Ghana Nursing Curr Student - FINAL Apr2014 - SyncVersion - 2-1

Student Syllabus
Supply Chain Management

for Health Training Schools in Ghana
May 2014
Developed by USAID | DELIVER PROJECT

Table of Contents
Table of Contents................................................................................................... i
Abbreviations/Acronyms ...................................................................................... iii
Session 1: Introduction to Health Supply Chain Management ............................ 1
Commodity Security .......................................................................................... 2
Purpose of a Logistics System .......................................................................... 5
The Logistics Cycle ........................................................................................... 6
Six Logistics Terms ........................................................................................... 9
Ghana Public Sector Health Commodities Pipeline......................................... 11
Ghana Public sector Health Commodities Pipeline ................................... 12
Session 2: Logistics Management Information Systems (LMIS) ........................ 14
Purpose of LMIS.............................................................................................. 15
3 Essential Data Items .................................................................................... 15
Logistics Records ............................................................................................ 16
Activity on Logistics Records ........................................................................... 16
Stock keeping Records ..................................... Error! Bookmark not defined.
Transaction Records ....................................................................................... 22
Consumption Records ..................................................................................... 23
Summary Reporting ........................................................................................ 24
Six Rights of LMIS ........................................................................................... 24
Summary Sheet............................................................................................... 27
Session 3: LMIS Completing Bin Card ............................................................... 29
Session 4: LMIS: Completing the Worksheet ..................................................... 37
Worksheet for Setting Maximum Stock and Re-order Quantities ........................ 39
Session 5: LMIS: Completing the RRIRV ........................................................... 40
Session 6: Storage of Health Commodities ........................................................ 44
The Purpose of Storage .................................................................................. 45
Shelf Life ......................................................................................................... 45
Guidelines for Proper Storage for Health Commodities................................... 46
Routine Visual Inspection ................................................................................ 46
Visual Inspection Exercise .............................................................................. 47
Session 7: Maximum-Minimum Inventory Control Systems ............................... 49
Inventory Control Systems .............................................................................. 50
Versions of Max-Min Inventory Control Systems ............................................. 51
Forced Ordering Version of Max-Min .............................................................. 51
Forced Ordering – Delivery Truck Variation .................................................... 51
Continuous Review Max-Min ........................................................................... 52
Developed by USAID | DELIVER PROJECT i

Continuous Review – Two-Bin Variation ......................................................... 53
Standard Version of Max-Min .......................................................................... 54
Order or Issue Quantity Formula ..................................................................... 54
Max-Min Inventory Control Exercise 1 ......................................................... 55
Max-Min Inventory Control Exercise 2 ......................................................... 56
Session 8: Assessing Stock Status ..................................................................... 58
Assessing Stock Status ................................................................................... 59
Formula for Assessing Stock Status ............................................................ 59
When to assess stock status ....................................................................... 61
Assessing Stock Status Exercise .................................................................... 62
Session 9: Facilities, Staffing and Procurement ................................................. 77
Activity 1 Logistics Roles/Responsibilities by Health System Level .............. 79
Activity 2: Roles and Responsibilities: Health System Staff ......................... 80
Sample Logistics Roles and Responsibilities of Staff ...................................... 80
Logistics Duties of Nurses ............................................................................... 83
Procurement .................................................................................................... 84
Session 10: Monitoring and Supervision of the Logistics System ....................... 86
Key Terms in Logistics Monitoring and Supervision and On-the-Job Training
(OJT) ............................................................................................................... 87
Small Group Activity ........................................................................................ 88
Guidelines for Planning and Conducting a Site Visit ....................................... 90
A Practical Experience: Field Trip ....................................................................... 94
Developed by USAID | DELIVER PROJECT ii

Abbreviations/Acronyms
AMC Average Monthly Consumption

ARV Antiretroviral
CBD Community Based Distribution
CMS Central Medical Stores
CS Commodity security
DAR Daily Activity Register
DHD District Health Directorate
EOP Emergency Order Point
FEFO First Expiry, First Out
FP Family Planning
GFATM Global Fund to Fight AIDS, Tuberculosis and Malaria
GHS Ghana Health Service
HMIS Health Management Information System
ICC Inventory Control Card
LMIS Logistics Management Information System
Max Maximum
Min Minimum
MOH Ministry of Health
MOS Months of Stock on Hand
NGO Non-Governmental Organization
OJT On-The-Job Training
PSD Procurement and Supplies Division (of MOH)
RRIRV Report, Requisition, Issue and Receipt Voucher
RMS Regional Medical Stores
SCM Supply Chain Management
SDP Service Delivery Point
SOH Stock on Hand
SOPs Standard Operating Procedures
STG Standard Treatment Guidelines
USAID United States Agency for International Development
WHO World Health Organization
Developed by USAID | DELIVER PROJECT iii

Developed by USAID | DELIVER PROJECT iv
Session 1:
Introduction to
Health Supply Chain Management
Developed by USAID | DELIVER PROJECT 1

Commodity Security
After listening to your tutor you should be able to complete the following
sentences by selecting and writing in the correct words. Note: Some words
maybe repeated or not used at all.
Obtain
Choose
Prescribe
Use
Reproductive health commodity security exists when every person is able

to ___________, __________, and ____________ quality contraceptives and
other essential reproductive health supplies whenever s/he needs them.
Commodity security exists when every person is able to ___________ and

___________ quality essential health supplies whenever s/he needs them.
Why does the word__________ not appear in the definition of Commodity

security? Circle the correct answers.
1. The doctor makes the decision about what specific drug is required to
treat the patient’s condition or which product is needed.
2. Doctors will prescribe medication in accordance the rational drug use

policies established by the MOH.
3. The MOH is not able to provide every medication available so it will

select a limited number of drugs to be included on the essential
medicines list.
4. Doctors will only provide medications after the patient has been
thoroughly examined by medical staff.

