Inventory Control and Good Storage Practices Training for ...siapsprogram.org/wp-content/uploads/2018/04/18-035... · HIV human immundeficiency virus min–max minimum–maximum MOHSS

Inventory Control and Good Storage Practices

Training for Primary Health Care Nurses and

Pharmacy Staff in Khomas, Ohangwena, and

Otjozondjupa Regions, Namibia

January 2017

Inventory Control and Good Storage Practices Training for Primary Health

Care Nurses and Pharmacy Staff in Khomas, Ohangwena, and Otjozondjupa

Regions, Namibia

Alemayehu Lemma Wolde

January 2017

Inventory Control and Good Storage Practices Training in Khomas, Ohangwena, and Otjozondjupa Regions

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This report is made possible by the generous support of the American people through the US

Agency for International Development (USAID), under the terms of cooperative agreement

number AID-OAA- A-11-00021. The contents are the responsibility of Management

Sciences for Health and do not necessarily reflect the views of USAID or the United States

Government.

About SIAPS

The goal of the Systems for Improved Access to Pharmaceuticals and Services (SIAPS)

Program is to assure the availability of quality pharmaceutical products and effective

pharmaceutical services to achieve desired health outcomes. Toward this end, the SIAPS

result areas include improving governance, building capacity for pharmaceutical

management and services, addressing information needed for decision-making in the

pharmaceutical sector, strengthening financing strategies and mechanisms to improve access

to medicines, and increasing quality pharmaceutical services.

Recommended Citation

This report may be reproduced if credit is given to SIAPS. Please use the following citation.

Wolde, A. 2017. Inventory Control and Good Storage Practices Training for Primary Health

Care Nurses and Pharmacy Staff in Khomas, Ohangwena, and Otjozondjupa Regions,

Namibia. Submitted to the US Agency for International Development by the Systems for

Improved Access to Pharmaceuticals and Services (SIAPS) Program. Arlington, VA:

Management Sciences for Health.

Key Words

Inventory management, training, primary health care (PHC), Ohangwena, Khomas,

Otjozondjupa, Namibia

Systems for Improved Access to Pharmaceuticals and Services

Pharmaceuticals & Health Technologies Group

Management Sciences for Health

4301 North Fairfax Drive, Suite 400

Arlington, VA 22203 USA Telephone: 703.524.6575

Fax: 703.524.7898

Email: [email protected]

Website: www.siapsprogram.org

mailto:[email protected]

http://www.siapsprogram.org/

iii

CONTENTS

Acronyms and Abbreviations ................................................................................................... iv

Executive Summary ................................................................................................................... v

Background ................................................................................................................................ 1 Training Objectives ................................................................................................................ 3

intervention ................................................................................................................................ 4 Training Content .................................................................................................................... 4

Groupwork Activities............................................................................................................. 5

Discussion of Outputs .............................................................................................................. 12

Conclusions and Recommendations ........................................................................................ 13

Annex A. Participant List All Regions and All Rounds .......................................................... 14

Annex B. Training Program-Generic for all Trainings* .......................................................... 18

Annex C. Sample Planning Exercise Sheet ............................................................................. 19

Annex D. Photos ...................................................................................................................... 20

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ACRONYMS AND ABBREVIATIONS

AIDS acquired immundeficiency syndrome

AMC average monthly consumption

ART antiretroviral therapy

ARV antiretroviral

CPD continued professional development

EDT Electronic Dispensing Tool

FESC Facility Electronic Stock Card

HIV human immundeficiency virus

min–max minimum–maximum

MOHSS Ministry of Health and Social Services

MSH Management Sciences for Health

NIMART Nurse initiated and managed ART

PHC primary health care

R/N registered nurse

SCMS Supply Chain Management Systems

SIAPS Systems for Improvement Access for Pharmaceuticals and Services

SOP standard operating procedure

SSV support supervision visit

TB tuberculosis

USAID US Agency for International Development

WHO World Health Organization

v

EXECUTIVE SUMMARY

Although the Ministry of Health and Social Services (MOHSS) with the US Agency for

International Development (USAID)–funded Systems for Improving Access to

Pharmaceuticals and Services (SIAPS) Program introduced a number of automated inventory

control tools, such as the Facility Electronic Stock Card (FESC) and Electronic Dispensing

Tool (EDT) for district hospitals, since June 2015, at the primary health care (PHC) level,

inventory control and storage practice are a major challenge and the major cause of stock-out

of medicines for antiretroviral therapy (ART), tuberculosis (TB), and malaria in all regions in

Namibia.

Stock card use has been a major challenge throughout the country, particularly at PHC

facilities, as evidenced by low scores (44% national average per the Support Supervision Visit

Report 2017). To ameliorate these challenges, the MOHSS has revised and distributed

standard operating procedures (SOPs) for the management of medicines and medical supplies

at PHC facilities in the period of 2015–16, and training on these SOPs has been provided to

all staff at the PHC level in the Khomas, Ohangwena, and Otjozondjupa regions in the

months of May, June, August, and November 2017.

