Current Status of HIV Pharmaceutical Management in Guangxi Province, China Helena Walkowiak, Management Sciences for Health /SPS Sharri Hollist, MSH/Strengthening.

Slides:



Advertisements
Similar presentations
Planning for Transition from Opti on B to B+: Rwanda Experience MUGWANEZA Placidie, Coordinator of HIV prevention Unit/RBC/MOH ART in pregnancy, breastfeeding.
Advertisements

Strategies to strengthen the distribution system to improve the availability of medicine Dr Wael Inmair Director Assistant, Central Medical Supply Store,
Guide to Writing The Procurement and Supply Management Plan Dr Luca Li Bassi Procurement Officer – The Global Fund Procurement and Supply Management Workshop.
Group III: Demand Forecasting
Reporting Requirements and Indicators for Supply Chain Management of HIV Diagnostics & Medicines: Kenya and Nigeria Yasmin Chandani, Coordinator for HIV/AIDS.
National PSM Coordination Mechanism Dr Vincent Habiyambere WHO/HIV Department AIDS Medicines & Diagnostics Service (AMDS) Bangkok, July 2005.
Priority Issues and Strategic Information Needs for Kenya in scaling up ART.
The Roadmap to Successful Xpert Implementation - 37 steps -
0 EMS Stakeholders Meeting 2011 August 25, 2011 Bob Leopold EMS and Trauma Systems Program.
 Capacity Development; National Systems / Global Fund Summary of the implementation capacities for National Programs and Global Fund Grants For HIV /TB.
Integrated Monitoring and Evaluation of HIV Programs in Malawi Dr Andreas Jahn 1,2 1 Dept. for HIV and AIDS, MOH, Malawi 2 I-TECH Malawi.
Capability Cliff Notes Series PHEP Capability 8—Medical Dispensing and Countermeasures What Is It And How Will We Measure It?
1 Measuring adherence using electronic dispensing data: nationwide electronic monitoring in Namibia Dr. David Mabirizi – Country Director MSH Namibia Third.
An Approach for Capacity Development & Transition
Comprehensive M&E Systems
Supply Chains Management for Pharmacy
1 Module PLANNING AND ORGANIZING EXTERNAL QUALITY ASSESSMENT.
Inventory Management: Distribution, ICS, LMIS Nairobi, 21 February, 2006 Yasmin Chandani HIV/AIDS Technical Coordinator.
Unit 8 Supply Chain. Objectives 1.Describe the special nature of health care commodities due to the need for provider advice and counseling 2.Describe.
Management of the Tuberculosis Drug Supply Module 13 – March 2010.
Module 10: Inventory Managing Stocks at the HIV Rapid Testing Site.
Accelerating TB/HIV activities in Zambia Alwyn Mwinga 2007 HIV Implementers Meeting 20 June 2007.
Using Mobile Technology to Strengthen HIV/AIDS Management in Remote Areas Authors: (1)Kunda, Mwape; (2)Pereko, Dawn; (2)Sumbi, Victor; (2)Mwinga, Samson;
Monitoring Drug and Commodity Supply Chains for ARV Programmes Yasmin Chandani John Snow Inc/DELIVER.
Tracking of Inter-Facility Patient Transfers and Retention on Antiretroviral Treatment in Namibia Presenter Naita Nashilongo Ministry of Health and Social.
Botswana National Program: Nurses Dispensing ARVs Tendani Gaolathe M.D Director Botswana-Harvard Partnership /PEPFAR Master Trainer Program.
Towards Strengthening Procurement and Logistics Management System for the Ministry of Health and Bangladesh June 20, 2011.
Pharmacovigilance in Kenya Dr. Dorine Kagai (NASCOP) Mr. George Muthuri (PPB) Ministry of Medical Services 23 nd November, 2009 ARV PV TRAINING TZ.
Use of an Indicator-Based System for Assessing, Monitoring, and Improving Pharmacy Practice Authors: Lates, J. (1); Sumbi, V. (2); Phulu, B. (1); Rushubiza,
Enhancing the culture of multi-disciplinary workshops on using data for decision-making: Tanzanian efforts to improve completeness of CD4 assessments Molly.
Introduction to Elements of In-Country Drug Management with Focus on TB Drugs Jim Rankin Director, Center for Pharmaceutical Management Management Sciences.
The Challenge of Scale-Up and International Distribution Richard C. Owens, Jr. Director, Supply Chain Management System XVIth International AIDS Conference.
Washington D.C., USA, July 2012www.aids2012.org Lessons from the Rapid Response of Namibia’s Supply Chain When Antiretroviral Treatment Guidelines.
Orientation on HIV care and ART Recording and Reporting System.
