L'analyse a porte sur Ia gestion d u mois de novembre. 2015. CONSTATS GLOBAUX. Taux de rapportage : De fayon glo bal e. le ta ux de rapport a depasse ...
Appendix A, Table A1: Key approaches as part of the OSPSANTE dashboard implementation Component User acceptance testing
Initial data entry Stakeholder sensitization
Capacity building
Nationwide launch
Dedicated data entry
Key approaches • Conducted user acceptance testing and made continuous adjustments to OSPSANTE • Tested the dashboard manual • Collaborated with Pharmacie Populaire du Mali (central medical stores) to retrieve and enter monthly warehouse stock reports into OSPSANTE for training • Facilitated institutional participation from USAID bilateral projects, Save the Children, and MEASURE Evaluation to support the launch of OSPSANTE and training • Encouraged the use of dashboard reports for decision making by other donors, such as UNICEF, WHO, UNFPA, and the Global Fund • Trained 160 health workers and senior MOH staff during four consecutive three-day workshops • Oriented users in data entry with real data from their respective health facilities • Trained users and supervisors on the monthly LMIS data entry process and on generating and analyzing reports • Formally launched OSPSANTE to all stakeholders • Established procedures for dashboard roll out • Disseminated standard operating procedures • Provided internet access to warehouse managers in 50 districts, five regional pharmacists, and six regional information system managers • Data were collected from 1,186 heath facilities between January 2014 and March 2015 and entered into OSPSANTE
Analyse du ra pport mensuellogistique des prod uits de sante, novembre 2015 Le 29 decembre 2015, Ia Direction de la Pharmacie et du Medicament a analyse les donnees logistiques generees par OSPSANTE. L'analyse a porte sur Ia gestion d u mois de novembre 2015. CONSTATS GLOBAUX Taux de rapportage :
De fayon glo bal e. le ta ux de rapport a depasse 80% pour tous les niveaux (PPM Centrale, Niveau Depot Regional , Niveau DRC, Niveau Etablissement). Disponibilite/ruptm·e : 1. Constats su r Ia disponibilite des intrants antipalud iques :
Le rapport mensuel in d iq uc q ue 61 ,1% des structures sont en haut risque de rupture d'intrants antipaludiques. Les Mois de Stock Disponible (MSD) pour les CTA, TDR, Artesunate 60mg injectable et MI L D sont inferie urs a 06 mois (niveau minimum de stock). II existe un faible risq ue de rupture (avec MSD situes entre 12 et 24) pour la Quinine 300 mg (14,4 MSD). u lfadox i nc pyri m ethamine comprime 500mg+25mg (18,3MSD) et artesunate amodiaquine 25 m g/67,5mg (23,5 MSD) Le pourcentage des etah l issements sanitaires ayant connu une rupture de stock d'au mains un produit antipal udique du·ant les trois derniers mois a diminu e de 1,5% de septembre a novembre 2015 (36,3°A• a 34,8%). 2. Constats sur Ia di sponibilite des produits conh·aceptifs :
Le rapport mensuel i nd ique q ue SO'Yo des structures sont en surstockage avec MSD tres eleves pour le Microgy non / Pilplan D (51 MSD), Microlut/ Ovrette (32,9 MSD). Le pourcentage d es etablissements sanitaires ayant connu u ne rupture de stock d'au mains un produit contraceptif durant les trois derniers mois a augmente de 3,2% entre septembre et octobre 201 5 (1 5,6% a 18,8%, ) mai s a baisse de 1,4% entre octobre et novembre 2015 (18,8% a 17,4%). 3. Medicamenll:s ft visi-e maternelle et infantile
On note que 58,1 % d estruc tures sont en haut risque de rupture. Les Moi s de Stock Disponible d e certai n s prod u i ls etaient les suivants: amoxici lline s upensi on l25mg (4,5MSD) amoxicill ine supension ?.SOn-g (3,4 MSD) ampicillin 500mg i njectable (3,5MSD), ceft:riazone
250mg injectable (1,6MSD), ceftriazonelg injectable (2 MSD), dexamethazone injectable 4mg (1,8MSD), gentamycine injectable 1Omg/ml (2,2MSD) et gentamycine injectable 40mg/ml (3,8MSD). Le Sulfate de Magnesiu m 'iO% ou Sg/1Oml ou 0,5g/ml injectable etai t en surstock avec 37,7 MSD Le pourcentage des etaJ,:i;:;ements sanitaires ayant connu une rupture de stock d'au moins un medicame nt c't visee ma tcrnelle et infan ti le durant les trois d erniers mois a augmente de 4,4% entre septemb·'e et novembre 2015 (37,4% a 41,8%). 4. Medicaments du panier : 30% des structures sont en haut risque de rupture. Les Mois de Stoc k Disponible pour artemether l umefantrin( 20/J20mg Pl/24 (3.6%), sel ferreux +ac i de folique comprime 60mg/400!-lg (3.8%,) et le para .:etamol 500mgcomprime (5.7%) so t inferie urs a 6 mois Le pourcentage des etablis .emcnts sanitaires ayant connu une ru pture de stock d'au moins un medicament du pan ier Pen gmente de 0,6% entre se ptembre et novem bre 2015 (26,4%27%). REGIONS/DISTRICT .\. l!NSUFFISANCE De maniere generale le bmx de rapportage pour les regions a ba isse d'octobre en novembre m nis Mopti est n ste stationnaire avec un tau x de 87,23% Les regions doivent faire des efforts pour augmenter le taux de rapportage. D'enorrnes efforts rc tent a faire a u niveau de certai ns districts sanitaires concernes dans les regions su iva tes : Kayes : Kayes et Kita. Koulikoro :
ara
Sikasso : Si k sso, Kolond ieba, Niena et Yorosso Segou : Bla et Macina Mopti : Douentza et Tcnenkou AC -T IONS A-E
TREPRENDRE PAR L ES REGIONS
-i- Reduire l e tav.· ::le rupture en diligentant l 'approvisionnemen t des formations san itaires. .!- Don ner des instructions fermes aux districts pour att i ndre 90% du taux de rapportage des donnees.