The training was needed to improve inventory control and good storage practices, thereby

improving access and restraining increases in the pharmaceutical budget by reducing expiries

and damaged pharmaceuticals and at the same time building the training capacity of the

regional pharmacists. Facilitation of these trainings was supported by the SIAPS technical

advisor.

The three regions trained a total of 152 health workers from all of their districts. The

professionals, mainly nurses and pharmacy technicians, were trained for two days and

received eight credits from the Health Professional Council of Namibia and a certificate of

participation from the MOHSS and SIAPS upon completion of training.

The training was considered comprehensive as it encompassed the entire inventory control

cycle and was designed to address challenges frequently encountered by facility staff. Core

concepts in inventory control and good storage practices were shared during the discussion

and group work presentation. The questions raised by trainees and the experiences exchanged

enabled staff to grasp the main goals and key processes of maintaining necessary inventory

levels. Participants are taught how to calculate stock levels and order quantities as well as

observe critical storage requirements to ensure the quality and safety of medicines.

Attendance at trainings in the Ohangwena and Otjozondjupa regions was far lower than

planned. This can be attributed to several factors but the major cause may be lack of

awareness of the importance of the inventory control. Effective communication with and

sensitization of the pharmacy managers about the importance of inventory control in

pharmaceutical management should take place at the district level, especially at PHC

facilities, to ensure participation of their staff in training. The MOHSS should organize the

relevant training for managers on this issue. The regional pharmacists should supervise the

trainees (public facility staff managing pharmacies) regularly and continue hands-on training

at the facility level to follow up on participants’ action plans, which they draw up at the end

of training. It would also be appropriate for the region to organize later training for staff who

did not attend the training sessions.

1

BACKGROUND

Namibia is situated on the Southwestern coast of Africa. It has a population of about 2.4

million, and is one of the most sparsely populated countries in the world (2.8 people/km2).

Namibia is an upper-middle-income country with an estimated gross national income per

capita of 5,630 US dollars (USD). Its Gender Development Index score has improved from

0.981in 2014 to 0.986 in 2015. Thirty-two percent of women and 44% of female-headed

households live below the poverty line. The unemployment rate in the country sits at 27.4%.1

Namibia operates an integrated pharmaceutical supply chain whereby the Central Medical

Store (CMS), a government entity, oversees the procurement, storage, and distribution of all

pharmaceuticals and clinical supplies for use in public health facilities in the country. The

range of product categories handled by the CMS includes: essential medicines, including anti-

retroviral medicines (ARVs), malaria medicines, TB medicines; contraceptives and other

reproductive health supplies; vaccines; HIV test kits; clinical supplies such as gloves, needles,

syringes, and bandages; surgical instruments such as scissors and blades; radiology supplies

such as X-ray films and contrast media.

Country ownership of the public health supply chain in Namibia is already strong, with the

government owning and driving major operational functions and contributing the bulk of

funds required for procurement of essential medicines and clinical supplies. The approximate

total value of health commodities procured annually through the CMS is about 950 million

Namibian dollars (NAD) (USD 80 million) in the period 2016–17. There is a modest

contribution for direct pharmaceutical budget from partners, mainly from the Global Fund, to

procure ARVs and related supplies.

Namibia operates a classic CMS distribution system for pharmaceutical management, with a

CMS warehouse at Windhoek and two Multi-Regional Medical Depots (MRMDs), located in

Oshakati in the northwest and Rundu in the northeast. Rundu and Oshakati MRMDs serve the

most populated part of the country, where approximately 40%–50% of the population resides.

Rundu MRMD serves seven health centers, 29 clinics, and one hospital in the Kavango

region and fills emergency orders from facilities from in the Caprivi region as well as Rundu

Intermediate Hospital. Oshakati MRMD serves seven district hospitals, 15 health centers, 64

clinics, and one mortuary (police facility).

Essential medicines should always be available in the right amounts, so that health workers

can effectively help their patients. Medicines and medical supplies play an important role in

every health system if they are used correctly. Medicines and medical supplies can cure

diseases, alleviate suffering, or correct and maintain body functions, preventing serious

consequences; help for preventive purpose as a prophylaxis; or be used for adjuvant therapy

in conjunction with a number of surgeries and diagnostics. Continuous availability of these

products and maintaining them in the required storage conditions, to avert overstock, stock-

out, and product deterioration is a critical function in pharmaceutical supply management.

Therefore, skills in inventory control and storage practices play a critical role, requiring a

trained pharmaceutical management staff. Unfortunately, in most developing and developed

1 MOHSS/Directorate: Special Programmes. 2017. National Strategic Framework for HIV/AIDS 2017/18–

2021/22. Windhoek: MOHSS.


