daily activity register for
ARVs
The following steps should be followed:
• Record the client number
• Record the type of ARV dispensed
• Record the quantity dispensed
• Calculate the total quantity dispensed at the
end of the day
• Calculate the quantity dispensed at the end of
the month
Exercise: Completing the Daily Activity Register for ARVs
You are the Pharmacy in charge at Kasama General Hospital. Complete
the ART daily activity register With the following information
• On august 1,2018 patient number 56 is making his monthly visit to the
ART clinic, You give him a combination of Zidovudine 300mg plus
lamivudine 150mg and single dose of Nevirapine 200mgtablets to take
for one month.
• On august 3, patient number 99 arrives and you give him a triple fixed
combination of Tenofovir 300mg/Lamivudine300mg/Efavirenz 600mg
Tablets to take for one month.
• On August 7, patient number 36 arrives to peak up Tenofovir
300mg/Lamivudine300mg/Efavirenz 600mg Tablets to take for one
month.
Completing the Daily Activity Register for
ARVs
• On august 10, patient number 44 is started on Tenofovir
300mg/Lamivudine300mg combination plus
Lopinavir/Ritonavir (Aluvia).
• On august 11 patient numbers 65 collects a combination
of Zidovudine 300mg plus lamivudine 150mg and single
dose of Nevirapine 200mgtablets to take for one month.
• On august 15 patient number 22,is given Abacavir 30
/Lamivudine 60mg and Efavirenz separately
• On 28 august a baby number 77 was given Zidovudine/
Lamivudine and Nevirapine for one month.
Completing the Daily Activity Register for
ARVs
• On august 29 patient number 39 was given
Tenofovir 300mg/Lamivudine300mg/Efavirenz
600mg Tablets to take for one month.
• On august 30, patient number 80 came and
collected on Tenofovir 300mg/Lamivudine300mg
combination plus Lopinavir/Ritonavir (Aluvia).
• On 30th
august patient number 100 was given PEP
medicine on Tenofovir 300mg/Lamivudine300mg
combination plus Atazanavir to take daily..
Job aid: Completing the Daily activity register
for HIV Test Kits
Cover page of the register write the following:
• Name of the facility
• Name of the testing site
• Name of the district
• Name of the province
• Book number
• Start date
Completing the Daily activity register for HIV
Test Kits
• The following steps should be followed:
• Record the client number and purpose of the test
• Record the type of test
• Record the quantity of test used
• Record the result ( R, NR or IND)
• Calculate the total quantity of the tests done at the
end of the day
• Summarise the total number of tests done at the
end of the month
Exercise: Completing the Daily activity
register for HIV Test Kits
• You are the in charge, complete the daily
activity reviser.
1. On June 5 of 2016,the beginning balances of
each test are; Determine 15 tests, SD bioline
8 tests.
2. You request and receive 100 determine tests
and 20 SD Bioline tests from the main store
room.
Exercise: Completing the Daily activity
register for HIV Test Kits
3.Following appropriate quality control procedures,
you run a known positive sample using determine
and SD Bioline .Then you run a negative sample and
determine and SD Bioline.
4.A sample for patient number 44 arrives at the
laboratory in the morning with a request for clinical
diagnosis for HIV. The sample is screened for HIV
using determine rapid test.The test is positive,so it is
retested to confirm using SD Bioline.The second test
is also positive.
Exercise: Completing the Daily activity
register for HIV Test Kits
5.Shortly afterwards patient number 56 arrives at the
clinic. The sample sent to the Laboratory is screened
using determine which shows that the patient is
positive, A confirmatory test is done using SD Bioline
and the result is negative.
6.A patient arrives at the clinic and is assigned number
308.The sample is first tested using dtermines and
the result is invalid.The sample is retested using
determine again and the result is negative.
Exercise: Completing the Daily activity
register for HIV Test Kits
7.another patient ,number 22 comes to the clinic for
prenatal care. The EMTCT doctor sends her sample to
the main Laboratory for an HIV test. The sample is
tested using determine and her test results are
negative.
8.In the afternoon a new Laboratory Technician begins
working at the main Laboratory and is trained how to
conduct HIV testing by using a known positive sample
on determine and SD Bioline. This is repeated using a
known negative sample on determine and SD Bioline.
Exercise: Completing the Daily activity
register for HIV Test Kits
9.Patient number 139 has come to the clinic in
the afternoon and the doctor determines that
she should be tested for HIV. The sample is
sent to the Laboratory and tested using
Determine and the results were positive .the
sample is tested using SD Bioline and the
results are also positive.
Exercise: Completing the Daily activity
register for HIV Test Kits
10.It is now the close of the business. Complete
the Daily activity Register for the
day ,including the summary for HIV tests by
purpose. Your physical count for each product
is as follows: Determine 105 tests, SD Bioline
21 Tests
Completing the internal Monthly summary
( IMSR)
• Only health centres with multiple testing sites
will need to complete the internal monthly
summary.
• Health centres with one testing site will use the
daily activity register and the stock control card
to complete the Rand R for HIV tests
• Health centre in charge for health centers with
multiple testing sites will summarise the data
for the month
Completing the internal Monthly summary
( IMSR)
Data to be summarised is as follows:
• Total quantity of each HIV test received at the
testing site during the month
• Total quantity of each HIV test used during the
month
• Losses and adjustments
• Total stock of each HIV test on hand at the
testing site as determined by a physical count
Completing the internal Monthly summary
( IMSR)
• The total number of positive ,negative and
indeterminate test results
• Once the IMSR are completed, they are sent
to the person designated for managing HIV
tests at the health centre
• Data from all the testing sites will then be
aggregated and used to complete the R&R
Completing the Report and Requisition for
HIV Test Kits
• Write the reporting period, facility name,
province and district and the type of test.