Commodity Security Framework
Finance
Forecast
Procure
Deliver

Commodity Security Framework: Explanation of Terms
Context refers to the overall situation that exists in the country where commodity
security is going to be achieved, including the political, policy, economic, social
and health environments.
Commitment, refers to the level of policy support and leadership, and includes
commitment by all partners: government, donors, private sector, and NGO
sector.
The next ring includes three elements or conditions that must be present,
Capital (financial resources). Not only must there be a variety of funding sources
(the government cannot meet all of the needs alone), but the funds must also be
made available to support all of the requirements needed to achieve Commodity
Security, including the purchase of the products and the infrastructure needed to
manage them.
Coordination among the various partners who are working together to achieve
Commodity Security, and as indicated in the boxes, this include the public sector
(government), as well as the private sector and donors.
Capacity to implement the system; this includes the supply chain that will get the
products where they are needed, service delivery that will give clients access to
the services, and the human and technical capability that will support all
elements of the system.
Commercial Sector, Public Sector, NGOs, and Social Marketing. In this

framework are actors who mobilize their capital, coordination and capacity in
order to bring services to the clients.
Clients, we must ensure that we are meeting the needs of the clients and
addressing specific issues that impact CS at the client level, such as access,
communities, method choice, met and unmet need, ability and willingness to pay,
and sources used.
Logistics is Essential to Commodity Security
Logistics is essential to CS. A program is able to make progress toward

commodity security when it can:
 FORECAST…accurately estimate commodity requirements

 FINANCE…obtain or organize adequate financial resources
 PROCURE…conduct timely and efficient procurement of products

 DELIVER…ensure reliable delivery to customers
Purpose of a Logistics System
General Categories of Health Commodities
During your instructor’s presentation it was mentioned that health commodities

area often grouped in various categories. What were the categories presented by
your instructor? Circle the correct column.
Essential Medicines Non-Full Supply Consumables

Full Supply Consumables Non-Full Supply
Non-Full Supply Full Supply FP and TB products
From the column that you selected above, write in the term that matches the
definition.
________________ commodities are those for which the supply is almost

guaranteed, that the product will always be available without fail.
Which of the following programs would be categorized as Non-Full Supply since

they frequently do not have the resources required to keep products in full supply
at all times? Circle the correct answer.
Tuberculosis Essential Medicines Family Planning HIV/AIDS
The Six Rights
Write in the 5 rights of logistics that are missing.
1. _______________________ 4. ______________________
2. _______________________ 5. ______________________
3. _______________________ 6. ____Cost______________
Remember that Right Cost also applies to logistics systems where commodities
are donated and/or given to clients for free because there are still costs
associated with delivering the product to the client (e.g., personnel,
transportation, and storage).

The Logistics Cycle
Complete the cycle by placing each term from the list below in the correct
location of the logistics cycle.
Quantification and Procurement Serving Customers

Product Selection Pipeline Monitoring
Policy LMIS
Adaptability Budgeting
Supervision Evaluation
Inventory Management, Storage and Distribution
Components of the Logistics Cycle
Serving Customers is shown at the top of the cycle to show its importance: we
do all of our work in logistics in order to serve the customer.

Product selection needs to select the products that are appropriate given the
program supported and the disease patterns of the country and also balance
those needs with things like cost and the ability to manage the products in the
system.
Quantification and Procurement are the actions that serve to get the products
into our country or program. First determine the right quantities that will be
needed to serve all of our customers. Second obtain those products from the
manufacturer or the re-seller, that is, procure products.
Inventory Management stores and distributes the products throughout the

system.
Storage must be adequate to maintain the quality of our products and
storage capacity must be adequate to manage all of the products in our
system.
Transportation must also be secure and reliable, and it must be available
on a regular basis.
The Logistics Management Information System (LMIS) is the means through

which we gather and communicate the information that allows managers to make
the decisions they need to make in order to ensure product availability and
customer service. The LMIS is shown at the center of the cycle, as it is
considered to be the engine which drives the logistics system
In the heart of the cycle we have:
Organization and staffing – a logistics cycle can only work if well-trained,

efficient staff monitor stock levels, place orders, and provide products to
clients.
Budget – allocation and management of finances directly affect all parts

of the logistics cycle. Mobilizing resources and securing a budget line item
for health commodities and logistics activities is extremely important and
essential to success.
Supervision – supervising the staff who work within the logistics system
keeps it running smoothly and helps to anticipate needed changes or
respond to supply problems or human resource constraints.
Monitoring and Evaluation – routine monitoring and periodic evaluation

of the pipeline and logistics system activities help demonstrate how well
the system is performing, the areas that can be improved as well as the
system’s impact on service provision.

Quality Monitoring is indicated around the entire logistics cycle because all
actions taking place within our cycle must be monitored to ensure that they are
functioning properly. If not, then corrective measures must be taken.
Policy Environment an organization or Government’s regulations and

procedures affect all elements of the logistics
Adaptability refers to the ability of the logistics system to successfully adapt to

changes. Logistics systems must be designed to be flexible and adapt to
constantly changing circumstances, such as changes in demand for a product, or
changes in funding policies for logistics activities.
Why Logistics Matters!
Logistics increases program impact – health programs cannot success unless

the supply chain delivers a reliable, continuous supply of health commodities to
its customers. With access to essential health commodities, more people are
more likely to use health services – and thus improve their health status.
Remember, “no product, no program!”
Logistics enhances quality of care – well-supplied health programs can provide

superior service, while poorly supplied programs cannot. Likewise, well-supplied
health workers can use their training and expertise fully, directly improving the
quality of care for clients.
Logistics improves cost efficiency and effectiveness – an effective supply chain

contributes to improved cost effectiveness in all parts of the program by: (1)
reducing losses due to overstock, waste, expiry, damage, pilferage, and
inefficiency; (2) protects other major program investments; and (3) maximizes the
potential for cost recovery.

Six Logistics Terms
Match the logistics term to its appropriate definition by writing the correct letter
next to it.
a. The time interval between when new stock is

____ Pipeline ordered and when it is received and available
for use.
b. Quantities to be issued are determined by
____ Lead time
personnel who receive the supplies.
c. Information about the quantity of goods
____ Pull (requisition) system
actually put in the hands of the clients.
d. The entire chain of storage facilities and
transportation links through which supplies
move from the manufacturer to the consumer,
____ Push (allocation) system
including the port facilities, central warehouse,
regional warehouses, district warehouses, all
service delivery points and transport vehicles.
e. Information about the quantity of goods
____ Dispensed-to-user data shipped from one level of the system to
another.
f. Quantities to be issued are determined by
____ Issues data
personnel who issue the supplies.
Lead Time
What would be the lead time in the following example?
A district places an order, sending the form to the region warehouse which
takes 5 days. It takes two weeks for the region officer to approve the order
and send it to the region warehouse. It then takes the warehouse staff two
weeks to pick and pack the order, and to get approval to ship the
products. It takes 5 days for the delivery vehicle to arrive at the district,
and another 10 days for the district warehouse staff to count the supplies
and place them on the racks to make them ready to issue.
Place your answer here. ___________________________________
Remember a logistics manager measures lead time and works to reduce it. In
looking at the example above, what options could a manager have to reduce lead
time? Write your suggestions in the white space below.