2

countries the emphasis given to the inventory control of pharmaceuticals is negligible, given

its affect on global development goals.

In general, inventory management for pharmaceutical supply sounds easy—all that must be

done is to order, receive, store, issue, and then reorder a limited list of items. Yet, as has been

observed, “we can distribute Coca-Cola all around the world, but we can’t seem to get

medication to save a child from something as simple as diarrhea” (Annie Lennox, 2008).2 In

reality, the task is difficult, and in many countries, including Namibia, poor inventory

management in the public pharmaceutical supply system leads to waste of financial resources,

shortages of some essential medicines or overages of others resulting in expiration, and a

decline in the quality of patient care.

The director general of the World Health Organization (WHO) asserted that “the lack of

availability of essential pediatric medicines, including antibiotics, is one reason why countries

are not making adequate progress towards some Millennium Development Goals.”3

Problems in inventory control generally feature subjective, ad hoc decisions about order

frequency and quantity, inaccurate stock records, and a lack of systematic performance

monitoring, all of which result in more frequent interim orders. Often, these problems are

directly related to lack of knowledge and appreciation of what inventory management

involves, as well as to ineffective management and chronic underfunding for the management

of this activity. Shortage of appropriately skilled staff is a critical challenge in Namibia, and

has mainly resulted from low levels of awareness of the importance of capacity building.

Inventory control and storage practices constitute a major challenge and are the major cause

of stock-out of medicines for antiretroviral therapy (ART), TB, and malaria in all regions in

Namibia. The MOHSS has revised and distributed SOPs for the management of medicines

and medical supplies at PHC facilities in the year 2015–16, however, training on these SOPs

has not been provided to all staff at the PHC level in the Khomas, Ohangwena, and

Otjozondjupa regions. Stock card use is a major challenge in the country, particularly at PHC

facilities, as evidenced by the lower scores (44% national average per the SSV Report 2017).

The MOHSS is decentralizing ART services through establishing nurse initiated and

managed ART (NIMART) sites, but the inventory control of ART is not being supported by

Facility Electronic Stock Cards (FESC) and staff are not oriented on this tool. Revised SOPs

have printed and distributed to the health facilities, which are ready for use in training. FESC

is being implemented at the PHC level, which makes it necessary to introduce the tool during

the training.

Since 2012/13, the Supply Chain Management Systems (SCMS) project and the SIAPS

Program, implemented by Management Sciences for Health (MSH), have been supporting

MOHSS and the regional management teams (RMTs) in building the capacity of PHC staff,

In 2017, SIAPS supported three regions: Khomas, Ohangwena, and Otjozondjupa. This report

covers the training in all three regions. These regional health departments have requested and

secured support to roll out training of inventory control and good storage practices at different

times. The trainings were conducted in May, June, and August and November in Khomas,

Ohangwena, and Otjozondjupa, respectively. See the annexes (A, B, C, and D) of the report

2 http://www.jhsph.edu/research/centers-and-institutes/ivac/resources/IVAC-Improving-Access-to-Essential-

Medicines.pdf 3http://www.who.int/dg/speeches/2007/eb120_opening/en/index.html

Background

3

for participants list, the generic training program, photos and practical exercises carried out

during the trainings.

Training Objectives

The trainings aimed to improve the management of ARVs, TB medicines, and related health

commodities. It was necessary to improve inventory control and good storage practices,

thereby improving access and further reducing the increasing pharmaceutical budget by

reducing cases of expired and damaged pharmaceuticals. The specific objectives of the

trainings were the following:

• Enable the health professionals working at the health facilities to manage

pharmaceuticals

• Introduce inventory control and storage practices concepts

• Sensitize the participants on the importance of pharmaceuticals management to the

patients

• Improve pharmaceutical ordering, receiving, storage, and distribution skills

• Motivate health workers toward recognizing the importance of inventory control and

good storage practices

• Sensitize participants on the budget implications of mismanagement of

pharmaceuticals

4

INTERVENTION

Three trainings were conducted, at different places and at different times. The content of the

training in all the sessions was the same and the duration of each training iteration was two

days. The training presentations are based on Managing Pharmaceutical Store: A Manual for

Clinics and Health Centres (2017)4. The trainings were conducted by regional pharmacists,

experienced PHC nurses, and pharmacist assistants with the technical support of the ART

logistic advisor from MOHSS/NMPC and the senior technical advisor from SIAPS (table 1).