4- Faire l e red eplc i cment des stocks
a I 'interie ur des regions concernees
Bamako, le 31 decembre 20 15
pour eviter les peremptions. \
Appendix B: Matrix of benefits and obstacles of Pharmadex Mozambique To determine why staff favored the manual process, the program and the MOH pharmaceutical department facilitated an interactive workshop to have staff identify a matrix of the benefits of and obstacles to using Pharmadex. Benefits
Resources
• Computer equipment • Good network infrastructure • Pharmadex installed and released
Process
Existence of regulations and standards
Results
•13 people trained in the use of Pharmadex • Introduced products authorized in Pharmadex • Introduced 48 registration processes
Factors that can help achieve the Pharmadex purpose • Troubleshooting and help desk functions • Hiring a programmer • Instruction manual • Hiring data capturing technicians or support from other pharmaceutical department units to the registration unit • Creating a dossier submission form according to Pharmadex • Ability to handle Pharmadex • Introduction of data by applicants • Review of requirements for registration • Approval of the registration process submission form • Setting and monitoring targets • Periodic meetings
Obstacles
Factors contributing to obstacles
• Many pending registration dossiers • Poor communication • Poor ability to use Pharmadex • Lack of a user manual • Lack of a troubleshooting manual • Lack of a computer technician with knowledge of programming in the pharmaceutical department
• High workload • Submission of a large number of registration dossiers per day • Lack of a continuous discussion forum on Pharmadex • Insufficient presence of SIAPS in the pharmaceutical department • Lack of indicators
• Data entry is time consuming • Errors (e.g., it may not save, forcing the user to restart the process)
Few processes introduced in Pharmadex
• Insufficient number of technical staff • Lack of prioritization of new process (Pharmadex use) •Many fields for entering data into Pharmadex • Existence of programming problems
The staff identified internal and external partners who may have interest in Pharmadex; their interests, concerns, and perspectives; and the means to obtain the support of the listed partners. Institution/ Interest partner INTERNAL PARTNERS Office of the Approval of registration Minister of forms, standards and Health procedures, etc.
Expected support
Partner concern
How to get support
Registration of all safe, efficacious, and quality products
Access to quality, efficacious, and safe medicines
Pharmadex implemented without compromising other activities, and users were given full ownership of Pharmadex (registration staff) Interest
Support to meet the needs (increase in personnel, contracting an IT programmer); equipment maintenance strategy
How to maintain Pharmadex (sustainability)
Use Pharmadex, expand its scope and use, and obtain measurable results Justify the need for additional staff using evidence-based methods
Institution/ partner EXTERNAL PARTNERS
Expected support
Partner concern
How to get support
USAID SIAPS Program, MSH
Simplified registration process that aligns with international medicine registration practices Technical, financial, and infrastructure support
Ensure maintenance and training on Pharmadex and registration process
Pharmadex is not being used (registration processes not introduced in Pharmadex)
Good performance in the use of Pharmadex
Ensure maintenance and training on Pharmadex and registration process Ensure maintenance and training on Pharmadex and registration process
Pharmadex is not being used (registration processes not introduced in Pharmadex) Pharmadex is not being used (registration processes not introduced in Pharmadex)
Good performance in the use of Pharmadex
Head of pharmaceutical department
WHO
A possible successor to the USAID SIAPS Program, MSH
Continued support for maintenance and the transition from the manual process to the computerized process
Good performance in the use of Pharmadex