Advantages/Disadvantages of Allocation (Push)/Requisition (Pull)
Requisition (Pull) systems are decentralized and place less burden on upper
level staff BUT it then requires trained staff at the lower levels to spend more
time doing commodity management and filling out forms than and then having
less time to serve clients. This system also requires more people to be trained
which take time and money.
Allocation (Push) systems require fewer trained staff, BUT it then increases the
workload of staff at the upper level
Note: “Allocation” does not imply “ration.” When commodities are not in full
supply, the higher level must determine how to fairly distribute what is available.
This is called “rationing.”
Requisition and allocation systems both require the same data elements; the only
difference is who does the calculation: staff at the lower level (requisition) or staff
at the higher level (allocation).
One system is not better than the other, what system to use is dependent on the
staff and resources available to the logistics system.
Key Distinction between Dispensed-to-User Data and Issues Data
Remember that DISPENSED-TO-USER Data are Information about the quantity

of goods actually put in the hands of the clients or used by clients, and only
Service Delivery Points (SDPs) put goods in the hands of clients; therefore, only
SDPs can generate dispensed-to-user data.
Remember that ISSUE Data are information on the quantity of goods between
facilities and/or transport, goods go from a truck to a warehouse, or a warehouse
to a truck, or warehouse to warehouse, you have issues data.

Ghana Public Sector Health Commodities Pipeline
Instructions:
For this individual exercise, look at the pipeline on the next page and answer the
following questions.
If you are not sure of any of the information, write in your best estimate. You will
have 8 minutes to complete this exercise. Be ready to share your answers with
the class.
1) Where are the sources of dispensed-to-user data and issues data?
2) How many levels are there in the system? What are they?
3) For each level, is it a pull or push system?
4) What are the lead times in this system?

Ghana Public sector Health Commodities Pipeline
Manufacture Port Donor

r
Central Medical Store (CMS)

RMS:
Deliver
commodities Regional Medical
Collect/distribute Stores (RMS) Tertiary Facilities
data Private Sector
Suppliers
Facilities:
Requisition Health
commodities Facilities
Provide data to
RMS
Community Based
Distribution (CBD) Agents
Clients
Developed by USAID | DELIVER PROJECT page 12

Session 2:
Logistics Management Information

Systems (LMIS)

Purpose of LMIS
The purpose of the logistics management information system (LMIS) is not to
generate paper, but it is the system of records and reports that you use to collect,
organize, and present logistics data gathered across all levels of the system.
Ultimately, this logistics data are presented to improve management decisions
that govern the logistics system.
Note: The only information that should be gathered is information which supports
the specific decisions which need to be made. Also LMIS is different from a
health management information system (HMIS). HMIS collect data about
patient’s health conditions or health services rendered whereas LMIS collects
data about commodities.
3 Essential Data Items

1. Stock on Hand: Quantities of usable stock available at any level or at
all levels of the system at a point in time.
2. Rate of Consumption: The average quantity of commodities

dispensed-to-users during a particular time period.
3. Losses/Adjustments: Losses are the quantity of health commodities

removed from the distribution system for any reason other than
consumption by clients (e.g., losses, expiry, damage). Adjustments
may include receipt or issue of supplies to/from one facility to another
at the same level (e.g., a transfer) or a correction for an error in
counting. Losses/adjustments may therefore be a negative or positive
number.
What are the three activities that happen to supplies in a logistics system?
1. _____ _________________________
2. ______________________________
3. ______________________________

Logistics Records
Match the supply activity to the correct record by placing the number in the box.
Activity Record
dispensed-to-users 1 Stock keeping
stored in inventory 2 Transaction
moved between facilities 3 Consumption
Notice that there is one type of record to record each activity.
Activity on Logistics Records

In your group take a look at the following records that are used in Ghana and:
1. Classify the records by their type – stock keeping, transaction,

consumption.
2. List what information should be included in each type of record
3. In the space below you can write any comments or questions that you
have on the records.

Family Planning Daily Summary and Monthly Totals
Clinic name: Month __________________
Clinic location: Year___________________

Contraceptives Dispensed
DATE Male Female Copper Ovrette Lo-Fem Nori-G Micro-G Micro-N Conceptrl Sampoon Depo Jadelle
Condom Condom T
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
13th
14th
15th
16th
17th
18th
19th
20th
21st
22nd
23rd
24th
25th
26th
27th
28th
29th
30th
31st
Totals
Stock
Bal.

MINISTRY OF HEALTH/GHANA HEALTH SERVICE
Bin Card
Commodity
Description
Number
Unit Expiry Date Commodity Location
Maximum Stock Re-order Emergency Order
Quantity: Quantity: Point:
From whom
Date received or Transaction Quantity Quantity Losses/ Quantity Expiry Initials
Reference Received Issued Adjustments on Hand Date
To whom issued

Stores Ledger
Commodity Number:
Description: Unit:
From whom received

or Transaction Quantity Losses/ Quantity on
Date Quantity Issued Initials
Reference Received Adjustments Hand
To whom issued
Sample Waybill
ORIGINAL
MINISTRY OF HEALTH
WAY-BILL No…
From………………………………………… To…………………………….………………
Date…………………………………………. Time despatched…………………………..
Name of Driver…………………………….. Vehicle No………………….……………….
Signature of Despatching Clerk…………………………………………………
No. Description of Load To Whom Consigned Weight
I CERTIFY THAT I have received the above loads for shipment and found them correct except as stated on the back
hereof.
Driver’s Signature……………………………… Place…………………………………………..
Date……………………………..20…………..
I CERTIFY THAT I have received the above loads and found them correct except as stated on the back hereof.
Receiver’s Signature…………………………… Place…………………………………………..
Rank…………………………………………….. Date……………………………..20…………..
N.B. – Any running stores issued at an outstation to be shown on back here

INVENTORY CONTROL CARD

Commodity
Description
Number
Unit Commodity Location
Maximum Stock Re-order Quantity: Emergency Order
Quantity: Point:
From whom
Date received or Transaction Quantity Quantity Losses/ Quantity on Expiry Initials
Reference Received Issued Adjustments Hand Date
To whom
issued

Types of stock keeping records:
Bin Cards
Bin Cards are individual stock keeping records that holds information about a
single product by lot number or batch number or expiry date. Bin cards are
kept with the products on the storeroom shelves/pallets.
Inventory Control Cards