• Write the beginning balance
• Write the total quantity received
• Write the total quantity used
• Write the losses and adjustments
• Explain any losses and adjustments
Completing the Report and Requisition for
HIV Test Kits
• Write the physical count
• Calculate Average Monthly Consumption
• Calculate the Maximum Quantity
• Calculate the Order quantity
• Write any remarks or comments
• Summarise tests used by Purpose
Completing the Report and Requisition for
HIV Test Kits
• Review the completed report
• Print your name /signature and date
• Have the order authorised and approved
• Submit the Rand R
Completing the Report and Requisition for
ARVs
• A report and requisition is used (R&R).
• This form is used at the Health Centers and
Hospitals
• Health centers send the R&R to the District for
review by the fifth day following the reporting
period.
• DHO and Hospitals after reviewing the R&R
send it MSL according to schedule
Completing the Report and Requisition for
ARVs
The following data is reported on the report
section of the R&R:
• Beginning Balance in the store room and
dispensary or testing site
• Total Quantity Received
• Total Quantity Used
• Losses and adjustments
• Ending Balance
Completing the Report and Requisition for
ARVs
• The following data is reported on the
requisition section of the R&R:
• Average Monthly Consumption
• Maximum Quantity
• Order Quantity
How to calculate the order quantity
Calculating the average monthly
consumption
Add the total quantity dispensed for the
current and the last two months
Divide by three
Round to the nearest dispensing unit
How to calculate the order quantity
Calculating the maximum quantity
• Multiply the average monthly consumption by
3
Calculating the order quantity
• Subtract the ending balance from the
maximum quantity
Completing the report for Drugs and Medical
supplies.
• A report and requisition Drugs and Medical
supplies is used (REMMS).
• This form is used at the Health Centers and
Hospitals
• Health centers send the REMMS to the District
for review by the fifth day following the
reporting period.
• DHO and Hospitals after reviewing the REMMS
send it MSL according to schedule
Placing an emergency order
• Tick the emergency order box at the top of the
report for essential drugs and medical supplies
• Use a red pen to write emergency order
across the top of each page
• Complete the REMMS for all the printed drugs
and medical supplies and send the form to the
DHO
Placing an emergency order
• DHO WILL Review and approve the emergency
order and send it the MSL commodity security
centre
• When the order is ready MSL will inform you
to go and collect the emergency order.
Receiving drugs and medical supplies from
Medical Stores Limited
• Locate the requisition or supply voucher
• Conduct a visual inspection
• Note discrepancies on the forms
• Sign the form
• Place and reorganize products according to
FEFO
• Enter and update the goods received
note(GRN) and the stock control cards
Storage of Drugs and Medical Supplies
The purpose of storage are as follows:
• Protect the quality of the product and its
packaging
• Make product available for use at the right
time
Storage conditions for Drugs and medical
Supplies
• Put temperature control devices in place (fan,
air conditioner)
• Ensure adequate ventilation (forced ventilation)
• Ensure adequate light to facilitate all work-
related activities
• Store products out of direct sunlight
• Store supplies not for immediate use in their
shipping cartons
Storage conditions Drugs and medical
Supplies
• Secure Storeroom from water (check the roof,
walls, floor and windows)
• Store all products on pallets at least 10cm off
the floor, 30 cm away from the walls and other
stacks, and not more than 2.5m high
Storage conditions Drugs and medical
Supplies
• Store chemicals & insecticides separately to
avoid contamination of drugs
• Display hazardous warning signs for chemicals
and other hazardous material
Storage conditions Drugs and medical
Supplies
• Limit access to authorised personnel
• Ensure windows, roof, walls and doors are well
secured
• Ensure that incoming & out going stock match
documentation
• Verify inventory records monthly through
physical counts
Storage conditions Drugs and medical
Supplies
• Clean the store regularly (have cleaning
schedule in place)
• Put pest control measures in place
Storage conditions Drugs and medical
Supplies
• Arrange products by expiration date (FEFO,
first-expiry, first out) or by FIFO (only for
products with no expiry date)
• Arrange supplies by
• –Alphabetical
• –Dosage form
• –Rate of stock movement
• –Therapeutic grouping
Storage conditions Drugs and medical
Supplies
• Storage area of adequate size & adequate
sorting and packaging space
• Adequate space for products requiring
refrigeration
• Store expired or damaged products in a
separate area & approved disposal procedures
in place
Storage conditions Drugs and medical
Supplies
• Secure Storeroom from water (check the roof,
walls, floor and windows)
• Store all products on pallets at least 10cm off
the floor, 30 cm away from the walls and other
stacks, and not more than 2.5m high
Inventory control System
• A system that informs the storekeeper how
much of a commodity to order, when to order
and how to maintain appropriate stock levels
• In Zambia the type of inventory control system
used is the Max-Min inventory control system
Three types of Max-Min Inventory Control
System
There are three types of Max-Min inventory
control systems
• Forced ordering
• Continuous review
• Standard Max-Min
Forced Ordering
• At the end of the review period, review all
stock levels and order enough stock to bring
stock levels up to the maximum ( ARVs)
Continuous Review
• Review the stock level of an item every time
an issue is made. If the stock level is at or
below the minimum level, order enough to
bring to the maximum
Standard Max-Min
• Review the stock level of all the items at the
end of the review period. For products that
are at or below the minimum level, order
enough to bring to the maximum. Products
above minimum are not ordered. ( essential
drugs)
How to maintain appropriate stocking levels
To maintain appropriate stocking levels, the
following need to be established:
1. Maximum and Minimum stock levels: ( level
above which and below which stock levels
should not be allowed to exceed or fall)
2. Emergency order point (level that triggers an
emergency order)
How to maintain appropriate stocking levels
To maintain appropriate stocking levels, the
following need to be established:
3. Review period:( the routine interval of time
between assessments of stock level to
determine if an order should be placed)
4. Lead time:(the time between when new stock
is ordered and when it is received and
available for use
How to maintain appropriate stocking levels
• 5 . Safety stock (the buffer/reserve stock kept
to protect against stock-outs caused by
delayed deliveries or unexpected demand in
consumption)
How to maintain appropriate stocking levels
• 5. Safety stock (the buffer/reserve stock kept
to protect against stock-outs caused by
delayed deliveries or unexpected demand in
consumption)
How to maintain appropriate stocking levels
• 5. Safety stock (the buffer/reserve stock kept
to protect against stock-outs caused by
delayed deliveries or unexpected demand in
consumption)
Stipulated max –min stock levels of the
EMLIP hybrid
Level Maximum
Months of
stock
Minimum
Months of
stock
Emergency
order
Point
Hospitals
( Level 1,2
& 3
3 2 2 weeks
Health
Centres
4 3 2 weeks
DHO 1 2 weeks 2 weeks
Assessing stock status
• Determine the total consumption for three
months
• Calculate the average monthly consumption
• Determine the current quantity of stock on
hand
• Calculate the months of stock on hand
• Take action if needed based on the months of
stock .
