Health Supply Chain Management: Session 6: Facilities, Staffing and Procurement Ghana Nursing Schools

Session Objectives By the end of the session, students will be able to: Identify the key logistics roles performed by each level of the Ghanaian health system List the key logistics responsibilities of health system staff Discuss the roles and responsibilities of nurses in health logistics system Define procurement and describe the role of health facility personnel in the process.

The Logistics Cycle

Logistics Roles: Health Facility Level Requisition the products that are needed to treat patients Provide the regional medical stores with the information it needs to fill the orders Once the ordered products are received at facility, store them until issued to service providers Dispense the products to the patients

Logistics Roles: District Level Review health facility requisition quantities Transmit requisitions to the RMS Assist facilities to process their payment cheques Follow up to ensure that payments are sent to the RMS Assist facilities with discrepancies or other problems with received commodities

Logistics Roles: Regional Level Provide price lists to facilities Set the schedules for commodity deliveries and related activities Deliver commodities to facilities Work with facilities and districts to resolve discrepancies Collect, collate and distribute data that are needed for decision-making by stores managers and program personnel at various levels

Logistics Roles: Central Level Procurement and Stores Division (PSD) supervises and guides: Storage and distribution functions (delegated to the CMS) Procurement (delegated to the Procurement Unit) All activities on the lower levels of the system

Logistics Roles: Multiple Levels Re-order commodities from their suppliers Perform inventory control to manage their stocks Monitor the condition of commodities in the stores

Staff with Logistics Duties: Small Health Facilities Facility In-Charge Storekeeper Dispensers Nurses/service providers

Staff with Logistics Duties: Hospitals Hospital In-Charge/Medical Superintendent Hospital Administrator Pharmacist In-Charge Laboratory In-Charge Medicines and Therapeutic Committee members Suppliers’ Officers Nurses/service providers

Staff with Logistics Duties: District Level District Director District Pharmacist District Public Health Nurse District Supply Officer District Budget Management Centre staff District Health Management Teams

Staff with Logistics Duties: Regional Level Regional Director Deputy Director of Pharmaceutical Services Deputy Director of Administration Regional Supply Officer

Staff with Logistics Duties: Central Level Pharmacist-in-Charge, Central Medical Stores, Procurement and Supplies Division of MOH Staff at the Supplies, Stores and Drug Division in GHS Program Managers such National Malaria Control Program (NMCP); National AIDS Control Program (NACP) Family Planning Manager, etc. Staff at donor organizations Staff at NGOs

Logistics Duties of Nurses (1) Calculate the quantities of commodities needed (assess stock) Request these commodities via the RIRV Place the order by: taking the RIRV to the district for verification submitting the RIRV to the RMS so the order can be processed and the commodities packed/delivered to health facility Receive commodities at the health facility: Verify the quantities received

Logistics Duties of Nurses (2) Sign the Way Bill and submit the documents to the driver Unpack the commodities and enter quantity received in the RIRV Arrange commodities in the store and update stock keeping records Issue commodities as needed to service delivery staff and record on bin cards Dispense commodities to patients as needed, recording on dispensed-to-user forms

Procurement roles for Health personnel

Procurement - Definition Procurement is the acquisition of goods, work and services. It is important that the goods/works/ services are appropriate and that they are procured at the best possible cost to meet the needs of the purchaser in terms of quantity, quality, time and location.

The Procurement Cycle

Procurement Roles 1. Planning of Requirements should include: Defining requirements Identifying source of funding 2. Specification of Requirements Technical Specifications equipment and / or materials Performance Specification functional criteria testing checking National / International Standards quality of materials performance and testing

Sourcing Methods of procurement Supply Sources Evaluation and Award Competitive/restricted/2-stage tendering International/national Request for Quotations or Single Source Procurement Request for Proposals for consultancy services Supply Sources registered suppliers existing suppliers trade sources or website Evaluation and Award Criteria for evaluation lowest cost quality and cost based selection

Inspection and Acceptance technical / performance specification quality standards trained staff Sample testing Acceptance Correct quantity Technical standards Timely delivery Required manuals or documentations

Warehousing Inventory Control and Management demand scheduling stock planning Audits Storage requirements Cold storage Security Shelf life Materials Handling equipment for handling safety of equipment security of stock allocation of responsibility

Distribution Distribution to end users in various locations Use of regional stores, Depots Consider transport requirements and available infrastructure

Disposal of Obsolete, Expired, Damaged and unserviceable Stores identification of obsolete / obsolescent materials valuation of stock authorisation system Formation of Board of Survey Board’s Recommendation Methods of Disposal Transfer to other public entities Sale by public tender to the highest tenderer Sale by public auction Destruction, dumping or burying whichever is appropriate

Evaluation Not to be confused with evaluation of tenders Review of performance of procurement function To assess compliance, efficiency and effectiveness May include procurement audits

Procurement Principles Professionalism Accountability Fairness Competiveness Value for money Effectiveness and Efficiency Transparency Ethical Approach