Zimbabwe MOHCW Male Circumcision Programme Supply Chain Management Dr. O. Mugurungi, Director AIDS&TB Programme Ministry of Health and Child Welfare June.
Lucile de Comarmond Chief Pharmacist Workshop on Impact of TRIPS/IP on Access to Medicine September 2014.
Zambian MOH Essential Drug Logistics System November 2009.
Overview of the Global Fund Procurement and Supply Management Issues Workshop for LAC Consultants th July 2009 Pharmaceutical Management Advisory.
Emtenan AlHarbi,Mcs Clinical pharmacist
From 3by5 to Universal Access to HIV/AIDS Treatment: AMDS Technical Briefing Seminar for Consultants on Procurement and Supply Management for HIV, TB and.
1 Overview of Fellowship Projects. Project to depend on what is available in host institution with strong mentorship Should address activities and tasks.
Securing the Supply of Condoms and Other Essential Products for HIV/AIDS Programs Tony Hudgins Yasmin Chandani John Snow Research & Training Institute.
Inventory Management: Distribution, ICS, LMIS Technical Briefing Seminar in Procurement and Supply Management for HIV, TB and Malaria Copenhagen, 1 February.
TBS 2008-H. Tata & M. Babaley Mapping and In-depth Assessment of Medicines Procurement and Supply Systems WHO Technical Briefing Seminar 17 th -21 st November.
CLICK TO ADD TITLE [DATE][SPEAKERS NAMES] The 5th Global Health Supply Chain Summit November , 2012 Kigali, Rwanda Outsourcing vaccine supply chains:
Consultant Advance Research Team. Outline UNDERSTANDING M&E DATA NEEDS PEOPLE, PARTNERSHIP AND PLANNING 1.Organizational structures with HIV M&E functions.
Sub module 1 Introduction to HIV care and ART recording and reporting system.
PILOTING THE USE OF MOBILE SHORT MESSAGING SYSTEMS (SMSs) TO IMPROVE ACCESS TO MEDICINES: EXPERIENCES FROM KENYA Njoroge, Tony; Maundu, Josephine; Wangai,
Pharmacovigilance in HIV/AIDS Public Health Programmes: Luxury or Priority? November 2009, dar Es Salaam.
INTRODUCTION TO LOGISTICS MANAGEMENT: COMMODITY FORECASTING AND SUPPLY CHAIN MANAGEMENT A presentation to RHU field staff By Albert Kalangwa (MCIPS, MBA,
Drug Management of Second-line anti-TB drugs through the Green Light Committee mechanism for programmes funded by the Global Fund to Fight Against AIDS,
Rapid decentralised scale-up of HIV care and treatment in Suba District MOH health facilities.
Comprehensive M&E Systems: Identifying Resources to Support M&E Plans for National TB Programs Lisa V. Adams, MD E&E Regional Workshop Kiev, Ukraine May.
Jeroen Van’t Pad Bosch, Technical Director Elizabeth Glaser Pediatric AIDS Foundation, Tanzania EGPAF PROJECT HEART STRENGTHENING HEALTH SYSTEMS THROUGH.
WASHTENAW COUNTY HEALTH DEPARTMENT 555 TOWNER ST. YPSILANTI, MI Strategic National Stockpile Overview: Volunteer Training.
STOCK MANAGEMENT, INVENTORY AND ACCOUNTABILITY STANDARDS: WHAT WE HAVE LEARNT, GOOD PRACTICE STANDARDS.
HHS/CDC Track 1.0 Transition in Rwanda Dr Ida Kankindi, Rwanda Ministry of Health Dr Felix Kayigamba, CDC-Rwanda August
Progress on Implementation of the Comprehensive HIV and AIDS Plan February 2004.
ADDRESSING PHARMACEUTICAL SUPPLY CHAIN NEEDS PRESENTATION TO HEALTH DONOR GROUP MEETING 8 July 2009.
Assessing Logistics System Supply Chain Management 1.
Improving health worldwide Implications for Monitoring of the HIV Care Cascade? Jim Todd MeSH Satellite Session IAS Durban, Monday 18 th.
Rapid scale up of Pharmacy module use at Mtwara region in strengthening Antiretroviral commodity management Yefta Emmanuel THPS - Pharmacy Technical Advisor.
EDM Strategy for Working with Countries: the Uganda Example
Procurement and Supply Management for iCCM – common challenges
The Procurement and Supply Management Plan
Finance analysis of pharmaceutical management interventions
Stock Management, inventory and accountability standards:
Inventory Management: Distribution, ICS, LMIS
11 iii. Define management and supervision roles and responsibilities
Comprehensive M&E Systems
Presentation transcript:

Current Status of HIV Pharmaceutical Management in Guangxi Province, China Helena Walkowiak, Management Sciences for Health /SPS Sharri Hollist, MSH/Strengthening Pharmaceutical Systems Beth Yeager, MSH/SPS Dr Connie Osborne, WHO Dr Zhang Lan, WHO December 9, 2008