The training was carried out using the following techniques:

Training slides—based on the PHC Medicines and Medical Supplies Management

Manual

Snap questions

Group exercises

In session interactions

Case study exercises

Implementation plan

Table 1. Facilitators of all trainings

S/N Facilitators Designation Regions Level

1 Wuletaw Chufo Pharmaceutical services All National 2 Alemayehu Wolde SIAPS All National 3 Alexander Anaba Senior pharmacist Ohangwena Regional 4 Julia Tshitayi Senior registered nurses Ohangwena District 5 Seija Nakamhela Pharmacist Khomas Regional 6 Sefinew Abate Pharmacist Otjozondupa District 7 Tsegaye Telila Pharmacist Otjozondupa District 7 Lynette S. Karises Pharmacist assistant Otjozondupa District

Training Content

The training covered the following focal areas/topics/practical case study exercises:

1) General logistics/supply chain management concepts in the Namibia context

2) Introduction to the essential medicines concept

3) Ordering (main and interim), receiving and issuing medicines

4) The pharmacy store: storage of medicines and cold chain management

5) Classwork: storage of medicines

6) Organizing the Store: stock arrangement

7) Inventory management session 1 and the dashboard

8) Groupwork: monthly consumption, min and max, order quantity

9) The stock card: a tool for inventory management and FESC

10) Classwork: completing the stock card

11) Assessing stock status

4 MOHSS 2017. Managing Pharmaceutical Store: A Manual for Clinics and Health Centres. Windhoek:

MOHSS.

Intervention

5

12) Groupwork: assessing stock status

13) Introduction to planning for improvement of good storage practices at the facilities

14) Groupwork on planning for improvement at the facilities

Groupwork Activities

1) VEN classification

2) Storage requirement and results of poor storage

3) Completing of stock cards based on the transaction

4) Calculating average monthly consumption (AMC), min–max, order quantities, and

months of stock

5) Preparation of the plan of action

Output of the Trainings

Attendance in the Khomas, Ohangwena, and Otjozondjupa Regions

A total of 152 health workers (table 2) were trained for two days each. The training in

Khomas was conducted for two rounds. All the participants were from the Khomas district

PHC facilities and hospitals. In Ohangwena, the region planned to train 90 staff; however, 58

participants attended a second-round training. In Otjozondjupa, the plan was to train 90 staff

from four (all) districts, but only 49 participants attended the training. Participants were

trained in two groups over a two-day period with two days for traveling.

Table 2. Number of health workers trained by designation and regions, 2017

Row labels Count of trainees by designation

Khomas region 45

Admin officer 6 Enrolled nurse 1 Pharmacist 1 Pharmacist assistant 20 Quality assurance 1 Registered nurse 15 Senior registered nurse 1

Ohangwena region 58

Enrolled nurse 23 Health assistant 1 Pharmacist 3 Pharmacist technician 1 Pharmacist’s assistant 8 Registered nurse 22

Otjozondjupa region 49

Enrolled nurse 21 Medical officer 3 Pharmacist 1 Pharmacist assistant 7 Registered nurse 11 Senior medical officer 2 Senior registered nurse 4

Grand total 152


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Figure 1 shows participant distribution by region, district, and gender. The distributions

clearly show that most of the participants, especiallly in the Ohangwena and Otjozondjupa

regions, came from the district where the training was conducted. Engela district in the

Ohangwena region and the Otjiwarongo district from the Otjozondjupa region accounted for

more than 50% participants. The major reason for this skewed distribution may have been the

proximity to the training venue as well as the skewed distribution of the health facilities in

these regions.

Figure 1. Participant distribution by region, district, and gender

The training produced positive outcomes, as seen in the post-test results. The participants

were quite excited about the exposure to new/updated knowledge. Practical operational

challenges were discussed and solutions offered, especially in the areas of stock card use,

FESC, and ordering of medicines. The training areas were plotted for- pre and post-tests and

compared for improvements made by the participant. Figures 2–5 display the pre- and post-

test results for the three regions.

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Figure 2. Pre-and post-test results in Khomas region, round 1 (May 2017)

Figure 3. Pre- and post-test results in Khomas region, round 2 (November 2017)

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Figure 4. Pre- and post-test results in Ohangwena region, round 1 (June 2017)

Figure 5. Pre- and post-test results in Ohangwena region, round 2 (June 2017)

More than 90% of the trainees improved in the post-tests, as shown in the figures 6–9. For

unknown reasons, some participants’ knowledge did not improve.

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Figure 6. Pre- and post-test results in Otjozondjupa region, round 1 (August 2017)

Figure 7. Pre- and post-test results in Otjozondjupa region, round 2 (August 2017)

Most of the participants, more than 90%, improved in the post-tests, as shown in figure 7. For

unknown reasons, some participants did not improve on the post-test or even had poorer

results on the post-test than the pre-test.

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Figure 8. Pre- and post-test results in Otjozondjupa region, round 1 (July 2017)

Figure 9. Pre- and post-test results in Otjozondjupa region, round 2 (July 2017)

The training was also considered for accreditation after the content was evaluated by the

Health Professional Council of Namibia and considered as part of continuous professional

development (CPD), with eight credits assigned to it for health care professionals who

attended the training (figure 10).

