Quantification, Procurement and Supply Management of UNCoLSC Medicines: Ugandan Experience Workshop on optimal Procurement of affordable and Quality Assured LSC for Maternal Health 8 th – 10 th September 2015

Presentation Outline Background Scope of RMNCH commodities procured in Uganda Involvement in the quantification process Quantification data challenges and how they have been overcome Challenges affecting RMNCH commodity security and mitigating interventions instituted

Background Availability of RMNCH commodities and services at SDPs is key to achieving MDGs 1,3,4,5 and 6 Access at facility level remains a challenge MOH has continued to build capacity for quantification and monitoring stock status and service delivery Quantification and Procurement Planning Unit (QPPU) established under Pharmacy Division to estimate national requirements and coordinate stakeholders’ contributions and supply plans

Scope of Procurement CategoryProductNotes Family Planning Products Emergency ContraceptivesUnpredictable demand Female CondomsDistributed through private sector (UHMG) implantsImplanon (3-year) & Jadelle (5-year) Maternal Health Commodities OxytocinProcured as part of Essential Medicines MisoprostolProcured as part of Essential Medicines Magnesium SulphateProcured as part of Essential Medicines New born health Products Antenatal CorticosteroidsProcured as part of Essential Medicines Chlorhexidine (7.1%)Not currently procured Injectable antibioticsProcured as part of Essential Medicines Resuscitation EquipmentOnly masks procured by NMS. JMS (Bags,Masks, Bulbs) Child Health Products Amoxicillin (250mg DT)Not currently procured. Only 125mg strength currently procured ORS and ZincORS/Zinc co-pack preferred. Procured as part of essential medicines

Involvement in the Quantification Process Multi-stakeholder Consultative process (Warehouses, MOH technical programs, SDPs, IPs, DPs) National level: Coordinated by QPPU NMS & HFs (Annual Procurement Plans for Essential Medicines for Hospitals and HCIVs) NMS & Districts (Essential Medicines Kit for HCII and HCIII)

Quantification Data Challenges Consumption/issues data may not reflect actual demand Demographic data may be outdated (e.g. UDHS 2011) Program targets may not be realistically aligned with system capacity Essential logistics data and/or service statistics not routinely collected from SDPs for all medicines

Overcoming Data Challenges Triangulation of data sources (consumption versus Morbidity method) Using expert opinion and key informants Using special survey reports and global averages Explore possibility of including all 13 LSCs in HMIS 105 for routine reporting

Challenges Affecting Security of UNCoLSC Lack of demand and awareness (ECPs, MgSo4, Chlorhexidine 7.1%) Some items (Amoxicillin 250mg DT & Chlorhexidine 7.1%) not on EMLU Lack of capacity of service providers (e.g. insertion and removal of implants) Policy barriers to service provision (e.g. Nurses Vs. insertion of implants) Funding mainly through DPs Manual LMIS (stock cards) New commodities not on order forms Distribution up to community level through VHTs: quantification, supply & reporting challenges

Interventions to improve Commodity Security and LMIS Central coordination mechanism (QPPU, RHCS/FP working groups, CSG meetings) Alternative distribution strategy to increase access to the private sector Addendum to the EMLU & UCG to include new RMNCH commodities and guidelines On the Job training and Performance assessment strategy (SPARs) Use of electronic LMIS (Rx Solution) Inclusion of 9 RMNCH items on tracer list of EMHS under DHIS2 Strengthen VHT supply system

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