BY MOSES TIEL EXECUTIVE DIRECTOR OF CENTRAL MEDICAL SUPPLIES - PowerPoint Presentation

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BY MOSES TIELEXECUTIVE DIRECTOR OF CENTRAL MEDICAL SUPPLIESMINISTRY OF HEALTHREPUBLIC OF SOUTH SUDANGENEVA 06.11.2014

CHALLENGES FACING CENTRAL MEDICAL SUPPLIESSlide2

OUTLINECountry ProfileChallenges facing central Medical StoresLittle Progress in Central Medical Stores

The Way Forward (in the near future)Slide3

Country ProfileSlide4
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THE REPUBLIC OF SOUTH SUDANIt was part of old Republic of Sudan until it became an independent country on July, 9th 2011Area: 644,775.43 sq. km

Population: approximately 11,090.104

Languages :

E

nglish, Arabic, Dinka, Nuer, Shiluk, Bari etc.

Currency:

S

outh

S

udanese pound (SSP)

1 USD = 2.970 SSP

Capital city : JubaSlide6

Challenges Facing Central Medical Stores1. Trained Health Personnel2. W

arehousing and Storage facilities

3. Funding Agents & their Coordination

4.

P

rocurement

5. Quantification

6. Inventory control of stock

7. Transportation and Distribution

8. Product Use

9. No National Laboratory for Quality Control Slide7

1. LACK OF SKILLED HEALTH PERSONNELThere is acute shortage of of health professionalsApproximately 1500 nurses and midwives 500 medical officers

45 specialists

20 dentists

120 pharmacy personnel (pharmacists & technicians)

A good number of health personnel are not practicing their professions

Many are employed by NGOsSlide8

2. Warehousing and StorageInadequate storage facilities at all levelsOnly two warehouses available in CMS in JubaOne warehouse of 600 m

2

(built in 2007)

Another warehouse of 320 m

2

(built in 1963)

No regional stores (only one in Juba belonging to Central

Equatoria

S

tate)

Irrational use of the few storage spaces available

Renting of private warehouses by the government and partners, leading to diversion of funds

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2. Warehousing and Storage (cont’d)Very little communication between CMS and other regional stores (if existent)No shared inventory of health commodities between ministry of health and other partners such as MSF, UNICEF, GOLBAL FUND, MALARIA, TB and HIV

programmes

Very poor inventory control procedures

No efficient policy of disposal of unusable health commoditiesSlide10

2. Warehousing & StorageSlide11

2. Warehousing & StorageSlide12

3. Funding of Health CommoditiesInsufficient resource allocation for health commoditiesDelay in release of funds to the suppliers of health commoditiesExistence of parallel

programmes

Multiplicity of funding agents without coordination

Inadequate and inconsistent nature of funding

Weak government ownership and coordination

Lack of accountabilitySlide13

4. Procurement ChallengesInadequate and inconsistent government funding for procurement of health commoditiesLack of trained procurement officers Lack of transparency in the procurement processes

Lack of long-term procurement plans

Lack of SOPs for key procurement activities

Procurement decisions not based on quantificationSlide14

4. Procurement Challenges (cont’d)Lack of performance standards for procurement services (government or outsourced)No involvement of technical experts and relevant stakeholders in the procurement and tender boardsIneffective national policies of procurement

Government policies change frequently with the change of governments or ministers

Absence of National Drug Procurement AgencySlide15

5. Quantification ChallengesNo data on morbidity and consumption of health commoditiesLack of dedicated staffWeak infrastructure to support an automated or computerized quantification processes

Lack of training on quantification of health commoditiesSlide16

6. Inventory Control Procedures ChallengesLack of or no trained personnelLack of inventory management standard operating procedures (SOPs)

Poor and inefficient reporting system from and to health facilities

Lack of data use culture

Lack of adequate storage spaces in the CMS and in the health facilities

Untimely arrival of commodities into the country and their distribution to the health facilities Slide17

7.Transportation & Distribution ChallengesThe road transportation system in the whole country is a nightmareMany parts of the country are inaccessible by road, especially in the rainy season (June – November)

The river transport is not well developed, but could provide a very important alternative method of transport

Some roads are relatively passable during the dry season(December – April)

other parts of the country could only be reached by airSlide18

7. Transportation & Distribution Challenges (cont’d)Lack of delivery vehicles (only 2 in CMS)No vehicles with cold-chain system

Insufficient capacity of transportation and distribution vendors in the private sector

Poor monitoring of outsourced services, such as transportation and storage

Lack of integrated distribution systems (ARVs, TB and antimalarial drugs and other parallel

programmesSlide19

7. Transportation & Distribution Challenges (cont’d)Ineffective flow of information from requisitioning health facilities to central medical storesNo computerized data management system to coordinate all the activities involved in the distribution processesSlide20

7. Transportation & Distribution Challenges (cont’d)Slide21

7. Transportation & Distribution Challenges (cont’d)Slide22

7. Transportation & Distribution Challenges (cont’d)Slide23

7. Transportation & Distribution Challenges (cont’d)Slide24

7. Transportation & Distribution Challenges (cont’d)Slide25

8. Product Use ChallengesAcute shortage of skilled health personnel (clinicians, nurses, pharmacists, technicians) who can use health products properlyLack of knowledge of product use

Non-availability and inconsistent use of STGs in all health facilities, especially in rural areas

Lack of easy access to health products due to cost, availability, distance, geography and transport

Lack of reliable record-keeping and data collection

Reluctance of patients to come to a health facility Slide26

Progress in Central Medical StoresRacking materials have been erected in two stores in JubaAir-conditioners have been installed in the 2 storesOn-going training of the staff in the management of warehouse operations i.e. use of forklifts and other basic handling machines

C

old room building construction completed

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Progress in the Central Medical StoresSlide28

Progress in the Central Medical StoresSlide29

Progress in the Central Medical StoresSlide30

Progress in the Central Medical StoresSlide31

Progress in the Central Medical StoresSlide32

The Improvement of Central Medical Stores in the Near FutureRecruitment of trainable staff in CMSConstruction of regional medical storesFormation and strengthening of drug and food control authority (DFCA) of South Sudan

Formation of health professionals council

CMS as a semi-autonomous body (Bill in SSLA)

Opening of 4 more training institutes for mid-level cadres such as nurses, pharmacy technicians, medical officers and community health educatorsSlide33

THANK YOU VERY MUCHMoses Tiel

Executive Director of Central Medical Supplies

moses_tiell@yahoo.com

Tel No. +211-955009493