Transcript Monitoring Indicators used by JSI/DELIVER Main Indicator

Reporting Requirements and
Indicators for Supply Chain
Management of HIV Diagnostics
& Medicines:
Kenya and Nigeria
Yasmin Chandani,
Coordinator for HIV/AIDS Technical Initiatives
JSI/DELIVER
Background
• Desk review of reporting requirements for
supply chain management by the Global
Fund and PEPFAR
– Global level
– Two country focus: Kenya and Nigeria
• Supplemented by interviews with JSI
country teams
• Limited time for document compilation and
review
Outline
• PEPFAR SCM Indicators
– Global
– Country Specific Findings & Comparison
• GFATM SCM Indicators
– Global
– Country Specific Findings & Comparison
• Conclusions
• LMIS Records & Reports ART Sites, Kenya
• JSI/DELIVER Global Indicators
PEPFAR Global SCM Indicators
• Indicator: Number of tests performed at
USG-supported laboratories during the
reporting period: HIV testing and HIV
disease monitoring
• What it Measures: # of tests performed (not
# of kits or reagents purchased).
Measurement is undertaken by reviewing
laboratory records maintained at each site,
and project records and documents.
Country Specific SCM Indicators
for PEPFAR: Kenya & Nigeria
• Report on JSI/DELIVER’s supply chain
related support to MOH, not supply chain
support provided by other USG recipients
• Developed in conjunction with MOH in both
countries
• Indicators organized within 5 program areas:
– 4 common to both countries,
– HIV/AIDS Treatment/ARV Drugs (Nigeria only)
– Cross Cutting Activities (Kenya only)
Comparison of PMTCT Indicators
Kenya
Nigeria
Number of sites where HIV Number of PMTCT sites with continuous full
supply of centrally procured HIV test kits and
tests are available
prophylactic ARVs (no stockouts)
Number of sites where
Nevirapine is in stock
Number of PMTCT sites following proper
storage and inventory management of HIV
test kits and prophylactic ARVs
Reporting rate (for LMIS
reports)
Number of PMTCT site pharmacists and
service providers trained in logistics
management
Number of supervisors trained in PMTCT
logistics system supportive supervision and
provided with supervisory tools
Semi-annual reviews of quantification of and
procurement plans for HIV test kits and ARVs
required for PMTCT sites
Comparison of Other
Preventive Area Indicators
Kenya
Number of condoms distributed
Nigeria
Number of ART and PMTCT sites with
continuous full supply of condoms (no
stockouts)
Number of GON and NGO facilities
following proper storage of and inventory
management of condoms
Comparison of Palliative Care
Indicators
Kenya
Number of kits
distributed
Nigeria
Number of DOTS implementing sites with
continuous full supply of TB drugs (no stockouts)
Number of DOTS implementing sites following
proper storage and inventory management of TB
drugs
Re-designed logistics management system for the
national TB program
Number of TB program zonal, state, LGA TB
coordinators and service providers trained in
logistics management
Number of supervisors trained in TB program
logistics system supportive supervision and
provided with supervisory tools
Comparison of Lab Infrastructure
Indicators
Kenya
No. of labs fully equipped for
HIV testing/ARV ass
Nigeria
Number of ARV program laboratories with
continuous full supply of HIV of selected
laboratory supplies (no stockouts)
Number of ARV program laboratories sites
following proper storage of and inventory
management of HIV and TB testing products
Number of ARV program laboratory
technicians trained in logistics management
HIV/AIDS Treatment/ARV Drugs
Indicators
Nigeria
Number of expansion ART sites assessed for ART service provision readiness
Number of ART sites with continuous full supply of ARVs (no stockouts)
Number of ART sites observed to be following proper storage and inventory
management of ARVs
Number of ART site pharmacists and storekeepers trained in logistics
management
Number of supervisors trained in ART logistics system supportive supervision
and provided with supervisory tools
Cross Cutting Indicators
Kenya
Information and tracking system in place - % reporting
Stockout rates of HIV tests
GFATM Global SCM Indicators
The proportion of randomly selected retail outlets and service delivery points that
have condoms in stock at the time of a survey, or all retail outlets and service
delivery points selected for survey
% of drug distribution nodes reporting on stock status (repletion, shortage,
consumption, quality, losses) on a monthly basis.
Treatment guidelines and utilization manuals developed and available at service
sites
Number or % of districts or other administrative unit with at least one drug
distribution center
% of drug distribution nodes/facilities reporting no drug shortage
% of project service delivery points with sufficient drug supplies
Unit cost(s) of project drug(s) and commodities
Number of project services deliverers trained in procurement and supply
management
Country Specific SCM Indicators
for GFATM: Kenya & Nigeria
• In Kenya, JSI consortium member to subrecipient to MOF/GOK for a Global Fund
grant in Round II
• In Nigeria, JSI is not involved in any
Global Fund activity (no JSI specific
indicators). Also no supply chain indicators
were discovered during the desk review of
two GFATM grants for Nigeria.