Assessing stock status
Exercise 1
• You 96 tins of Aspirin at the end of August,
June 29
July 30
August 28.5
how long will these tins last?
Assessing stock status
Exercise 2
• You 100 tins of Paracetamol at the end of
August,
June 30
July 31
August 32.5
how long will these tins last?
Deciding what action to take after stock
status has been determined
• No action required if months of stock is between
3 and 2 months
• If months of stock is greater than 3 months the
facility is overstocked return some stock to the
pharmacy
• If months of stock is 2 months and 2 weeks the
facility is under continue monitoring
• If months of stock is less than 2 weeks you are
below emergency order point.
Forecasting
• Forecasting is the prediction of future
demand.
• It is the basis of planning and decision making
• Forecasts are rarely accurate because they are
based on assumptions and may be affected by
external factors
Forecasting
• Judgement Methods
• Causal Methods
• Time series Methods
Forecasting
Forecasting techniques
• Judgement Methods (Qualitative approach):
Sales force estimates
Executive opinion
Delphi method,
Markets research
Forecasting
Forecasting techniques
• Causal Methods
 linear regression
Forecasting
• Time Series Methods ( Quantitative
approach)
Simple Moving Average
Weighted Moving Average
Exponential Smoothing
Exponential Smoothing with Trend
Trend ,cyclical, seasonal and random.
Quantification
• The process of estimating the total quantities
and the costs of the products required for a
specific health program, for o future period
Quantification
Why quantify
• To Prevent Shortages of drugs
• To avoid wastage
• To make best use of available financial
resources
• To facilitate central bulk purchases
Quantification
Quantification Methods
Consumption Method: based on record of
past consumption of individual items
Morbidity Method: based on the number of
expected attendance
Quantification
Information required for quantification :
• Total consumption in a period,
• Number of days the product was out of stock
• Number of days the product was available
• Adjusted average consumption
Quantification
• Process to determine quantity needed and
financial means required
• It involves estimating how much of a specific
item is needed and the financial means
required
Handling damaged and Expired Products
• Store damaged and expired products
separately from usable stock
• Write Damaged or Expired stock on the box or
shelf
• Record the quantity and the expiry date
Completing the MSL Returns Authorisation
Form
• Write the name of your facility
• Write your name, date and sign
• For each product being returned ,enter the
MSL code number, description, pack size,
quantity , expiry date and explanation for why
the product is being returned
Completing the Report for Returning
Products
• Write the name of your facility
• Write your name, date and sign
• For each product being returned ,enter the
MSL code number, description, pack size,
quantity , expiry date and explanation for why
the product is being returned
Monitoring and supervision
• Monitoring: is the checking on a regular basis
to ensure that assigned activities are being
carried out.
• It requires regular checking and recording of
activities taking place in a project or program
Monitoring and supervision
• Supervision: the process of ensuring that
personnel have the knowledge and skills
required to carry out their responsibilities
effectively, and to provide immediate on the
Job training ,as needed.
End of presentation

Supply Chain Management in Leadership.pptx

  • 1.
  • 2.
    OVERVIEW OF SUPPLYCHAIN MANAGEMENT • Prior to the 1980s, business firms were using terms such as, “logistics”, and “operations management” instead of supply Chain Management. • The term was coined by a British logistician and consultant by the name of, Keith Oliver in the 1980s.
  • 3.
    OVERVIEW OF SUPPLYCHAIN MANAGEMENT • The term was first used in public in an interview with Arnold Kransdorff of the Financial Times on 4 June 1982 • The term Supply Chain Management came into widespread use in the 1990s
  • 4.
    OVERVIEW OF SUPPLYCHAIN MANAGEMENT Continuous evolution of the supply chain and of the techniques to manage it effectively were motivated by the following: • Fierce competition in today’s global markets, • Introduction of products with shorter life cycles
  • 5.
    OVERVIEW OF SUPPLYCHAIN MANAGEMENT • The heightened expectations of customers, • New rules of competition and the downward pressure on prices, • Continuing advances in communications and transportation technologies (e.g., mobile communication, Internet, and overnight delivery),
  • 6.
    OVERVIEW OF SUPPLYCHAIN MANAGEMENT • Supply chain management builds upon the concept of logistics and seeks to achieve linkage and coordination between the processes of other entities in the pipeline ( suppliers and customers).
  • 7.
    According to thecouncil of Supply Chain Management Professionals ( CSCMP,2011) • “Supply Chain Management encompasses the planning and management of all activities involved in sourcing, procurement ,and all logistics management activities Definition of Supply Chain Management
  • 8.