Inventory Control Cards, which generally have one per commodity, are
sometimes kept in ledger or book form, and may be kept in the product
manager’s office
Note that smaller facilities will usually use only one type of stock keeping
record, a bin card or an inventory control card, whereas larger warehouses
may use both bin cards (kept with the products) and inventory control cards
(kept in the office).
Stores Ledgers
Stores Ledgers are a third type of stock keeping card, also kept in book form,
and usually completed by the storekeeper at the RMS.
Stock keeping records must contain at least the following data.

the balance of stock on hand at any time
losses and adjustments
Transaction Records
There are many types of transaction records, including:
packing slips
way bills
receiving reports
indent requests/requisitions
Transaction records must contain at least the following data/information:
quantity of commodity being ordered/shipped

authorization to ship/receive commodity
proof of receipt, usually by signing and dating the form

Note that transaction records typically do not include any of the essential
data elements, just the data that are related to the products being ordered,
shipped or received.
Note: Each brand and formulation of each product must be reported

separately.
Consumption Records
Consumption records by noting that consumption records can include:
daily activity registers

tick sheets
Consumption records must contain at least the following data:
dispensed-to-user data
Dispensed-to-user data can only come from the service delivery point,
where the products are actually given to the clients.
Job Aids for Assisting with the Completion of Forms
Note: Job aids are provided in the SOPs Manual to assist with completing forms.

Summary Reporting
Records versus Reports
Records are forms on which data are collected and, in general, remain in the
facility where they are recorded.
Reports are forms on which data are moved from one level in a logistics system to
another.
Six Rights of LMIS
Six Rights How the Rights Apply to LMIS

The Right Goods The right information on the LMIS forms
In the Right Quantity Enough information on the forms
In the Right Condition Accurate data
Delivered to the Right Place Sent to the next level
At the Right Time Reported at the right time (monthly, etc.)
For the Right Cost Applies to commodities when they are

donated
(personnel time, transport, and storage)

FORM B - FAMILY PLANNING RETURNS
Tick one: a. single clinic, monthly Month: District Use Only
Facility---------------------------------------------- b. clinic aggregate
c. district stores Year a. Total clinic
Subdistrict------------------------------------------ d. regional stores b. W/FP
c. %W/FP (b/a*100)
District---------------------------------------------- d. report expected
T o tal N ew A ge G ro up( Y e a rs )
A c c e pt o rs
e. report received
Region--------------------------------------------- 10 - 14 15 - 19 20-24 25-29 30-34 3 5 & A bo v e f. %reporting (e/d*100)
Report is to besubmitted Monthly to DHMT or
to RHMT with copies to relevant agency
ST OC K B A LA N C E S T O C K R E Q UIR E D C E D IS C E D IS S UB M IT T E D : A C C EP T OR S B Y M ET H OD
Unit P ric e c o lle c t e d C E D IS R E T A IN E D
BRAND NAM E 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
=
( Ins e rt
Loss /
a ppro pria t e Ending Col 3 x Quantity [Cedis] (if SDHS - DHMT - RHMT - NEW
na m e s ) MOH/GRMA/ TOTAL Couple
Issued / Transferred Balance number Required not an SDHS 50% DHMT 10 % RHMT 10% DHMT REG. CENT. ACC. ACCEPTORS
Beginning Received PPAG/CC/Priv Demostratio Col 3 x Col 9 Continuing TOTAL VISITS (from Years
Dispensed [circle one] [1+2-3-4- of months [Col 7 - MOH x Col 10 x Col 10 x Col 10 50% x Col 40% x Col 30% x Col (1st Ever
Balance ate n/ tally sheet) Protection
5] required Col 6] agency) 10 10 10 Users)
Expired
TOTAL 0 0 0 0 0 0 0
LO - FEM 0.00 0.00 0.00 0.20/cycle 0 0 0 0 0 0 0 0 0.00
OVRETTE 0.00 0.00 0.00 0.20/cycle 0 0 0 0 0 0 0 0 0.00
0.00 0.00 0.00 0.1/3pieces 0 0 0 0 0 0 0 0 0.00

MALE CONDOM
0.00 0.00 0.00 0.03/piece 0 0 0 0 0 0 0 0 0.00
FEMALE CONDOM
IMPLANTS (NORPLANT) 0.00 0.00 0.00 2.0/piece 0 0 0 0 0 0 0 0 0.00
NATURAL 0 0.00
SAMPOO (VFT)
DEPO PROVERA 0.00 0.00 0.00 0.5/dose 0 0 0 0 0 0 0 0 0.00
MICRO - G 0.00 0.00 0.00 0.20/cycle 0 0 0 0 0 0 0 0 0.00
COPPER 'T (IUD) 0.00 0.00 0.00 2.0/unit 0 0 0 0 0 0 0 0 0.00
F/STERlLIZ 0.00 0.00 0.00 10 0
VASECTOMY 0.00 0.00 0.00 10 0 0 0 0 0 0 0 0 0.00
LAM 0.00 0.00 0.00
NORIGYNON 0.00 0.00 0.00 0.5/dose 0 0 0 0 0 0 0 0 0.00
POSTINOR 2 0.00 0.00 0.00 2.0/pack 0
MICR - N 0.00 0.00 0.00 0.2/cycle 0 0 0 0 0 0 0 0 0.00
CYP Factors
Pills = 13 cycles/CYP
Condoms = 120 pieces/CYP VFTs = 120 cycles/CYP LAM = Depo Provera = 4 doses/CYP No rigyno n = 12 do ses per CYP
IUD = 3.5 CYP/insertion

Norplant = 3.5 CYP/insertion Sterilisation = 11 CYP/procedure Vasectomy = 10 CYP/procedure Natural = 2 CYP /user

Report, Requisition, Issue and Receipt Voucher
Commodities to be received during the Month of (month, year)……………………………
Facility Name:…………………….. Date: ……………………..
District: …………………….. Serial No: 0038402
Region: …………………….. Voucher No: ……………………..
Usable At or below Minimum
Last month’s Quantity to Quantity Total Item Quantity Unit Price Total Item Quantity Folio
Commodity Stock on re-order Units Unit Price
Product Consumption reach Max Ordered Price Issued at Issue Price Received Number
No: hand Quantity? Issued
A B C D E F G H=F x G I J K=I x J L M
Updated Price List
Tablets and Capsules

Acetylsalicylic Acid Tab 300mg 002769 TAB Y / N
Albendazole Tab 200mg 002762 TAB Y / N
Y / N
Y / N
Chloroquine Tab 150mg 000765 TAB Y / N
Y / N
Paracetamol Tab 500mg 000159 TAB Y / N
Oral Liquids
Chloroquine Base 80mg/5ml 001447 SYR Y / N
Y / N
Injections
Chloroquine Injection 40mg/ml 000760 INJ Y / N
Streptomycin injection 1gm 000301 VIAL Y / N
Y / N
Medical Supplies
Blood Bags (Double) 000071 PCS Y / N
Total Order Price Total Issue Price
558.50
Requisitioned by: Picked by Received by:
Name/Signature/Date Name/Signature/Date Name/Signature/Date
Reviewed by: Packed by: Verified by:
The Report, Requisition, Issue and Receipt Voucher must be completed and submitted even if no commodities are ordered. RMS needs
the Stock on Hand and consumption data included in the RRIRV.