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Figure 10. Accreditation results from Namibian Health Professional Council for first-

round training for Khomas, Ohangwena participants

12

DISCUSSION OF OUTPUTS

The key message is that effective inventory management can provide reliable availability and

assured supply of low-cost products even in remote areas, with poor infrastructure So why

then are there so still so many problems with public sector inventory management of

pharmaceuticals? In many cases, no systematic procedures and rules exist to guide staff, a

problem compounded by lack of understanding of the basic issues of proper inventory

management on the part of managers. These core concepts were reflected during the

discussion and groupwork presentation. As the managers seem to have limited understanding

of the importance of inventory control, they do not send their staff to relevant trainings. The

main challenge experienced was non-attendance at the training by most intended critical

participants (nurses from PHC clinics), especially those from Eenhana and Khomas districts.

A 64% attendance rate was achieved in Ohangwena, with Eenhana PHC accounting for bulk

of failed attendance. The attendence rate in the Khomas and Otjozondjupa regions was only

50%.

The issue of training duration was also a challenge, as there was little time for participants to

do more hands-on practice exercises and exhaustively discuss their operational challenges.

Participants were enjoined to go back to their facilities and implement their drawn-up action

plan according to set implementation dates. This will be followed by increased supervisory

visits by the district pharmacist and regional pharmacist to monitor implementation of the

action plans and compliance with the use of stock cards at these facilities.

13

CONCLUSIONS AND RECOMMENDATIONS

The training objectives were mostly met, as after the training participants understood the

basic skills of stock control and inventory management, identified their challenges, and were

able to use skills acquired at the training to draw up action plans to start solving these

problems. The trainings were successful with regard to content, even though not all target

trainees participated

Most of the trainees scored above 69% in the post-test evaluation and all of them did very

well on practical and skill-based assessments. All trainees who had scored below 50% on the

pre-test scored above 50% on the post-test, an encouraging result.

The following recommendations were put forward, bearing in mind the challenges

experienced:

Effective communication and sensitization of the managers on the importance of

inventory control for pharmaceutical management should be in place at the district

level, especially for PHC, to ensure participation in training. The MOHSS should

organize training for managers on this issue.

Continuing hands-on training should be done at the facility level as a follow-up of the

action plans drawn up by participants.

It is also appropriate if the region organizes training for those who did not attend the

trainings, as there were facilities that were not represented at these sessions.