    Definition of Logistics TheCSCMPP also define Logistics – “The part of supply chain management that plans ,implements, and controls the efficient ,effective forward and reverse flow and storage of goods ,services and related information between the point of origin and point of consumption in order to meet customers requirements...
  • 9.
    Definition of Logistics •Logistics management is an integrating function ,which coordinates and optimizes all logistics activities, as well as integrates logistics activities with other functions including marketing , sales, manufacturing ,finance, and information technology”
  • 10.
    Comparison of logisticsand supply chain management: • Logistics typically refers to activities that occur within the boundaries of a single organization such as procurement, distribution, storage, and inventory management. • Supply Chain Management (SCM) acknowledges all of traditional logistics and also includes activities such as marketing, new product development, finance, and customer service.
  • 11.
    Comparison of logisticsand supply chain management: BASIS FOR COMPARISON LOGISTICS SUPPLY CHAIN MANAGEMENT Objective Customer satisfaction; to ensure the six rights right product with the right quality In the right quantity at the right time in the right place at the right price to the ultimate customer) Competitive advantage How Many Organisations are involved One Multiple Evolution A long time ago Modern concept
  • 12.
    Purpose of Logistics Thepurpose of a logistics system is to ensure the six rights: • The right drugs and medical supplies • in the right quantities • in the right condition • are delivered to the right place • at the right time • for the right price.
  • 13.
    The logistics cycle Policy/legal Frame work adaptability SERVING CUSTOMER PRODUCT SELECTION FORECASTING AND PROCUREMENT INVENTORY MANGEMENT Logistics management information system Organization and staffing, financing and budgeting, supervision evaluation
  • 14.
    Major Activities ofthe Logistics Cycle • Serving Customers:Everyone working in logistics must remember that their job is to select, procure, store, or distribute products to meet customer needs • Product selection: In a health logistics system, a national formulary and therapeutics committee, pharmaceutical board, board of physicians, or other government-appointed group select products to meet the needs of patients.
  • 15.
    Major Activities ofthe Logistics Cycle • Quantification :After products are selected, managers must determine the quantity needed for each product, for a specific time period—this is called quantification. Quantification depends on accurate forecasting Procurement: Procurement plans are based on requirements estimates that are determined mathematically for each product.
  • 16.
    Major Activities ofthe Logistics Cycle • Inventory management: A program’s inventory control strategy specifies how much stock to store and where to store it. Enough stock should be available to meet customer needs until a new order is received; but not so much that stocks expire or are wasted or that you exceed storage capacity.
  • 17.
    Major Activities ofthe Logistics Cycle • Quality monitoring:Quality monitoring appears between each activity of the logistics cycle and ensures that the quality of all the activities in the cycle are monitored. Management Information Systems: Information drives the logistics cycle; without it, the logistics system cannot run smoothly. Managers gather information about each activity in the system and then analyze that information to make decisions.
  • 18.
    Major Activities ofthe Logistics Cycle Organization and Staffing:A logistics system can only work when the staff are well-trained and operate in a supportive environment. They must have the right tools to do their jobs, whether they place orders, coordinate shipments, oversee deliveries, or keep a warehouse functioning effectively to ensure that the right product, in the right quantity, is shipped to the client.
  • 19.
    Major Activities ofthe Logistics Cycle Organization and Staffing:A logistics system can only work when the staff are well-trained and operate in a supportive environment. They must have the right tools to do their jobs, whether they place orders, coordinate shipments, oversee deliveries, or keep a warehouse functioning effectively to ensure that the right product, in the right quantity, is shipped to the client.
  • 20.
    Major Activities ofthe Logistics Cycle • Supervision:If the logistics system is carefully watched, it will run smoothly and staff will anticipate any needed changes. The effective supervision of logistics activities minimizes problems and/or resolves them quickly before any one problem becomes a crisis.
  • 21.
    Major Activities ofthe Logistics Cycle • Budgeting : affects the product selection, quantity of products procured, amount of storage space available, transport, and number of staff working in logistics. To have the entire system operating effectively, logistics activities must be included in operational planning and receive sufficient funds.
  • 23.
    Use of standardoperating procedure manual • The manual is intended to simplify and standardise the work required for logistics management in order to allow health workers more time for client focused activities. The manual guides health care workers in completing the following tasks with the help of Job aids.
  • 24.
    Use of standardoperating procedure manual • Maintaining adequate supplies of commodities • Reporting essential logistics data and ordering of commodities from MSl • Receiving and storing • Recording and reporting issues • Monitoring logistics activities throughout the system
  • 25.
    Supply chain pipeline •The pipeline includes the entire chain of storage facilities and transportation links that move supplies from the manufacturer to the consumer, including port facilities, central warehouses, regional warehouses, district and sub district stores, service delivery points, and transportation vehicles.
  • 26.
    Supply chain pipeline •A supply chain consists of activities and organisations that materials move through on their journey from initial suppliers to the final customer.
  • 27.
    Supply chain pipeline •A supply chain consists of activities and organisations that materials move through on their journey from initial suppliers to the final customer.
  • 28.
    Supply chain pipeline •The pipeline includes the entire chain of storage facilities and transportation links that move supplies from the manufacturer to the consumer, including port facilities, central warehouses, regional warehouses, district and sub district stores, service delivery points, and transportation vehicles
  • 29.
    Logistics management informationsystem ( LMIS) • The basic purpose of an LMIS is to collect and report information to other levels in the system in order to make decisions regarding the quantity and time to distribute drugs and medical supplies.
  • 30.