Summary Sheet
Logistics Record and Reports: Summary
* denotes essential information
Stock Keeping Records Stock Keeping Data

Bin Cards Stock on Hand*
Inventory Control Cards Losses/Adjustments*
Stores Ledgers Issues
Receipts
Transaction Records Transaction Data

Packing Slips Quantity
Way Bills Ordered/Shipped/Received*
Receiving Reports Authorization to Ship/Use*
Proof of Receipt/Signature*
Dates for Each Transaction*
Consumption Records Consumption Data

Prescription Registers Quantity Dispensed to User *
Family Planning Daily Summary and Time Period/Dates*
Monthly Totals
Daily Activity Registers
Tick Sheets/Logs
Treatment/Dispensing Registers
Summary Data
Summary Reports Quantity Dispensed to User*
Family Planning Returns Stock on Hand*
Report, Requisition, Issue and Receipt Losses/Adjustments*
Voucher

Session 3:
LMIS Completing Bin Card

Bin Card Exercise, Part 1
Starting a New Bin Card
Today is January 7, 2008 and you are starting new Bin Cards for the health
commodities at Fortuna Health Center in Manya Krobo District in Eastern Region.
The previous Bin Cards are full.
Start new Bin Cards for the following commodities:
a. Amoxicillin 250 mg capsules, CMS commodity number 002770 TAB, last balance
from the previous Bin Card is 200 capsules, which have an expiry date of July
2009. This commodity is stored on shelf 3.
b. Streptomycin 1 gm. vials, CMS commodity number 000301 VIAL, last balance
from the previous Bin Card is 20 vials, which have an expiry date of September
2008. This commodity is stored on shelf 10.
c. Paracetamol 500 mg tablets, CMS commodity number 000159 TAB, last balance
from the previous Bin Card is 400 tablets, which have an expiry date of
December 2008. This commodity is stored on shelf 4.
Note: The commodity numbers in the exercise are illustrative and are not the
true CMS commodity numbers.

Bin Card Exercise, Part 2
Instructions:
Record the following transactions on the Amoxicillin 250 mg. capsules Bin Card.
8 January 2008 Issued 100 capsules to the dispensary with an expiration date
of 7/2009 using voucher 01/DS/D/01.
23 January 2008 Received 400 capsules from RMS on voucher RMS/08/12 with
an expiration date of 10/2009.
30 January 2008 Stocktaking indicated 500 capsules in stock.
5 February 2008 Issued 100 capsules to the dispensary with an expiration date
13 February 2008 Issued 200 capsules to the dispensary with an expiration date
20 February 2008 Received 400 capsules from RMS on voucher RMS/08/36 with
27 February 2008 Stocktaking indicated 580 capsules in stock. No known reason
for discrepancy.
4 March 2008 Issued 300 capsules to the dispensary with an expiration date
19 March 2008 Received 300 capsules from RMS on voucher RMS/2008/67

with an expiration date of 4/2010.
26 March 2008 Stocktaking indicated 580 capsules in stock.
8 April 2008 Issued 200 capsules to the dispensary with an expiration date
16 April 2008 Issued 200 capsules to the dispensary 80 with an expiration

date of 10/2009 and 120 with an expiration date of 4/2010 using
voucher 04/DS/D/12.
23 April 2008 Received 500 capsules from RMS on voucher RMS/08/88 with
30 April 2008 Stocktaking indicated 680 capsules in stock, 100 of which were
damaged by water which seeped into a cracked bottle.
6 May 2008 Issued 300 capsules to the dispensary with an expiration date
21 May 2008 Received 200 capsules from RMS on voucher RMS/08/101 with
28 May 2008 Stocktaking indicated 480 capsules in stock.

3 June 2008 Issued 200 capsules to the dispensary with an expiration date
of 4/2010 using voucher 06/DS/D/01
25 June 2008 Received 300 capsules from RMS on voucher RMS/08/122 with

Bin Card
Commodity
Description
Number
From whom
To whom issued

Instructions:
Record the following transactions on the Streptomycin 1 gm. Vials Bin Card.
9 January 2008 Issued 15 vials to the dispensary with an expiration date of

9/2008 using voucher 01/DS/D/02.
23 January 2008 Received 50 vials from RMS on voucher RMS/08/12 with an

expiration date of 1/2009.
30 January 2008 Stocktaking indicated 55 vials in stock.
6 February 2008 Issued 20 vials to the dispensary, 5 vials with an expiration date
of 9/2008, the rest with 1/2009 using voucher 02/DS/D/03.
14 February 2008 Issued 20 vials to the dispensary with an expiration date of

20 February 2008 Received 50 vials from RMS on voucher RMS/08/36 with an

27 February 2008 Stocktaking indicated 65 vials in stock.
5 March 2008 Issued 30 vials to the dispensary with an expiration date of

19 March 2008 Received 50 vials from RMS on voucher RMS/08/67 with an

26 March 2008 Stocktaking indicated 85 vials in stock.
9 April 2008 Issued 40 vials to the dispensary with an expiration date of

17 April 2008 Issued 25 vials to the dispensary with an expiration date of

23 April 2008 Received 50 vials from RMS on voucher RMS/08/88 with an

30 April 2008 Stocktaking indicated 70 vials in stock.
7 May 2008 Issued 40 vials to the dispensary, 20 with an expiration date of

1/2009, 20 with an expiration of 6/2009 using voucher
05/DS/D/04.
21 May 2008 Received 25 vials from RMS on voucher RMS/08/101 with an

28 May 2008 Stocktaking indicated 55 vials in stock.
4 June 2008 Issued 40 vials to the dispensary with an expiration date of

