Logistics for Health. To Improve Drug Supply System in Cambodia. RACHA Logistics
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1 for Health To Improve Drug Supply System in Cambodia RACHA
2 Contents background and its activities Drug supply system history MoH distribution/reporting structure of drug supply system Computerized system for drug supply Integration of electronic reporting system Connectivity and data security Capacity building Future plan Challenges & constrains Conclusions & recommendations
3 Background and Activities Initial development of logistics information system occurred in 1998 with development of EDB supply system of Ministry of Health (TA from JSI). Conduct nationwide study on stock management at Health Centers, Referral Hospitals and Operational District pharmacies. Initial development of re-ordering methodologies and general logistics procedures for lower levels. Guideline development on management manual for HCs, RHs,, ODs
4 Background and Activities Introduction and training of re-ordering methodologies and logistics procedures at HC, RH and OD level. Initial development of computerization system on drug supply management at Operational District pharmacy (ODDID) in On-job training to OD pharmacists on facilitative supervision in RACHA focus areas. Introduction of OD contracting performance scheme in some pilot ODs.
5 Background and Activities Expansion of facilitative supervision activities to other provinces. Expansion of computerization system on drug supply management for other operational district pharmacies. Official handover Operational District Drug Inventory Database (ODDID) to Ministry of Health. Official training on drug management computerization system to nationwide OD pharmacies.
6 Background and Activities Development of computerization system for drug management supply at Central Medical Store (NatDID( NatDID) NatDID is officially approved to use at CMS from 2006 Development of drug management computerized system for provincial pharmacists (ProDID( ProDID) In progress of feasibility study on drug management computerized system for referral hospitals
7 Drug Supply System History MoH Health sector reform in 1995 Operational District pharmacies, Referral Hospital, Health Centers Introduction of drug supply management tools to health personnel. First nationwide training to RH pharmacists and HC storekeepers 1998 First nationwide training to OD pharmacists on Management of Drug Supply in 1999 Introduction of computerized system for OD pharmacies in late 2000
8 Distribution/Reporting Structure Ministry of Health Central Medical Store CMS Essential Drug Bureau EDB - DDF Provincial Health Department PHD, Provincial Drug Office Operation District Office Operational District Pharmacy 24 PHDs 76 ODs Referral Hospital - RH 68 RHs 973 HCs Health Center - HCs
9 Drug Computerized System Ministry of Health Central Medical Store CMS Essential Drug Bureau EDB - DDF Provincial Health Department PHD, Provincial Drug Office Operation District Office Operational District Pharmacy 24 PHDs 76 ODs Referral Hospital - RH 68 RHs 973 HCs Health Center - HCs
10 Drug Computerized System NatDID National Drug Inventory Database Fully functioning at Central Medical Store since earlier 2006 Able to produce online reporting on stock status at Central Medical Store (CMS) Able to produce electronic invoicing to OD pharmacies Able to get electronic drug consumption report from ProDID or ODDID Provide special features to get stock status report of all nationwide ODs including national programs
11 Drug Computerized System ODDID Operational District Drug Inventory Database Initial development and pilot in 3 ODs in late 2000 (Chhouk( OD, Sortnikum OD, Sampov Meas OD) Expansion to 14 ODs with ODDID update version (ODDID2002) Official handover to the ministry of health on August Expansion to 62 ODs with ODDID update version (ODDID2003) released in July PCs supported by KfW Expansion to nationwide ODs with ODDID update version (ODDID2005) released in March 2005
12 Drug Computerized System ODDID Expansions ODDID Areas Pilot in 3 ODs Official use in 14 ODs, ODDID2002 Official use in 62 ODs, ODDID2003 with 49 PCs by KfW Official use in Nationwide ODs, ODDID2005
13 Drug Computerized System ODDID2005 Features Screening health facility consumption report/requests Provide suggested quantity to supply to health facilities Inventory management at OD pharmacy Generate OD request with suggested order quantity based on MoH guideline to central level Special features to produce stock status report by all facilities and all national programs