    Essential logistics data •STOCK ON HAND: quantity of usable stock at a particular level of the system at a particular point in time • CONSUMPTION DATA: quantity of drugs dispensed to clients during a particular period of time • DATA ON LOSSES AND ADJUSTMENTS : quantity of drugs no longer available for distribution, which have not been dispensed, but are damaged or expired are called losses and additions and subtractions to the available drug supply, which were not received through the normal mechanism of receipt are called adjustments. These are either transfers, drugs loaned to (-)/from (+) another facility, or drugs “found” (+) as a result of a previous miscount
  • 31.
    Records and Reportsused in the management of ARV ,EMLIP and HIV test kits logistics system • Stock Control Card • Stock Control book • GRN • Supply voucher • Requisition form
  • 32.
    Stock Keeping Records DescriptionType of data collected on the Transaction record •Stock Control Card •Inventory Control Card •Stores Ledger •Stock On Hand •Losses and adjustments •Quantity to Order •Quantity On Order
  • 33.
    Transaction Records Description Typeof data collected on the Transaction record •Requisition and issue voucher •Issue voucher •Packing Slip •Delivery note Quantity of product being • Ordered •Shipped, • Received
  • 34.
    Consumption Records Description Typeof data collected on the Transaction record •Dilly Usage Register •Log book •Tick sheet •Test Register Product used or dispensed to the end user at the service delivery point
  • 35.
    Forms used inmanaging drugs Form name Purpose activity Stock control card To account for drugs in the storeroom Issuing Storing Receiving Reporting and ordering Physical inventory ART daily activity register To record and track the number of ARV drugs dispensed to patients Dispensing Reporting and ordering Drug log book Collect information on amounts of drugs dispensed Dispensing Reporting and ordering Report and requisition To provide logistics data to MOH-LMU To report on stock status To order drugs Reporting and ordering
  • 36.
    Forms used inmanaging drugs Form name Purpose activity Supply voucher To request for drugs form the health center to the district To request for drugs from the ward to the hospital pharmacy Ordering Receiving Issuing Dispatch note To account for receipts from MSL receiving Report for returning products To track products returned to MSL from health facility level storing Dangerous drugs register To record and track the number of dangerous drugs dispensed to patients Dispensing Reporting and ordering
  • 37.
    Recording transactions inthe stock control card • Complete one SCC for each product • Enter the code, the name and form of the drug, unit, strength ,maximum level and the minimum level • Enter the date of the transaction • Enter the reference number
  • 38.
    Recording transactions inthe stock control card • In the issued to or received from column enter Balance brought forward if this is the first line of a new stock control Physical count if you have done a physical count MSL or Pharmacy in red if receiving Loss or adjustment
  • 39.
    Recording transactions inthe stock control card • In the remarks column provide a brief explanation for any loss or adjustment or add any other comment. • Keep the stock control card close to were products are being stored and issued in the pharmacy.
  • 40.
    Recording transactions inthe stock control card EXERCISE UPDATING A STOCK CONTROL CARD FOR AMOXYCILLIN CAPSULES 250MG AT KASAMA GENERAL HOSPITAL Unit 1000 • On 1/1/2012 conducted a physical count and found 50 bottles. • On 2/1/2012 issued to 5 bottles ward J • On 3/1/2012 issued to3 bottles to ward B • On 4/1/2012 issued 2 bottles to ward c • 0n 5/1/2012 loaned 10 bottles to Kasama DHO
  • 41.
    Recording transactions inthe stock control card • On 6/1/2012 received 30 bottles from medical stores limited • On 7/1/2012 issued 5 bottles to ward G • 0n 15/1/2012 issued 10 bottles to casualty • On 20/1/2012 Kasama DHO returned 10 bottles that was loaned • On 30/1/2012 issued 10 bottles to ward A • On 31/1/2012 conducted a physical count and found 44 bottles
  • 42.
    Recording transactions inthe stock control card Exercise 2 You are opening a stock control card, at Kasama General Hospital .Use the following information to update the stock control cards. • Doxycycline tablets 100mg bottle of 100(MSL code 798) • 1 January 2012 You open a new stock control card, bringing a balance of 40 bottles • 2 January 2012 You receive from Medical stores limited 50 bottles with a reference number of 798 • 3 January 2012 You issue to outpatient 10 bottles on internal requisition number 800 • 4 January 2012 You loan Kasama district 5 bottles on internal requisition number 801
  • 43.
    Recording transactions inthe stock control card • 5 January 2012 You issue to ward G 5 bottles on internal requisition number 818 • 6 January 2012 You issue to ward C 2 bottles on internal requisition number 819 • 10 January 2012 You drop one bottle and the tablets are damaged • 12 January 2012 You issue to ward J 10 bottles on internal requisition 820 • 16 January 2012 your receive from Kasama district 5 bottles on internal requisition 450 • 20 January 2012 You issue to ward B 5 bottles on internal requisition 821 • 31 January 2012 You conduct a physical count and you find 58 bottles
  • 44.
    Recording transactions inthe stock control card • In the received column enter the quantity received • In the issued column enter the quantity issued • In the losses and adjustment column enter the exact amount of the loss or adjustment • In the balance column enter the calculated balance
  • 46.
    Ordering Drugs andMedical supplies from the Pharmacy • A supply voucher is used • Health centres also use the supply voucher to order supplies from the DHO
  • 47.
    Supply Voucher TO --------------------------------- From ------------- Requested By: ------------- Signature-------------------- Date---------------- Authorised By: --------- Signature-------------------- Date------------------ ( A) ITEM CODE ( B ) DESCRIPTI ON,STREN GTH (C) UNIT ( D) BALANCE AT HAND (E) QUANTITY REQUESTE D (F) QUANTITY SUPPLIED (G) QUANTITY RECEIVED (I) REMARKS Approved By: ----Issued By: ----Delivered by-------- Received by: Date----- Date----------------- Date--------------- Date---------
  • 48.
