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Zimbabwe MOHCW Male Circumcision Programme. Supply Chain Management Dr. O. Mugurungi, Director AIDS&TB Programme Ministry of Health and Child Welfare June 2010. OUTLINE (Logistics Cycle applied to MC commodities). Background Funding Product Selection Forecasting Procurement

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zimbabwe mohcw male circumcision programme

Zimbabwe MOHCWMale Circumcision Programme

Supply Chain Management

Dr. O. Mugurungi,

Director AIDS&TB Programme

Ministry of Health and Child Welfare

June 2010

outline logistics cycle applied to mc commodities
OUTLINE(Logistics Cycle applied to MC commodities)
  • Background
  • Funding
  • Product Selection
  • Forecasting
  • Procurement
  • Storage and Distribution
  • Next Steps
1 background
1. BACKGROUND

3

In 2009, overall adult HIV prevalence in Zimbabwe was 13.71%

Approximately 10.3% of adult males reported to be circumcised (ZDHS 2005-2006)

In 2009, MOHCW started actively promoting Male Circumcision (MC) as part of a comprehensive HIV prevention strategy

MC pilot phase started May 09 with 5 sites represented different models of service delivery

2,805 procedures performed between May09

and Dec09 at 5 pilot sites (351/ month)

2258 MC procedures performed between

Jan and April 2010 ( 567/month)

56,000 procedures planned over 12 months

at approximately 22 sites

2 funding
2. FUNDING
  • Currently approximately 60,000 new HIV infections per year
  • Achieving target of scale up of MC to 80% of males in 15 to 29 age group will result in:
    • 2015: 5000 infections/year averted
    • 2020 : 15,000 infections/year averted
    • 2025: 30,000 infections/year averted
  • Estimated funding to achieve this target:
    • US $80 million between 2011 to 2015
    • Commodity costs approximately US $40 million
  • USAID Support to National Programme
    • PSI: programmatic
    • SCMS: commodities and Supply Chain : $1.5M for Y1
  • MOHCW engaged Bill & Melinda Gates Foundation, WHO, UNFPA
  • Commodities cost per procedure is estimated at US$43.45 in first year (MC Kits: $16.95; balance : bulk surgical item, infection prevention, waste disposal and emergency kits; equipments)
3 products selection
3. PRODUCTS SELECTION
  • Based on recommendations and standard kits from “PEPFAR Nov 2009 “Male Circumcision Partners’ Meeting Commodities and Improved Coordination of Male Circumcision for HIV Prevention”
  • Zimbabwe MOHCW selection (based on experience in pilot phase) : Kit Option 3: Forceps guided surgical technique - Kit of fully disposable surgical Instruments and consumables
  • Products supplied by SCMS consolidated procurement mechanism (lower prices, increased coordination between suppliers and recipients, and improved product quality)
  • 83 items MC kits and commodities categorized as follows:
    • MC surgical instrument and consumable sterile kits – 1 Item
    • MC surgical procedure bulk items – 12 Items
    • Infection prevention and waste disposal items – 20 Items
    • Emergency toolkit - 36 Items
    • Equipment – 14 Items
4 forecasting
4. FORECASTING
  • Quantities of commodities to be procured quantified in coordination with:
    • MOHCW AIDS&TB MC Programme
    • MOHCW Directorate of Pharmacy Services Logistics SubUnit
    • PSI Zimbabwe
    • SCMS
  • Quantities needed by MC procedures based on
    • PEPFAR Guideline
    • Discussions with MC clinics doctors

and nurses

    • Observed consumption at selected sites
    • PSI Zimbabwe’s experience with

procurement of MC commodities

during pilot phase

5 procurement
5. PROCUREMENT
  • Programme Start up (Apr 2009- June 2010)
    • Kits, related commodities and equipments procured by PSI (USAID and UNFPA funding)
  • Programme Scale up (Jul 2010 – June 2015)
    • Kits, related commodities and equipments procured by SCMS (USAID Funding)
      • 5,000 kits to arrive in Zimbabwe in July/August 2010
      • 23,900 kits, related commodities ordered and to arrive between Jul – Dec 2010
    • Equipments procured by PSI (USAID) and UNFPA
6 storage and distribution
6. STORAGE AND DISTRIBUTION
  • Storage at NatPharm (MOHCW Central Medical Stores)
  • Distribution : MC commodities to put included on MOHCW-LSU ARV ordering and distribution system supported by SCMS
  • Forced ordering system : maximum (4 months stock) minimum (2 months stock)
  • Emergency orders placed when stock falls below 1 month of stock
  • Bi-monthly review period and reporting
  • Logistics management information systems including stock cards and consumption/requisition forms (patient and logistics data)
  • ARV availability at site level > 99%
slide10

6. STORAGE AND DISTRIBUTION(Ctd.)

To ensure continuous availability, MC commodities divided into three categories

  • Equipment i.e. operating table; diathermy machine
    • One off supply
    • recorded on facility asset register
  • Replenishable items included in infection prevention and waste disposal kit and emergency tool kit
    • Supply of one kit per year
    • No buffer at central level
    • Recorded on receipt voucher

3. Sterile MC Kits and replenishable items

    • Frequently used items
    • Buffer stock kept at central and facility level
    • Consumption, loss and adjustment and stock on hand tracked on stock cards and reported on Consumption/Requisition form

10

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7. NEXT STEPS

June 2010 : MC commodity ordering and distribution will be incorporated into the MC strategic plan

June 2010: Develop SOPs ordering and distribution system

June 2010: Develop training curriculum for ordering and reporting

July 2010: Print revised Logistics Management Information System (LMIS) forms

Aug 2010: Train staff from existing and new sites on ordering and distribution system

Aug 2010: Facilities placing first order – August 2010

Sep - Oct 2010: continue resource mobilization with partners based on updated consumption data from LMIS

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