14

ANNEX A. PARTICIPANT LIST ALL REGIONS AND ALL ROUNDS

SN Gender Names Facility District Designation Region

1 F Ruben Ilonga Grabab Khomas Registered Nurse Khomas

2 M Simon Kandjimbi Grobab Khomas

Pharmacist’s Assistant

Khomas

3 M Thomas Shipushu Okaryangava Clinic Khomas Khomas

4 F Doline Goreses Whimbili Khomas Khomas

5 F Helena Shangula Khomosdal HC Khomas Khomas

6 F Maria T. Penda Otjimuse Khomas Khomas

7 F Maria N. Nekongo Maxwilil Khomas Khomas

8 M Thomas Shuutameka

Defence Clinic Khomas Khomas

9 F Sandra Mercy Mutahane

Defence Clinic Khomas Khomas

10 F Helena S. Iyambo Robert Mugabe Khomas Registered Nurse Khomas

11 F Shanyengange Peneyambeko

Omundundu Clinic Engela

Enrolled Nurse

Ohangwena

12 F Wilhelm Hamukwaya

Edundja Clinic Eenhana Ohangwena

13 M Herman Nangolo Epembe Clinic Eenhana Ohangwena

14 M Joseph Sheya Epinga Clinic Eenhana Ohangwena

15 M Lazarus Shapange

Oshikunde Clinic Eenhana Ohangwena

16 F Sevelen Hangula Edundja Clinic Engela Ohangwena

17 M Junias Hambadi Ohaukelo Clinic Engela Ohangwena

18 F Itridis Naloliwa Iipinge

Omundundu Clinic Engela Ohangwena

19 F Saima Eliakim Edundja Clinic Eenhana Ohangwena

20 F Sabina Hamalwa Edundja Clinic Eenhana Ohangwena

21 F Martha Indongo Omuhongo Clinic Eenhana Ohangwena

22 F Selma Mweukonga

Omundaungilo Clinic Eenhana Ohangwena

23 M Teofilus Naukushu

Ongula Clinic Eenhana Ohangwena

24 F Tressia Niilungu Onangolo Clinic Eenhana Ohangwena

25 M Andreas Sheehela

Ohalushu Clinic Engela Ohangwena

26 F Victoria Udina Ohangwena Clinic Engela Ohangwena

27 F Penexupifo Kondjeninasho

Omungwelume Clinic Engela Ohangwena

28 F Martha Shikolalye Onekwaya Clinic Engela Ohangwena

29 F Lucia Daniel Ekoka Clinic Okongo Ohangwena

30 F Saima Itamalo Ohaukelo Clinic Okongo Ohangwena

31 F Victoria Kashile Okongo Clinic Okongo Ohangwena

32 F Beata Shakuyungwa

Okongo Clinic Okongo Ohangwena

33 F Raimo Haufiku Omboloka Clinic Okongo Ohangwena

34 M Toini Ngonuhapo Okambembe clinic Engela Health Assistant Ohangwena

35 M Miller Nyanyiwa Engela Dist Hosp Engela

Pharmacist

Ohangwena

36 F Nsuami Makaya Engela Dist Hosp Engela Ohangwena

37 M Adebayo Ayodeyi Okongo Dist Hosp Okongo Ohangwena

38 F Rosalia Gotrieb Okongo Clinic Okongo Pharmacist Technician

Ohangwena

39 M Immanuel Shikesho

Eenhana Dist Hosp Eenhana


Ohangwena

40 M Leonard Shipanga

Engela Dist Hosp Engela Ohangwena

41 F Linda Namibinga Engela Dist Hosp Engela Ohangwena

42 F Alina Shipalanga Odibo Health Centre Engela Ohangwena

43 F Hilma Shindubu Odibo Health Centre Engela Ohangwena

44 F Priskilla Laudika Ongenga Clinic Engela Ohangwena

45 F Sylvia Mweenda Ongha healthcentre Engela Ohangwena

46 F Jona Kayofa Okongo Dist Hosp Okongo Ohangwena

Annex A. Participant List All Regions and All Rounds

15


47 F Salome Nakwafila Epembe Clinic Engela

Registered Nurse

Ohangwena

48 M Andreas Ekandjo Eenhana Dist Hosp Eenhana Ohangwena

49 F Kamati Immanuel Onekwaya Engela Ohangwena

50 M Mateus Immanuel Engela Clinic Engela Ohangwena

51 M Efraim N Lebeus Olukula Clinic Okongo Ohangwena

52 F FJosephine Haimo

Eenhana Dist Hosp Eenhana Ohangwena

53 F Anna Ndamanomhata

Eenhana Dist Hosp Eenhana Ohangwena

54 F Selma Abital Eenhana Dist Hosp Eenhana Ohangwena

55 F Monika Mwapota Onambutu Clinic Eenhana Ohangwena

56 F Rauna Issak Onangolo Clinic Eenhana Ohangwena

57 F Beata Johannes Oshaango Clinic Eenhana Ohangwena

58 F Monika Hedimbi Oshandi Clinic Eenhana Ohangwena

59 F Ndilimeke Shifidi Endola Clinic Engela Ohangwena

60 F Ulla Nghihalwa Eudafano Clinic Engela Ohangwena

61 F Liisa Haixwema Hamukoto Wakapa Clinic

Engela Ohangwena

62 F Lahya Amutenya Ohangwena Clinic Engela Ohangwena

63 F Olivia Dumeni Onamukulo Clinic Engela Ohangwena

64 F Ottilie Shailemo Ondobe Clinic Engela Ohangwena

65 F Shimau Helena Ongenga Clinic Engela Ohangwena

66 F Klaudia Nghole Okatope Clinic Engela Ohangwena

67 F Hendrina Shiningombwa

Eenhana Dist Hosp Okongo Ohangwena

68 F Ndesheetelwa Shakuyungwa

Okongo Clinic Okongo Ohangwena

69 F Precious Nsala Sizuka

Poly Clinic Grootfontein

Enrolled Nurse