    JOB AID FORRECORDING TRANSACTIONS IN THE SUPPLY VOUCHER • Enter only one transaction in each line • Use a blue or black pen to enter the transactions • From: enter the name of your ward, clinic or department • To: enter the name of the store , pharmacy or department to which the supplies will be obtained from • Name of requisitionist: enter your name
  • 49.
    JOB AID FORRECORDING TRANSACTIONS IN THE SUPPLY VOUCHER • Signature: sign • Date: Enter the date of the transaction • Item number: Enter the serial number for each drug • Item description: Enter the name and the form of the drug • Strength: Enter the strength • Unit: Write the individual unit for the drug • Quantity in stock: Enter the stock on hand in your storeroom
  • 50.
    JOB AID FORRECORDING TRANSACTIONS IN THE SUPPLY VOUCHER • Quantity ordered: Enter the quantity you are ordered • Quantity received: Enter the quantity received if receiving • Quantity issued: leave this blank • Signature: print your name and then your signature after checking. • Remarks: provide a brief explanation for any loss or adjustment
  • 51.
    EXERCISE USING ASUPPLY VOUCHER MSL CODE PRODUCT DESCRIPTI ON UNIT STOCK ON HAND AVARAGE MONTHLY CONSUMPT ION MS 0079 Fluid Giving Set 25 3 10 MS 005 Examination Gloves ,Larg e 100 3 12 EM 0032 Amoxicillin Capsules 250mg 1000 2 8 EM 00348 Paracetamol Tablets 500mg 1000 4 15
  • 53.
    Completing the Dailyactivity register for ARVs The following steps should be followed: • Record the client number • Record the type of ARV dispensed • Record the quantity dispensed • Calculate the total quantity dispensed at the end of the day • Calculate the quantity dispensed at the end of the month
  • 54.
    Exercise: Completing theDaily Activity Register for ARVs You are the Pharmacy in charge at Kasama General Hospital. Complete the ART daily activity register With the following information • On august 1,2018 patient number 56 is making his monthly visit to the ART clinic, You give him a combination of Zidovudine 300mg plus lamivudine 150mg and single dose of Nevirapine 200mgtablets to take for one month. • On august 3, patient number 99 arrives and you give him a triple fixed combination of Tenofovir 300mg/Lamivudine300mg/Efavirenz 600mg Tablets to take for one month. • On August 7, patient number 36 arrives to peak up Tenofovir 300mg/Lamivudine300mg/Efavirenz 600mg Tablets to take for one month.
  • 55.
    Completing the DailyActivity Register for ARVs • On august 10, patient number 44 is started on Tenofovir 300mg/Lamivudine300mg combination plus Lopinavir/Ritonavir (Aluvia). • On august 11 patient numbers 65 collects a combination of Zidovudine 300mg plus lamivudine 150mg and single dose of Nevirapine 200mgtablets to take for one month. • On august 15 patient number 22,is given Abacavir 30 /Lamivudine 60mg and Efavirenz separately • On 28 august a baby number 77 was given Zidovudine/ Lamivudine and Nevirapine for one month.
  • 56.
    Completing the DailyActivity Register for ARVs • On august 29 patient number 39 was given Tenofovir 300mg/Lamivudine300mg/Efavirenz 600mg Tablets to take for one month. • On august 30, patient number 80 came and collected on Tenofovir 300mg/Lamivudine300mg combination plus Lopinavir/Ritonavir (Aluvia). • On 30th august patient number 100 was given PEP medicine on Tenofovir 300mg/Lamivudine300mg combination plus Atazanavir to take daily..
  • 58.
    Job aid: Completingthe Daily activity register for HIV Test Kits Cover page of the register write the following: • Name of the facility • Name of the testing site • Name of the district • Name of the province • Book number • Start date
  • 59.
    Completing the Dailyactivity register for HIV Test Kits • The following steps should be followed: • Record the client number and purpose of the test • Record the type of test • Record the quantity of test used • Record the result ( R, NR or IND) • Calculate the total quantity of the tests done at the end of the day • Summarise the total number of tests done at the end of the month
  • 60.
    Exercise: Completing theDaily activity register for HIV Test Kits • You are the in charge, complete the daily activity reviser. 1. On June 5 of 2016,the beginning balances of each test are; Determine 15 tests, SD bioline 8 tests. 2. You request and receive 100 determine tests and 20 SD Bioline tests from the main store room.
  • 61.
    Exercise: Completing theDaily activity register for HIV Test Kits 3.Following appropriate quality control procedures, you run a known positive sample using determine and SD Bioline .Then you run a negative sample and determine and SD Bioline. 4.A sample for patient number 44 arrives at the laboratory in the morning with a request for clinical diagnosis for HIV. The sample is screened for HIV using determine rapid test.The test is positive,so it is retested to confirm using SD Bioline.The second test is also positive.
  • 62.
    Exercise: Completing theDaily activity register for HIV Test Kits 5.Shortly afterwards patient number 56 arrives at the clinic. The sample sent to the Laboratory is screened using determine which shows that the patient is positive, A confirmatory test is done using SD Bioline and the result is negative. 6.A patient arrives at the clinic and is assigned number 308.The sample is first tested using dtermines and the result is invalid.The sample is retested using determine again and the result is negative.
  • 63.
    Exercise: Completing theDaily activity register for HIV Test Kits 7.another patient ,number 22 comes to the clinic for prenatal care. The EMTCT doctor sends her sample to the main Laboratory for an HIV test. The sample is tested using determine and her test results are negative. 8.In the afternoon a new Laboratory Technician begins working at the main Laboratory and is trained how to conduct HIV testing by using a known positive sample on determine and SD Bioline. This is repeated using a known negative sample on determine and SD Bioline.
  • 64.