SCM Indicators for GFATM
Recipient in Kenya
Time and length of procurement
Cost, number and type of items procured
Number of items delivered
Supply Chain efficiency including warehousing and storage conditions
Stockout of commodities
Summary of Country Specific
Findings
• For PEPFAR:
– Even within common program areas,
indicators selected by each country are not
identical
– Neither country selected the global indicator
as one to measure supply chain performance
• For Global Fund:
– Only two indicators selected by recipient in
Kenya are similar to global indicators
Conclusions
• No convergence between SCM indicator for
PEPFAR and those proposed by GFATM
• In the absence of globally mandated
indicators, each country selected their own
SCM performance measures
• Based on a review of the indicators
recommended and used in the two countries,
it is clear that there are differences in defining
and measuring certain indicators, for example
product availability
Conclusions
• The indicators selected by PEPFAR and
GFATM globally and at country level are not
comprehensive for measuring SCM functions
– For example, GFATM recommended indicators include some
outcome indicators (relating to product availability) as well as
some process indicators (e.g., relating to availability of
guidelines and training of providers) but not the full range of
either process or outcome indicators related to procurement
and supply chain management functions.
• The indicators selected by countries cannot
be fully compiled using routine information
systems but rely on site visits as well
Overview of Records &
Reports Used for SCM by
Public Sector/MOH ART
Sites in Kenya
Potential source of monitoring
indicators based on routine data
available through LMIS
LMIS Records & Reports for ARV
Drugs in Kenya: Health Facilities
• Daily Activity Register
for Antiretroviral drugs
• Monthly Facility LMIS
Report for
Antiretroviral drugs
• Counter Requisition &
Issue Voucher
• Stock Card
• Monthly ART Patient
Summary Sheet
• Daily Activity Register
– Drugs for
Opportunistic
Infections
• Monthly Facility LMIS
Report- Drugs for
Opportunistic
Infections
LMIS Records & Reports for ARV
Drugs in Kenya: Districts
• Monthly District LMIS
Report for
Antiretroviral drugs
• Monthly District LMIS
Report- Drugs for
Opportunistic
Infections
• Counter Requisition &
Issue Voucher
• Issue & Receipt
Voucher
• Stock Card
LMIS Records & Reports for ARV
Drugs in Kenya: Central Warehouse
• Stores Ledger Card
• Bin Card
• Stock Adjustment
Card
• Counter Requisition
& Issue Voucher
• Issue & Receipt
Voucher
• Counter Receipt
Voucher
• Summary
Feedback Reports
Standardized M&E
Indicators for SCM Used
by JSI
Indicators based on a combination
of routine data from LMIS and
data collected via site visits
Monitoring Indicators used by
JSI/DELIVER
•
Main Indicator: Percentage of
facilities that experienced a stockout at any point during a given time
period
•
Definition: This indicator measures
the percentage of facilities (service
delivery points, warehouses) that
experienced a stock-out of a
method/brand/product expected to
be provided or issued by that site at
any time during a specified period
(e.g. the past 6 or 12 months)
Related Indicators:
• Percentage of facilities stocked out
or any product on day of visit
• Percentage of facilities fully
stocked (all products) on day of
visit
• Mean number of products stocked
out/in on day of visit
• Percentage of products stocked
out/not stocked out at any time
during past 6 (or 12) months
• Mean number of times each
method was stocked out in the past
6 (or 12) months
• Mean duration of stockouts
Monitoring Indicators used by
JSI/DELIVER
• Main Indicator:
Percentage of facilities
that maintain acceptable
storage conditions
• Definition: This indicator
measures the percentage
of storage facilities that
meet acceptable storage
conditions.
Related Indicators:
• Percentage of facilities
meeting all (or a desired
percent) of the storage
conditions
Monitoring Indicators used by
JSI/DELIVER
• Main Indicator: Percentage of
facilities that receive the
quantity of products ordered
• Definition: For all products that
the program is committed to
supplying, this indicator
measures the percentage of
difference between the amount
ordered in the last order period
(or other defined period of
time) and the amount received
for that period
Related Indicators:
• Average duration of time
between the date an order was
placed and when it was
received
• Percentage of facilities that
received their last four orders
according to schedule
Monitoring Indicators used by
JSI/DELIVER
• Main Indicator: Accuracy of
Logistics Data for Inventory
Management
• Definition: For each
method/brand/product of
interest, this indicator measures
the accuracy of logistics data as
the percentage of discrepancy
between (1) physical stock
count and stock record count,
and (2) stock record count and
logistics management
information system (LMIS)
report count
Related Indicators:
• Percentage of facilities that
keep accurate logistics data for
inventory management
• Percentage of facilities that
completed and submitted an
LMIS report for the most recent
reporting period
Monitoring Indicators used by
JSI/DELIVER
• Main Indicator: Percentage of
facilities whose stock levels
ensure near-term product
availability
• Definition: This indicator
measures the percentage of
facilities with stock levels
greater than zero and below the
established maximum level for
each full supply
method/brand/product of
interest, at a specified point in
time (e.g. the day of visit)
Related Indicators:
• Percentage of time during a
given period that each product
of interest is adequately stocked
(this indicator requires an
automated LMIS system or
extensive review of historical
stock ledgers)
• Percentage of facilities with all
full supply products adequately
stocked for near-term
availability
• Percentage of facilities that are
understocked, adequately
stocked, and overstocked
Questions?
Thank you for
your attention
Thanks To:
Jaya Chimnani, M&E
Advisor, JSI/DELIVER
Elizabeth Bunde, M&E
Advisor, JSI/DELIVER