1. Zambia’s Country Experiences
QUANTIFICATION

2. Presentation Outline Background Relevant RMNCH indicators
Quantification methodologies
Data Challenges
Strategies
Conclusion

3. Geographical Location

4. Some Key Demographic indicators (ZDHS and Census)
Baseline
Total Population
14.5 Million (2014 projection)
Population Growth Rate
2.8%
Total Fertility Rate
National 5.3
Adolescent Pregnancy Rate
( ) National:29%
Unmet Need:
27%
Unplanned Births
40%
16% Unwanted
Contraceptive Prevalence Rate modern method
45%

5. Introduction Quantification part of the annual planning process.
Include staff with different expertise
Exercise conducted in collaboration with stakeholders implementing maternal and Child Health activities in Zambia

6. Overall objective
To determine national commodity needs to facilitate resource mobilization and commodity procurement.

7. Stakeholders UNFPA SFH USAID DELIVER CHAZ ZHECT PPAZ UNICEF
MSL, MSZ, CHAI

8. Quantification team
National quantification teams for different product category formed e.g. ARVs, Contraceptives, Essential medicines
Different tools and Methodologies use to undertake the quantification process,
13 lifesaving commodities for maternal health part of the quantification process

9. Methodology Mainly three different forecast methodologies Demographic,
Services statistics and
Consumption based
Spreadsheet and quantimed used

10. Methodology
Morbidity method: -used for new programmes or for programmes where consumption data is not available.

11. Methodology
Collect and review logistics data from the Central Medical Stores Limited and cooperating partners
Develop assumptions
Assumptions and draft forecast reviewed with stakeholders.

12. Methodology
Forecast results for all three methodologies reviewed, reconciled and select methodology(s) that yields most realistic, results.
Account for recent issues/consumption, programmatic interventions, and ongoing trends in commodity use.

13. Methodology
Limitations in all forecast methods reviewed

14. Data Challenges Demographic-Based Forecast for commodities
Information on private sector activities is typically not readily available
Require other statistics not available in the DHS, e.g. brand mix for FP.
DHS data does not take into consideration programmatic changes.
Data from the private sector not comprehensive

15. Data Challenges Consumption-Based Forecast for Essential medicines
Using central-level MSL demand data and not consumption data.
Stock outs experienced at both Central and facility levels.

16. Services Based Forecast for contraceptive
Dispensing protocol for contraceptives not consistently adhered to.
HMIS client data is not disaggregated by method.
Data on Emergency Contraceptives not captured through HMIS.
Limited visibility to stock outs and rationing at facility level by national level

17. Strategies Instituted
Annual National forecasting and quantification is currently led by government with support from partners.
F & Q review meetings
Central Medical Stores Limited implementing last mile distribution of commodities to health centres
National Supply chain strategy launched

18. Strategies Instituted
Draft RHC Strategy developed
FP Technical working Group subcommittee on supply chain
Focal person for RH commodities
National supply chain coordination committee meetings
Technical support to health facilities
Training more facility-level health workers in supply chain management to improve on data management

19. Strategic priorities to help meet the objectives
Stock outs at service delivery points
“To improve the distribution, availability and security of family planning commodities from the central level to service delivery points, including both contraceptives and consumables”
Governance structure and program coordination
“To strengthen the central, provincial and district-level structures to better coordinate and monitor government and partner activities, in order to deliver services efficiently”

20. Conclusion
To enhance accuracy in quantification and forecasting of medicines and medical supplies within the Ministry through provision of accurate data
Improved coordination and communication among stakeholders in the Supply chain

21. THANK YOU

22. Commodity Security and Logistics Management Information System

23. Commodity Security
Ensures that patients can choose, obtain, and use medicines and other health commodities as and when they need them.

24. Commodity Security Challenges and LMIS of UNCoLSC medicines
Inadequate funding and delayed disbursement of funds for procurement
Misoprstol, MgSo4 not routinely reported
Weak links between quantification and procurement planning.
Inadequate real time data for decision making at Central Level

25. Commodity Security Challenges and LMIS of UNCoLSC medicines
Capacity at Central and Facility Levels lagging demand for efficient supply network services (e.g. HR, Storage)
Use and provider issues in utilizing commodities and provider biases that promote preferential use of a product they are used to.

26. 3 most successful measures ensuring commodity security
Establishment of regional hubs by MSL
Last mile distribution to health centres by central MSL and Mentorship
Holding Quarterly Logistics Management Coordinating Meetings for Districts and Provincial Pharmacist and Managers

27. Effective LMIS at different levels
Electronic LMIS rolled out at district level
Monthly report and requisition for essential medicines/contraceptives for facilities

28. Conclusion
Health Management Information System (HMIS) registers adequately captures most aggregate planning data.
Strengthened HMIS with two electronic platforms – a web based
District Health Information System (DHIS2) and a Health Facility based reporting tool called eLMIS – recently rolled out nationwide