    Exercise: Completing theDaily activity register for HIV Test Kits 9.Patient number 139 has come to the clinic in the afternoon and the doctor determines that she should be tested for HIV. The sample is sent to the Laboratory and tested using Determine and the results were positive .the sample is tested using SD Bioline and the results are also positive.
  • 65.
    Exercise: Completing theDaily activity register for HIV Test Kits 10.It is now the close of the business. Complete the Daily activity Register for the day ,including the summary for HIV tests by purpose. Your physical count for each product is as follows: Determine 105 tests, SD Bioline 21 Tests
  • 66.
    Completing the internalMonthly summary ( IMSR) • Only health centres with multiple testing sites will need to complete the internal monthly summary. • Health centres with one testing site will use the daily activity register and the stock control card to complete the Rand R for HIV tests • Health centre in charge for health centers with multiple testing sites will summarise the data for the month
  • 67.
    Completing the internalMonthly summary ( IMSR) Data to be summarised is as follows: • Total quantity of each HIV test received at the testing site during the month • Total quantity of each HIV test used during the month • Losses and adjustments • Total stock of each HIV test on hand at the testing site as determined by a physical count
  • 68.
    Completing the internalMonthly summary ( IMSR) • The total number of positive ,negative and indeterminate test results • Once the IMSR are completed, they are sent to the person designated for managing HIV tests at the health centre • Data from all the testing sites will then be aggregated and used to complete the R&R
  • 70.
    Completing the Reportand Requisition for HIV Test Kits • Write the reporting period, facility name, province and district and the type of test. • Write the beginning balance • Write the total quantity received • Write the total quantity used • Write the losses and adjustments • Explain any losses and adjustments
  • 71.
    Completing the Reportand Requisition for HIV Test Kits • Write the physical count • Calculate Average Monthly Consumption • Calculate the Maximum Quantity • Calculate the Order quantity • Write any remarks or comments • Summarise tests used by Purpose
  • 72.
    Completing the Reportand Requisition for HIV Test Kits • Review the completed report • Print your name /signature and date • Have the order authorised and approved • Submit the Rand R
  • 74.
    Completing the Reportand Requisition for ARVs • A report and requisition is used (R&R). • This form is used at the Health Centers and Hospitals • Health centers send the R&R to the District for review by the fifth day following the reporting period. • DHO and Hospitals after reviewing the R&R send it MSL according to schedule
  • 75.
    Completing the Reportand Requisition for ARVs The following data is reported on the report section of the R&R: • Beginning Balance in the store room and dispensary or testing site • Total Quantity Received • Total Quantity Used • Losses and adjustments • Ending Balance
  • 76.
    Completing the Reportand Requisition for ARVs • The following data is reported on the requisition section of the R&R: • Average Monthly Consumption • Maximum Quantity • Order Quantity
  • 77.
    How to calculatethe order quantity Calculating the average monthly consumption Add the total quantity dispensed for the current and the last two months Divide by three Round to the nearest dispensing unit
  • 78.
    How to calculatethe order quantity Calculating the maximum quantity • Multiply the average monthly consumption by 3 Calculating the order quantity • Subtract the ending balance from the maximum quantity
  • 79.
    Completing the reportfor Drugs and Medical supplies. • A report and requisition Drugs and Medical supplies is used (REMMS). • This form is used at the Health Centers and Hospitals • Health centers send the REMMS to the District for review by the fifth day following the reporting period. • DHO and Hospitals after reviewing the REMMS send it MSL according to schedule
  • 80.
    Placing an emergencyorder • Tick the emergency order box at the top of the report for essential drugs and medical supplies • Use a red pen to write emergency order across the top of each page • Complete the REMMS for all the printed drugs and medical supplies and send the form to the DHO
  • 81.
    Placing an emergencyorder • DHO WILL Review and approve the emergency order and send it the MSL commodity security centre • When the order is ready MSL will inform you to go and collect the emergency order.
  • 83.
    Receiving drugs andmedical supplies from Medical Stores Limited • Locate the requisition or supply voucher • Conduct a visual inspection • Note discrepancies on the forms • Sign the form • Place and reorganize products according to FEFO • Enter and update the goods received note(GRN) and the stock control cards
  • 85.
    Storage of Drugsand Medical Supplies The purpose of storage are as follows: • Protect the quality of the product and its packaging • Make product available for use at the right time
  • 86.
    Storage conditions forDrugs and medical Supplies • Put temperature control devices in place (fan, air conditioner) • Ensure adequate ventilation (forced ventilation) • Ensure adequate light to facilitate all work- related activities • Store products out of direct sunlight • Store supplies not for immediate use in their shipping cartons
  • 87.
    Storage conditions Drugsand medical Supplies • Secure Storeroom from water (check the roof, walls, floor and windows) • Store all products on pallets at least 10cm off the floor, 30 cm away from the walls and other stacks, and not more than 2.5m high
  • 88.
    Storage conditions Drugsand medical Supplies • Store chemicals & insecticides separately to avoid contamination of drugs • Display hazardous warning signs for chemicals and other hazardous material
  • 89.
    Storage conditions Drugsand medical Supplies • Limit access to authorised personnel • Ensure windows, roof, walls and doors are well secured • Ensure that incoming & out going stock match documentation • Verify inventory records monthly through physical counts
  • 90.
    Storage conditions Drugsand medical Supplies • Clean the store regularly (have cleaning schedule in place) • Put pest control measures in place
  • 91.
    Storage conditions Drugsand medical Supplies • Arrange products by expiration date (FEFO, first-expiry, first out) or by FIFO (only for products with no expiry date) • Arrange supplies by • –Alphabetical • –Dosage form • –Rate of stock movement • –Therapeutic grouping
  • 92.
    Storage conditions Drugsand medical Supplies • Storage area of adequate size & adequate sorting and packaging space • Adequate space for products requiring refrigeration • Store expired or damaged products in a separate area & approved disposal procedures in place
  • 93.