25 June 2008 Received 50 vials from RMS on voucher RMS/08/122 with an


Bin Card
Commodity
Description
Number
From whom
To whom issued

Instructions:
Record the following transactions on the Paracetamol 500 mg tablets Bin Card.
10 January 2008 Issued 200 tablets to the dispensary with an expiration date of
23 January 2008 Received 1000 tablets from RMS on voucher RMS/08/12 with
30 January 2008 Stocktaking indicated 1200 tablets in stock.
7 February 2008 Issued 500 tablets to the dispensary, 200 with an expiration
date of 12/2008, the rest with an expiration date of 6/2010 using
voucher 02/DS/D/04
19 February 2008 Issued 500 tablets to the dispensary with an expiration date of
20 February 2008 Received 500 tablets from RMS on voucher RMS/08/36 with an
27 February 2008 Stocktaking indicated 700 tablets in stock.
6 March 2008 Issued 500 tablets to the dispensary with an expiration date of
19 March 2008 Received 500 tablets from RMS on voucher RMS/08/67 with an
26 March 2008 Stocktaking indicated 600 tablets in stock. 100 tablets missing.
10 April 2008 Issued 500 tablets to the dispensary with an expiration date of
18 April 2008 Issued 100 tablets to the dispensary with an expiration date of
23 April 2008 Received 1000 tablets from RMS on voucher RMS/08/88 with
30 April 2008 Stocktaking indicated 1000 tablets in stock.
8 May 2008 Issued 500 tablets to the dispensary with an expiration date of
21 May 2008 Received 1000 tablets from RMS on voucher RMS/08/101 with
28 May 2008 Stocktaking indicated 1500 tablets in stock.
5 June 2008 Issued 600 tablets to the dispensary with an expiration date of
25 June 2008 Received 500 tablets from RMS on voucher RMS/08/122 with

Bin Card
Commodity
Description
Number
From whom
To whom issued

Session 4:
LMIS: Completing the Worksheet

Completing the Worksheet exercise
Instructions
Using the Job Aid Completing the Worksheet for Setting Maximum and Re-order
Quantities in the SOP manual, you will be using the blank Worksheet below and the
Bin Cards you completed in the Bin Card session to determine the maximum stock
quantity, re-order quantity and the emergency order point for three commodities you
were working within the exercise.
Please follow the instructions as given by the Instructor or Tutor.

Worksheet for Setting Maximum Stock and Re-order Quantities
(to be completed every six months)
Facility Name: District: Region:
A B C D E
Total Average Monthly Maximum Stock Re-Order Emergency
Product Dispensed Past Consumption Quantity Quantity Order Point
6 Months =A/6 =Bx3 =C/2 =D/3
Acetylsalicylic Acid Tab 300mg 3420
Albendazole Tab 200mg 1580
Amoxicillin Cap 250 mg
Artesunate + Amodiaquine Tab 50/153 mg (6+6 Tab
360
Blister Pack)
Chloroquine Tab 150 mg 1200
Metronidazole Tabs 200 mg 280
Paracetamol Tab 500mg
Oral Liquids
Chloroquine Base 80 mg/5ml 20
Amoxicillin suspension 125mg/5ml, 100ml 240
Injections
Chloroquine Inj. 40mg/ml 80
Streptomycin Inj.1gm
Benzathine penicillin Inj 2.4mu 120
Medical Supplies
Blood Bags (double) 20
Copy the Maximum Stock Quantity, Re-order Quantity and Emergency Order Point in the appropriate box on the Bin Card
for each product.
Completed Title: Date:
by:
Verified by: Title: Date:

Session 5:
LMIS: Completing the RRIRV

Completing the RRIRV
Using the Job Aid; Preparing the Requisition Portion of the Report, Requisition, Issue and
Receipt Voucher in the SOP manual as directed by the Tutor, preparing the RRIRV that you
find below using the job aid to help you.
Note that some of the information for the commodities has been filled in already for you.
Prepare the RRIRV for the same health facility as in the previous exercises.
To complete the top part of the RRIRV, use the following information:
Information for RRIRV
Month of: July 2008
Facility Name: Fortuna Health Center
District: Manya Krobo
Region: Eastern Region
Date: 26 June 2008
Voucher: FHC/08/07

Report, Requisition, Issue and Receipt Voucher
Commodities to be received during the Month of (month, year)……………………………
Facility Name:…………………….. Date: ……………………..
District: …………………….. Serial No: 0038402
Region: …………………….. Voucher No: ……………………..
Usable At or below Minimum
Last month’s Quantity to Quantity Total Item Quantity Unit Price Total Item Quantity Folio
Commodity Stock on re-order Units Unit Price
Product Consumption reach Max Ordered Price Issued at Issue Price Received Number
No: hand Quantity? Issued
A B C D E F G H=F x G I J K=I x J L M
Updated Price List

Acetylsalicylic Acid Tab 300mg 002769 TAB 600 560 Y / N 1000 .15
Albendazole Tab 200mg 002762 TAB 285 350 Y / N 500 .10
Amoxicillin Cap 250mg 002770 CAP Y / N 500 .15
Artesunate + Amodiaquine Tab 50/153 mg 002778 TAB
70 64 Y / N 20 .45
(6+6 Tab Blister Pack)
Chloroquine Tab 150mg 000765 TAB 200 450 Y / N 1000 .10
Metronidazole Tab 200mg 001105 TAB 50 60 Y / N 100 .34
Paracetamol Tab 500mg 000159 TAB Y / N 1000 .02
Oral Liquids
Chloroquine Base 80mg/5ml 001447 SYR 6 8 Y / N 10 1.15
Amoxicillin suspension 125mg/5ml, 100ml 001448 SYP 42 50 Y / N 10 .65
Injections
Chloroquine Injection 40mg/ml 000760 INJ 15 20 Y / N 10 2.50
Streptomycin injection 1gm 000301 VIAL Y / N 10 4.00
Benzathine penicillin Injection 2.4mu 000760 INJ 18 45 Y / N 10 4.50
Medical Supplies
Blood Bags (Double) 000071 PCS 0 10 Y / N 5 5.00
Total Order Price Total Issue Price
Requisitioned Received
by: Picked by by:
Reviewed by: Packed by: Verified by:

Session 6: Storage of Health Commodities

The Purpose of Storage
The purpose of storage is to protect the quality of the product and its
packaging throughout the supply chain and make the product available
for distribution.
In order to accomplish this there are some key storage activities which
include:
Material receiving and incoming inspection – this activity occurs

during the unloading of vehicles and includes visual inspection of
delivered packages to insure nothing was damaged in transit.
Put away – this process includes moving products from where they
are received and assigning them to their designated storage area.
Picking and packing – to fill shipping requests, products must be

located, pulled from inventory, and prepared for shipment. This
activity also requires correct labeling.
Shelf Life
Shelf life is the length of time from manufacturing date to the
final date a product can be safely used, or the length of time that
product can be stored without affecting its usability, safety,
purity, or potency.
Which of the following statements about shelf life is not true?