14 Drug Computerized System ODDID2005 Features Able to produce and send electronic drug consumption report to Ministry of Health by e or removable drive Able to receive electronic invoicing from Central Medical Store (CMS) Able to generate semi-final HC/RH consumption reports Get ready to link with NatDID and ProDID
15 Electronic Reporting System NatDID and ODDID2005 are ready for electronic reporting system of drug supply system from central to OD level Electronic drug consumption report from OD pharmacies can be produced by ODDID and sent to NatDID via e-e mail or any other removable drives Electronic invoicing from CMS can be also produced by NatDID and sent directly to OD pharmacies via e or any other removable drives
16 Electronic Reporting System Ministry of Health Central Medical Store NatDID Provincial Health Department Drug Office or any removable drives See and Approve in Computer System Samba connectivity Electronic drug consumption report Samba connectivity ProDID OD Office OD Office See and Approve in Computer System See and Approve in Computer System ODDID ODDID
17 Electronic Reporting System Electronic Approval Process at OD Level Provincial Health Department Drug Office Samba connectivity Drug consumption report ProDID Samba connectivity System requires User Name and Password to approve electronically. User Name and Password is given to only authorized persons(od director, Deputy directors) to approve electronic report OD Office OD Office See and Approve in Computer System See and Approve in Computer System ODDID ODDID
18 Electronic Reporting System Ministry of Health Central Medical Store System requires User Name and Password to approve electronically. User Name and Password is given to only authorized persons(phd director, Deputy directors) to approve electronic report OD Office Samba connectivity NatDID or any removable drive Provincial Health Department Drug Office Drug consumption report OD Office Samba connectivity ProDID See and Approve in Computer System ODDID ODDID
19 Electronic Reporting System Ministry of Health Central Medical Store NatDID Electronic Invoice or any removable drive Provincial Health Department Drug Office ProDID Samba connectivity Samba connectivity OD Office OD Office ODDID ODDID
20 Connectivity and Data Security Use SAMBA and TWIST Falcon as connectivity equipments. Able to use GSM/GPRS service for data transmission via e 9 ODs are successfully operated SAMBA equipment for their data transmission every month to RACHA. (Pilot starting from March 06 until now) SAMBA TWIST Falcon equipments will release to use nationwide in earlier At least, 5 USD need to pay for mobile phone service in order to keep live of this connectivity.
21 Connectivity and Data Security ODDID data is stored in different storage drives and automatically backup every transaction occurs. Every month, ODDID data is also sent central level for the security backup.
22 Capacity Building Equip ODDID users and health personnel with IT ability by training provision. On-job training provision to ensure OD pharmacists are using the system in the right way. Facilitative supervision skills are required in order to interpret, understand well the stock management reports and tackle stock management issues provided by the system.
23 Future plan Develop Drug Management computerization at Referral Hospital (HOSDID) Develop electronic monitoring tools for provincial and central supervisor Develop electronic tools for monitoring Drugs Management at RH Develop electronic tools for monitoring Rational Drug Use (RUD) Revise RUD training curriculum Develop and implement RUD awareness at community
24 Challenges and Constrains Limited IT skills of health personnel and lacking of human resources including supervisory team. Limited financial supports for the system sustainability. Since the connectivity is relied on local phone service, it s s sometimes unsecured for data transmission. Limited participation/ Involvement from partners
25 Conclusion and Recommendation LMIS plays a very crucial role to ensure drugs are managed and dispensed effectively to patients and it s s highly appreciated by the Ministry and other NGOs. On-going supports such as health personnel incentives, IT skills, on-time technical support and phone service payment in order to keep the system run smoothly. SAMBA connectivity equipment is not used only for LMIS, but also for other communications such as spreading health information from central to lower level and other repeat alert system for other national programs. More Participation from counterparts/partners
26 for Health Thank you!!! RACHA
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