    Storage conditions Drugsand medical Supplies • Secure Storeroom from water (check the roof, walls, floor and windows) • Store all products on pallets at least 10cm off the floor, 30 cm away from the walls and other stacks, and not more than 2.5m high
  • 94.
    Inventory control System •A system that informs the storekeeper how much of a commodity to order, when to order and how to maintain appropriate stock levels • In Zambia the type of inventory control system used is the Max-Min inventory control system
  • 95.
    Three types ofMax-Min Inventory Control System There are three types of Max-Min inventory control systems • Forced ordering • Continuous review • Standard Max-Min
  • 96.
    Forced Ordering • Atthe end of the review period, review all stock levels and order enough stock to bring stock levels up to the maximum ( ARVs)
  • 97.
    Continuous Review • Reviewthe stock level of an item every time an issue is made. If the stock level is at or below the minimum level, order enough to bring to the maximum
  • 98.
    Standard Max-Min • Reviewthe stock level of all the items at the end of the review period. For products that are at or below the minimum level, order enough to bring to the maximum. Products above minimum are not ordered. ( essential drugs)
  • 99.
    How to maintainappropriate stocking levels To maintain appropriate stocking levels, the following need to be established: 1. Maximum and Minimum stock levels: ( level above which and below which stock levels should not be allowed to exceed or fall) 2. Emergency order point (level that triggers an emergency order)
  • 100.
    How to maintainappropriate stocking levels To maintain appropriate stocking levels, the following need to be established: 3. Review period:( the routine interval of time between assessments of stock level to determine if an order should be placed) 4. Lead time:(the time between when new stock is ordered and when it is received and available for use
  • 101.
    How to maintainappropriate stocking levels • 5 . Safety stock (the buffer/reserve stock kept to protect against stock-outs caused by delayed deliveries or unexpected demand in consumption)
  • 102.
    How to maintainappropriate stocking levels • 5. Safety stock (the buffer/reserve stock kept to protect against stock-outs caused by delayed deliveries or unexpected demand in consumption)
  • 103.
    How to maintainappropriate stocking levels • 5. Safety stock (the buffer/reserve stock kept to protect against stock-outs caused by delayed deliveries or unexpected demand in consumption)
  • 104.
    Stipulated max –minstock levels of the EMLIP hybrid Level Maximum Months of stock Minimum Months of stock Emergency order Point Hospitals ( Level 1,2 & 3 3 2 2 weeks Health Centres 4 3 2 weeks DHO 1 2 weeks 2 weeks
  • 105.
    Assessing stock status •Determine the total consumption for three months • Calculate the average monthly consumption • Determine the current quantity of stock on hand • Calculate the months of stock on hand • Take action if needed based on the months of stock .
  • 106.
    Assessing stock status Exercise1 • You 96 tins of Aspirin at the end of August, June 29 July 30 August 28.5 how long will these tins last?
  • 107.
    Assessing stock status Exercise2 • You 100 tins of Paracetamol at the end of August, June 30 July 31 August 32.5 how long will these tins last?
  • 108.
    Deciding what actionto take after stock status has been determined • No action required if months of stock is between 3 and 2 months • If months of stock is greater than 3 months the facility is overstocked return some stock to the pharmacy • If months of stock is 2 months and 2 weeks the facility is under continue monitoring • If months of stock is less than 2 weeks you are below emergency order point.
  • 109.
    Forecasting • Forecasting isthe prediction of future demand. • It is the basis of planning and decision making • Forecasts are rarely accurate because they are based on assumptions and may be affected by external factors
  • 110.
    Forecasting • Judgement Methods •Causal Methods • Time series Methods
  • 111.
    Forecasting Forecasting techniques • JudgementMethods (Qualitative approach): Sales force estimates Executive opinion Delphi method, Markets research
  • 112.
    Forecasting Forecasting techniques • CausalMethods  linear regression
  • 113.
    Forecasting • Time SeriesMethods ( Quantitative approach) Simple Moving Average Weighted Moving Average Exponential Smoothing Exponential Smoothing with Trend Trend ,cyclical, seasonal and random.
  • 114.
    Quantification • The processof estimating the total quantities and the costs of the products required for a specific health program, for o future period
  • 115.
    Quantification Why quantify • ToPrevent Shortages of drugs • To avoid wastage • To make best use of available financial resources • To facilitate central bulk purchases
  • 116.
    Quantification Quantification Methods Consumption Method:based on record of past consumption of individual items Morbidity Method: based on the number of expected attendance
  • 117.
    Quantification Information required forquantification : • Total consumption in a period, • Number of days the product was out of stock • Number of days the product was available • Adjusted average consumption
  • 118.
    Quantification • Process todetermine quantity needed and financial means required • It involves estimating how much of a specific item is needed and the financial means required
  • 119.
    Handling damaged andExpired Products • Store damaged and expired products separately from usable stock • Write Damaged or Expired stock on the box or shelf • Record the quantity and the expiry date
  • 120.
    Completing the MSLReturns Authorisation Form • Write the name of your facility • Write your name, date and sign • For each product being returned ,enter the MSL code number, description, pack size, quantity , expiry date and explanation for why the product is being returned
  • 121.
    Completing the Reportfor Returning Products • Write the name of your facility • Write your name, date and sign • For each product being returned ,enter the MSL code number, description, pack size, quantity , expiry date and explanation for why the product is being returned
  • 122.
    Monitoring and supervision •Monitoring: is the checking on a regular basis to ensure that assigned activities are being carried out. • It requires regular checking and recording of activities taking place in a project or program
  • 123.
    Monitoring and supervision •Supervision: the process of ensuring that personnel have the knowledge and skills required to carry out their responsibilities effectively, and to provide immediate on the Job training ,as needed.
  • 124.