Outline of Presentation  Overview of the WHO, MSH, Guangxi province ARV management Program  Objectives of the Assessment  Key findings  Options/strategy for strengthening ARV pharmaceutical management in Guangxi Province

ARV Management in Guangxi Province - Strengthening Pharmaceutical Systems (SPS) Program – An Overview  Funded by U.S. Agency for International Development  Implemented by Management Sciences for Health and supported by WHO  5 year award  June 29, 2007 – June 28, 2012

In collaboration with NCAIDS and WHO Workshop in Guangxi Province to introduce a tool for assessing the management of ARVs (July 2008)

Key Objectives of the Assessment  Map the flow of ARV medicines through the supply system including the processes of procurement, quantification, distribution and dispensing  Understand the roles and responsibilities of staff at each level in managing medicines for the ART Program  Identify forms, tools and procedures used for procuring ARV medicines, managing inventories, recording medicines transfers, dispensing, and reporting data  Solicit feedback on which procedures and tools currently being used are effective in managing ARV medicines and which may need to be strengthened to support program scale up

Site Visits: December 3 to 7, 2008 Unit Level Guangxi Autonomy Provincial CDCThe Fourth People's Hospital Provincial/City Guilin CDCGuilin The Third People's Hospital City Luzai County CDC Luzai County People’s HospitalCounty Liuzhou CDC Guangxi Autonomy Longtan Hospital City/Provincial Heng County CDC Heng County People's HospitalCounty

Status of the ART Program  The number of patients on ART is increasing rapidly From approximately 3,500 at end of 2007 to 5,217 including 144 children at end September ,000 projected at end of 2008 and 15,000 at end 2009 Increase of patients from 2007 to 2008 averaged 106% at sites visited (range 21% to 194%)  2 nd line – 25 plus several patients waiting for VL results  37 treatment sites in 21 counties 3 sites provide treatment for children  ARVs are procured primarily by the MOH, with additional donations from the Clinton Foundation and Glaxo

ARV Supply System in Guangxi Province  ARVs are dispensed at 3 levels of health care system – provincial, prefecture/city and county levels  At each level, CDC orders for the sites from the level above usually quarterly using a pull system Longtan Hospital orders directly from Provincial CDC Some stores and sites have been ordering monthly due to shortages at provincial store  Lead time: between 1 day and 1 week  Supplies are collected and transportation is reported to be a significant cost  Some sites requisition medicines from CDC store monthly or quarterly, and others as needed

Key Findings: Strengths  In general, many ART pharmaceutical management operations are reported to be working well Standard procedures for ordering, receiving and dispensing medicines and reporting are followed across sites Communication and coordination between provincial level and stores/sites is generally good and sites can return short dated stock for exchange Guangxi ARV drug management protocol available Storage space is generally adequate and secure; pallets, shelving and A/C available in most sites Dispensing supplies – envelopes and labels available

Key Issues (1)  Inadequate stocks of ARVs at Provincial Store No ARVs purchased through national procurement in 2008 ARVs are procured through bidding process at provincial level as necessary to fill the gap No stockouts have occurred for patients but the provincial level staff are on constant alert to manage shortages Orders from lower levels often cannot be filled in full increasing order frequency, management and transport costs To avoid stockouts, sites issue smaller quantities to patients who must return more frequently to collect refills increasing their transportation and in some cases accommodation costs

Key Issues (2)  Record keeping and reporting needs to be strengthened No standard forms to record inventory transactions (receipts, issues, running balance) Other gaps – expiry date monitoring and temperature monitoring tools “Too many forms” – some forms and reports are reported to be duplicative; tools need to be streamlined and consolidated where possible In long term, sites request a database linked to the patient information system

Key Issues (3)  Written standard operating procedures for managing medicines and controlling inventories at each level are not in place Many staff managing ARVs are part time so sites want standardized procedures and simple tools to streamline activities to ensure efficient use of staff  No formal methods for forecasting needs Methods used for annual planning and quarterly or monthly procurement are diverse e.g. buffer stocks Developing assumptions about future use reported to be especially problematic as guideline changes are implemented and numbers of patients and regimens used increase Sites request “simple tools” and procedures to analyze data and quantify needs supplemented by training

On-going and proposed support under the SPS program  Review of existing manual forms and tools to identify options to streamline, consolidate and fill gaps  Draft SOPs and related tools have been developed First training on SOP implementation – June 2009 Develop procedures and a supervision tool for monitoring Provide follow up support  Site visit findings were discussed with national and provincial stakeholders and partners to prioritize needs, identify options and develop an action plan to strengthen existing ARV management systems in Guangxi Province eg., Strengthening quantification procedures suggested by other partners