Interim Approach (IA) For Health Commodities Distribution BY
Minnnie Sirtor Bowier JSI / USAID|DELIVER PROJECT February
2015
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Presentation Outline Overview of Liberia Background - IA
Objectives - IA Key components Impact of Ebola Achievements
Challenges
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SIERRA LEON GUINEA IVORY COAST ALANTIC OCEAN
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Over view of Liberia Population of approx. 4 million Currently
has the 1 st African female president Has one of the largest rain
forest and 2 seasons (dry and raining) Experienced 14 years civil
unrest (1989 2003) Maternal mortality stands at 1,072/100,000 live
births 5% of the population are women of reproductive age Unmet
need for family planning is 31%
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Over view of Liberia contd : It is a Country that has a 10 yrs
National Supply Chain Master Plan (SCMP ) One of the countries hard
hit by the ebola epidemic in March 2014 to present Amidst ALL
this:
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Background / History of the Interim Approach (IA) Serious
challenge with implementation of the SCMP Accountability for
commodities Commodity security Data availability for decision
making, etc Led to concerns by partners and donor agencies The
MoHSW formed a Supply Chain Task Force led by Minister Tolbert
Nyenswah The task force appointed a technical committee which
developed a concept paper on IA
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Health Commodity Supply Chain Flow Chart Central Warehouse
County Depots Client HF Client
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What is the Interim Approach (IA)? IA is a modified top-up
commodities distribution system in which a team of HCWs determine
quantities and supply commodities based on physical inventory at
facility and develop logistics data report OBJECTIVES OF INTERIM
APPROACH (IA) Ensuring commodity security Accountability &
transparency Reporting / availability of data for decision
making
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Interim Approach Rounds June 2013: Interim Approach adopted by
MOHSW July/August 2013: pilot distribution conducted October 2013:
first round of distribution began February 2014: 2 nd Round
distribution May 2014: 3 rd Round distribution September - October
2014: 4 th Round distribution February 2015: 5 th Round
distribution
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How does distribution work under IA?
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11 Interim Approach- Distribution options Truck loaded with
products; quantities based on previous quarter consumption data
Truck drives with stock to facility IA team calculates consumption
and stock on hand; tops up to maximum stock level Option 1 Separate
Data Collection and Delivery Option 2 Combine data collection and
delivery Mobile Warehouse Truck loaded with pre- determined packs
of quantity to deliver Truck drives with stock to facility IA team
visits HF, calculates consumption, stock on hand and quantity to
deliver, returns to warehouse
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Impact of the Ebola Virus What happened during the ebola
outbreak? Things change more rapidly Killed about 3,935 persons
including health workers Health facilities were closed Even when
opened clients were afraid to visit Clients could not have access
to FP commodities Ebola Treatment Units (ETU) were later
established WHO recommended the NO TOUCH POLICY People fled the
country
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Health workers are at the front line
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Response Strategies Temperature Check Frequent Hand Washing No
Touching
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Distribution during the ebola outbreak Restoration of health
services was and is emphasize Facilities had to be resupplied with
commodities For resupply the IA was used but with all caution
Health workers were trained to use Personal Protective Equipment
(PPE) Limited entry into facilities Use of PPE during commodity
delivery
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Results from the IA Consistent decline in stockout rates rounds
1-4 except for depo provera that was stock out at the central level
during the fourth round High delivery coverage/reporting rates
Greater visibility of data, including consumption data and stock on
hand/stock status Greater accountability: quantities issued match
quantities received Data verification exercise combined with EUV
Capacity building of both central and county level staff
Harmonization of distribution of other commodities with IA
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Montserrado
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Delivery coverage (4 Counties)
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Commodity Supply Chain Flow Chart Central Warehouse County
Depots Client HF Client
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Accountability in movement of products Product BONG LOFA Qty
Requested on SBRR Qty Issued by NDS (from invoice) Qty Received by
Depot Quantity received recorded on Stock Card Qty Requested on
SBRR Qty Issued by NDS (from invoice) Qty Received by Depot
Quantity received recorded on Stock Card (IUD) or Copper T
0000189000 Depo-provera 14,8007,200 12,1777,200 Jadelle 407410
424420 Male Condom (3,000) 346,700336,000 -219,575-00 Microgynon
22,01822,320 3,600 Microlut 2,8662,880 4,5124,320
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Challenges Inadequate/weak human capacity, infrastructure and
data management at county level Poor accessibility to some health
facilities due to bad roads 22
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Challenges Inadequate supportive supervision on supply chain at
county level Facilities closure due to EVD epidemic impacted
coverage Changes in the distribution team members due to competing
priorities (Ebola Response) by the county health team
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Thank you Questions? NO PRODUCT NO PROGRAM NO PRODUCT NO
PROGRAM