(Circle your answer)
a. Each commodity has a specified shelf life and that similar

products may have different shelf lives if they are produced by
different manufacturers
b. A manufacturer determines shelf life by making assumptions

related to the conditions under which the product will be stored
or shipped, such as temperature, humidity, etc., and then
conducts time and quality studies, over several years
c. A joint committee of doctors and pharmacist may determine the

shelf life of products within their health facility
d. Countries may have policies that reduce shelf lives if they know
that conditions make it difficult to adhere to the manufacturer’s
assumptions

Guidelines for Proper Storage for Health Commodities
See: Storage Procedures in the SOPs Manual.
Routine Visual Inspection
When to inspect health commodities

Health commodities should be inspected:
every time products are received from the manufacturer (usually

at the central level)
each time the warehouse or clinic receives supplies
when conducting a physical inventory dispensing products to a
client
when issuing products from one level to another
when investigating complaints
when supplies are about to expire
when supplies show signs of damage
when products have been kept under improper storage
conditions
Visual inspection is done each time we come in contact with the

products (physical inventory, issuing, receiving) or each time we
suspect that there is a problem with the quality of our products.
What to look for in a routine visual inspection
package and product integrity: check for damage to packaging

and products.
manufacturing defects: incomplete supply, missing or illegible
identification information.
labeling: make sure that products are labeled with date of
manufacture or expiration, lot number and manufacturer's name
missing contents: such as a bottle of chase buffer missing from
an HIV test kit; litmus paper missing from a lab kit.
presence of foreign matter inside unit package
Color, smell, consistency changes

Visual Inspection Exercise
In pairs, read the “What to look for” column and match with the corresponding
“What to do about it”. You have ten minutes to complete this exercise.
What to look for What to do about it
Damage to packaging (tears, Ensure that lot number, manufacturer’s name, and product storage
perforations, water or oil stains,
or other damage) and products requirements are recorded on bin cards and storage labels. If expiration
(such as broken or crumbled A dates are not visible, open outer carton and check dates on inner boxes. If
pills or tablets or torn packets of expiration dates are not visible on inner boxes, check individual units. Use a
condoms or IUDs) large marker to write the expiration date on unmarked boxes and cartons.
Information on boxes or cartons Visually inspect all products. Remove any product that appears damaged or
is illegible B unacceptable.
Missing products or empty

boxes C Discard any damaged items and distribute the remainder as normal.
Unlike torn or dirty cartons, holes or frayed edges may be the result, not of
Cartons unlabeled with the date handling, but rather of pests. Check boxes for signs of termite damage and
of manufacture or expiration on D rats, which are attracted to pills. Inspect inner boxes and products for
outer and inner packaging mechanical damage, remove any damaged products, and destroy them
according to established procedures. Distribute the remainder as normal.
Check expiration date on cycle or carton. If expired, destroy according to

established procedures. If within the shelf life, check to see if any storage
Products found outside the history is available. If ideal conditions probably have been followed, remove
warehouse or clinic E any broken or crumbled cycles/tablets. Remove any dried-out or discolored
condoms and condoms with broken packaging. Destroy these as
appropriate. Distribute remainder as normal.
Check inner boxes or products and write on outside of box; distribute

Contents not identified on normally. If information is illegible due to exposure to water or chemicals,
multiple unit cartons F thoroughly inspect product for damage. If you are unsure that no damage
has occurred, quarantine supplies for testing or destruction.
Check the product visually for mechanical damage. Remove any damaged
Dirty, torn, or otherwise products and destroy according to established procedures. Distribute the rest
damaged boxes G
as normal.
Oral contraceptives and

spermicidal tablets: Changes Open box and check contents. If contents all have the same product and the
in color of pills or crumbling same expiration date (and lot number, if possible), write information on outer
under pressure of a finger box. If contents are mixed, separate and repackage according to product
H type, brand, expiration date, and lot number. Visually check for damage.
Condoms: Lubricant has dried or Remove any damaged products and destroy according to established
changed color and/or the procedures. Distribute the rest as normal.
condom is broken
Cartons with holes and/or frayed This may indicate pilferage, removal by upper level, or removal by a donor
edges I for testing. Notify upper level about missing stock.
All such products will almost certainly have been affected by the elements.
Any product left outside for almost any amount of time will probably be
Water-damaged cartons J damaged from moisture, rain, direct sunlight, and/or pests and should be
destroyed according to established procedures.

Session 7: Maximum-Minimum
Inventory Control Systems

Inventory Control Systems
Definition of an Inventory Control System
A process for keeping track of products, objects, materials or commodities.
Purpose of an Inventory Control System
To determine when stock should

be ordered/issued
To determine how much stock
should be ordered/issued
To maintain an appropriate
stock level of all products, avoiding shortages and oversupply.
Key Terms in Inventory Control
Max stock level/max quantity: the level of stock above which inventory
levels should not rise. It should be expressed in “months of stock” and
indicates how long supplies will last.
Min stock level/min quantity: the level of stock at which inventory should be
replenished. It should be expressed in “months of stock.”
Review period: the time scheduled to examine stock levels and determine if
additional stock is needed.
Review period stock: the amount of stock that is dispensed during the
review period.
Safety stock level: an additional buffer, cushion or reserve stock kept on

hand to protect against stockouts caused by delayed deliveries, increased
demand etc.
Lead time stock level: the level of stock used between the time new stock is
ordered and when it is received and available for use.
Emergency Order Point (EOP): the level of stock that triggers an immediate
emergency order.

Versions of Max-Min Inventory Control Systems
Forced Ordering version – the trigger for ordering is the end of the
review period
Continuous Review version – the trigger for ordering is when the
facility reaches the minimum level
Standard version – the trigger for ordering is the end of the review
period for stocks that are at or below minimum
Each version has advantages and challenges.
Forced Ordering Version of Max-Min
Decision Rule
Review all stock levels at the end of each Review Period. Order or issue
enough stocks to bring the stock levels up to Max.
If the stock level for any item falls below the Emergency Order Point before
the end of the Review Period, place an emergency order.
Advantages and Challenges
Advantages
Very simple decision rule – order to max at the end of every review
period; no need for constant stock assessment
Because orders are placed are regular intervals, transportation can be
schedule for specific times which make ensuring transport easier
Every facility orders or is resupplied at the end of every review period
Can control/monitor the submission of reports (all facilities should be
reporting/ordering every review period).
Challenges
Some orders for small quantities of some products (you always order
everything, even if you've used only a little of your stock).
Forced Ordering – Delivery Truck Variation

Delivery Truck Variation of Forced Ordering is simply this: the delivery truck
visits each facility at the end of each review period, say monthly or quarterly,
looks to see how much stock is on hand, and tops the facility up to its Max.