Otjozondjupa

70 M Lubanda O Musweu

Okahandja Dist Hosp Okahandja Otjozondjupa

71 F Bilhildis Gowaseb Okahandja Dist Hosp Okahandja Otjozondjupa

72 F Florence Karamata

Okahandja Dist Hosp Okahandja Otjozondjupa

73 F Samanda Auxas Otjozondu Clinic Okahandja Otjozondjupa

74 F Helena P Hangalo

Okakarara Dist Hosp Okakarara Otjozondjupa

75 F Daisy U Mujahere Okakarara Clinic Okakarara Otjozondjupa

76 F Theoboldina Kaitjizemine

Okondjatu Clinic Okakarara Otjozondjupa

77 F Nauyele N Kamholo


78 M Richart Zaondja Okakarara Dist Hosp Okakarara Otjozondjupa

79 F Regina Riruako Okamatapati Clinic Okakarara Otjozondjupa

80 F Paulina Hamases

Otjiwarongo Dist Hosp

Otjiwarongo Otjozondjupa

81 F Tauno P Amunyela


82 F Felicity Schrader Otjiwarongo Otjozondjupa

83 F Johanna Pinehas Otjiwarongo Otjozondjupa

84 M Benhard Akwenye

Otjiwarongo Police Station


85 F Norma NU Kahamboe

Osire Clinic Otjiwarongo Otjozondjupa

86 M Whysley Useb Kalkfeld Clinic Otjiwarongo Otjozondjupa

87 M Joseph Ipinge Kalkfeld Clinic Otjiwarongo Otjozondjupa

88 F Martha Shiimi Otjiwarongo Police Station


89 F Laina Lukas Etunda Clinic Otjiwarongo Otjozondjupa

90 M Dr Dick Manatsa Grootfontein Dist Hosp

Grootfontein

Medical Officer

Otjozondjupa

91 F Dr Laura Muszinguani



92 M Dr Olenga J Otjiwarongo Dist Otjiwarongo Otjozondjupa


16


Olenga Hosp

93 M Onyekachi U Adindu

Okakarara Dist Hosp Okakarara Pharmacist Otjozondjupa

94 M Gerson Aib Grootfontein Dist Hosp

Grootfontein


Otjozondjupa

95 M Wilhelm Antindi Grootfontein Military Hosp

Grootfontein Otjozondjupa

96 M Erasmus T Kamboo


97 F Kaarukire Rukata Otjiwarongo Dist Hosp


98 F Martha Aikanga Otjiwarongo Otjozondjupa

99 F Ester T Nghilungilwa



100 F Johanna Shilimela

Otavi Health Centre Otjiwarongo Otjozondjupa

101 F Hilde Kambonde Poly Clinic Grootfontein

Registered Nurse

Otjozondjupa

102 M Festus Lavo Kalongo

Nau-aib Clinic Okahandja Otjozondjupa

103 F Martha Shilomboleni

Otjozondu Clinic Okahandja Otjozondjupa

104 F Elisabeth Pataka Ovitoto Clinic Okahandja Otjozondjupa

105 F Idda N Nashongo Okakarara Dist Hosp Okakarara Otjozondjupa

106 F Olichen M Endjere



107 F Hilma N Haimbondi

Osire Clinic Otjiwarongo Otjozondjupa

108 F Kathrina A Hifititeko



109 F Josefina P Shitaleni

Orwetoveni Clinic Otjiwarongo Otjozondjupa

110 M Michael Ucham Otjiwarongo Dist Hosp


111 F Veronica Eigowas Poly Clinic Grootfontein Otjozondjupa

112 M Dr Steve Kabamba Ngoy

Okahandja Dist Hosp Okahandja Senior Medical Officer

Otjozondjupa

113 M Justin Mukeba Mutombo



114 F Emilia K Tobias Okakarara Dist Hosp Okakarara

Senior Registered Nurse

Otjozondjupa

115 F Hilma N Muhenje



116 F Agnes M Mudabeti


117 F Maria Negumbo Otjiwarongo Otjozondjupa

118 F Elizabeth Hamwaanyena

Intermediate Hosp Katutura

Khomas Registered Nurse Khomas

119 M Natanael Ngeshapu

Windhoek Dist Khomas Enrolled Nurse Khomas

120 F Hileni Hatutale Ministry of Defence Khomas Officer

Khomas

121 M Paulus Ngololo Ministry of Defence Khomas Khomas

122 M Kagiso Totwe Intermediate Hosp Katutura

Khomas

Pharmacist Assistant

Khomas

123 M Brian Kaela Khomas Khomas

124 F Julia Nghuukufwa Windhoek Dist Khomas Khomas

125 F Zita Ilukena Windhoek Dist Khomas Khomas

126 F Rebekka Fotolela Windhoek Dist Khomas Khomas

127 M Michael Simataa Windhoek Dist Khomas Khomas

128 F Dhimbulukweni Mumbala

Windhoek Dist Khomas Khomas

129 F Ivy Chika Windhoek Dist Khomas Khomas

130 F Linea Amutenya Intermediate Hosp Katutura

Khomas Khomas

131 M Immanuel Naukushu

Windhoek Central Hosp

Khomas Khomas

132 M Natangwe Itengula


Khomas Khomas

Annex A. Participant List All Regions and All Rounds

17


133 F Vivoliana Kapner Central Medical Store

Khomas Khomas

134 F Irya Valombola Khomas Khomas

135 F Jane Lichisa

Intermediate Hosp Katutura

Khomas Quality Assurance

Khomas

136 F Lovisa Amoomo Khomas

Registered Nurse

Khomas

137 F Nikanor Victor Khomas Khomas

138 F Suoma Petrus Khomas Khomas

139 F Martha Ihuhwa Khomas Khomas

140 F Viangana Marenga

Khomas Khomas

141 F Laili Sheetekela Windhoek Dist Khomas Khomas

142 F Angelika Kemanye

Windhoek Dist Khomas Khomas

143 F Mercia Uazena


Khomas Khomas

144 F Selma Willbard Khomas Khomas

145 F Paulina Ilonga Khomas Khomas

146 F Odette Demoura Khomas Khomas

147 F Wilhelmina Bundje

Khomas Khomas

148 F Lettie Ankonga Ministry of Defence Khomas

Senior Officer

Khomas

149 F Lef Taimi Kadalwa

Ministry of Defence Khomas Khomas

150 F Ndapewoshali Mhata


151 M Immanuel Haulyondjamba


152 F Lahya Malakia Intermediate Hosp Katutura

Khomas Senior Registered Nurse

Khomas

18

ANNEX B. TRAINING PROGRAM-GENERIC FOR ALL TRAININGS*

Inventory Management and Good Storage Practices Training, Pharmacist Assistants

and Nurses in Khomas Region Venue: Heja Game Lodge May 15–16, 2017

Time Activity Facilitator

Monday, May 15, 2017

08h00 – 08h30 Registration All

Opening prayer

Introductions All

Welcoming remarks Regional director

Housekeeping Ms. Seija

Objectives of the training and expectation of participants Mr. Wuletaw

08h30 – 09h00 Pre-test All

0900h – 09h45 General Logistics/Supply Chain Management Concepts with Namibian Context

Mr. Wolde/Tsegaye

10h00 – 10h15 Plenary All

10h15 – 10h30 TEA BREAK All

10h30-11:00 Introduction to Essential Medicines Concept Mr. Wuletaw/Ms. Seija

11h00 – 11h30 Ordering (Main and Interim), Receiving, Issuing Medicines Ms. Seija/Wuletaw

11h30-12:30 The Pharmacy Store – Storage of Medicines Mr. Wolde/Ms. Seija

12h30 – 13h00 Plenary All

13h00 – 14h00 LUNCH

14h00 – 14h30 Class Work: Storage of Medicines All

14h30 – 15h00 Plenary

15h00 – 15h30 TEA BREAK

15h30 – 16h30 Organizing the Store – Stock Arrangement Mr. Wolde/Ms. Seija

16h00 – 17h00 Discussion All

Tuesday, May 16, 2017

08h00 – 08h30 Recap Participant

08h30 – 10h30 Inventory Management Session I and II and Intro of FESC Mr. Wolde/Ms. Seija

10h30 – 10h45 TEA BREAK

10h45 – 11h30 Group Work: Monthly consumption, Min and Max, Order Qty.

All

11h30 – 12h45 The Stock Card – A Tool for Inventory Management (FESC)

Mr. Wuletaw/Wolde

12h45 – 13h00 Class Work – Completing the Stock Cards All

13h00 – 14h00 LUNCH

14h00 – 14h15 Assessing Stock Status Ms. Seija/Mr. Wuletaw

14h15 – 15h00 Group Work – Assessing stock status

15h00 – 15h30 Brief Introduction – How to Plan for Improvement of Inventory Control and Good Storage Practices at the Facilities Level

Ms. Seija/Mr.Wolde

15h30 – 16h30 Group Work on Planning for Improvement of Inventory Control and Good Storage Practices at the Facilities

Ms. Seija/Mr. Wolde

16h30 – 17h00 Post-test and closing Ms. Seija/all *Training programs for all regions were the same except for the moderators and the dates of the training.

19

ANNEX C. SAMPLE PLANNING EXERCISE SHEET

Division Pharmaceutical Services – Xxx Region

Inventory Management and Good Storage Practices Training Workshop Work plan Name:……………… Duty station:…………… Date:……………

Problem Area % Level of

Compliance Activities to Improve

Target Date

Improved % Compliance Level

Monitoring Strategy

There is no stock card in use at our facility. Difficult to know the stock level at any time without counting

0% 1 Get the stock card at the facility

100% 90–95% acceptable

Supervisors support visit

2 Stock take

3 Establish a stock card

4 monitor the stock movement

Minimizing the interim order to the suppliers (RMS, CMS, hospital)

Currently 6 orders b/n orders

1 Set up the stock levels

1 Orders b/n intervals

2 Orders are acceptable

Orders monitored at supplier point.

2 Monitor the order triggering points

3 Do the stock take during every order

4 Calculate order quantity for all products

1

2

3

4

20

ANNEX D. PHOTOS

Participants of Ohangwena Region, Ondangwa Town Lodge

Regional HealthDirector of Otjozondjupa , Mrs. M. F. Kavezembi, opening the training at Otjiwarongo, C’est Bon Hotel

Annex D. Photos

21

Participants at C’est Bon Hotel, Otjiwarongo, Otjozondupa Region

Participants at Heija Lodge, Khomas region

Documents

Inventory Control and Good Storage Practices Training for ...siapsprogram.org/wp-content/uploads/2018/04/18-035... · HIV human immundeficiency virus min–max minimum–maximum MOHSS