The decision rule for the Delivery Truck Variation is exactly the same as
with the “normal” variation of Forced Ordering: at the end of the Review
Period.
Advantages
Min (and Max) will be lower, because Lead Time is zero
You can put expired or damaged product back on the truck to be taken for
disposal
You can collect your LMIS reports on the spot to take back, and help local
staff complete them if they are having trouble
Training requirements are much less significant
If a supervisor goes along with the truck you can accomplish many other
supervisory and training activities at the same time as commodities are
being delivered
Challenges
If the delivery schedule is unreliable, Safety Stocks will have to be set
higher
If the truck breaks down the whole system breaks down, so the
emergency order procedures should include some kind of backup
transportation scheme.
Sufficient number of staff must be available in the office to complete
logistics mgmt. and other duties while team leaders are away making
deliveries.
The system may require larger trucks as trucks must carry more stock
than they will deliver.
Continuous Review Max-Min
Decision Rule
Review the stock level for each item every time an issue is made. If the
stock level is at or has fallen below Min, order enough stock to bring
the level up to Max.

Advantages
The storekeeper's decision rule is simpler

The system is more responsive and flexible, since orders can be placed
any time.
Small orders are eliminated because stock levels are at a min when an
order is place.
Challenges
There is no ability to control transportation, since orders are placed any

time: a single facility might order pills today, condoms tomorrow, and
ARVs next week.
In facilities where there is a great deal of activity, the storekeeper's job is
harder because the conversion from quantity to months of stock must be
made every time stock is issued.
Continuous Review – Two-Bin Variation

In this variation, each facility is given two cartons or boxes or other “bins” of
each product, and staff are told to issue or dispense from the first carton until
it is empty, and then to simultaneously start issuing from the second carton
and order a new carton.
Advantages
With the Two Bin system no record keeping or calculations are

required at the lower level. (The tutor can mention that this might be
the case for Community Based Distribution programs and commercial
retail sales programs.)
Challenges
Deciding how “big” the bins are.

Adjusting bin sizes based on increased consumption.

Standard Version of Max-Min
Decision Rule
Review all stock levels at the end of each Review Period. For
products which are at or have fallen below Min, order enough
stock to bring stock levels up to Max.
If the stock level for any item falls below the Emergency Order Point
before the end of the Review Period, place an emergency order.
Advantages
Small orders are avoided (you only order when you actually need more
stock.) This is a big advantage in a program that manages e.g., 150
products or more.
In programs with many products, standard systems eliminate the need
to assess stock status continually (as in continuous review) and to
reduce the number of calculations that must be made because fewer
products will be ordered or issued than in forced-ordering.
Because orders are placed at regular intervals (i.e. end of each review
period), transportation can be schedule for specific times, making it
easier to ensure the availability of transport resources.
Challenges
Min is higher, Max is higher, and the pipeline is longer, especially if the
review periods are long. This can lead to increased costs, require
more storage and result in expiry.
Storekeepers must learn the max, min and EOP; know how to assess
stock status; and be able to calculate the order or issue quantity. More
training will be required.
Order or Issue Quantity Formula
max stock quantity*

– stock on hand
– quantity on order
= Order or issue quantity
*Note: max stock quantity =

Average Monthly Consumption (AMC) times Max Stock Level

Max-Min Inventory Control Exercise 1
Forced Ordering Maximum-Minimum Inventory Control
Using the formula on how to determine order quantity on page 43 of this

syllabus and the data given below, calculate the quantity of Brand X condoms
to order if the maximum stock level for Brand X is 5 months and an
emergency order point of 1 month. One case of 3000 condoms was ordered
and has not yet been received. Use an average of the last 3 months data for
your calculations.
Brand X Condoms Balance of Brand X on hand

Dispensed-to-Users October 1, 2014 is 2335 pieces.
September 10 2508
October 10 3000
November 10 2778
December 10 2178
January 11 2552
February 11 2240
March 11 2846
April 11 2530
May 11 2478
June 11 2612
July 11 2108
August 11 2868
September 11 2424

Max-Min Inventory Control Exercise 2
Forced Ordering Maximum-Minimum Inventory Control
Using the formula on how to determine order quantity on page 43 of this

syllabus and the data given below, calculate the quantity of ARVs to order if
the maximum stock level for ARVs is 4 months and an emergency order point
of 1 month. Use an average for your calculations.
ARV ARV
Dispensed-to-Users October 1, 2014 is 16548 pieces.
June 11 12112
July 11 12058
August 11 13254
September 11 12859

Session 8:
Assessing Stock Status

Assessing Stock Status
In assessing stock status we turn data and numbers (absolute) into
information we can use for determining how long our stock will last (relative).
Formula for Assessing Stock Status
Stock on Hand
Months of Stock
Average Monthly =
Consumption On Hand
(Quantity Dispensed-to-users)
The data and numbers need for this formula are the stock on hand at the time
that the calculation is being made and the average monthly consumption for
the product.
Stock on Hand data
Stock on hand data can be obtained from physical inventories or from stock
records that are complete and up to date.
Definition of Physical Inventory
A physical inventory is the process of counting by hand the total

number of units of each commodity in your store or health facility at
any given time.
Purpose of Physical Inventory
The purpose of a physical inventory is to compare actual stock on

hand for each commodity with the amount recorded on the stock card.
When to Conduct a Physical Inventory
Physical inventories should be conducted at least once a year for

large facilities and more often for smaller ones – typically once a
month for service delivery points
Physical inventories should be done more frequently than once a
year if discrepancies between actual balance on hand and the
balance listed on the stock records are frequently found.

Average Monthly Consumption Data
Average Monthly Consumption data are obtained from consumption records
To ensure that our stock status calculation is accurate we use an average

consumption of three months. It is the sum of the last three months of
consumption data divide by three.
Rounding Rules for AMC and MOS
AMC Rounding:
In dispensing a product to a customer you do not give them a part of a
cycle, or other product. For AMC you always round up to the nearest
whole number. Example: 3.73 is rounded to 4; also 2.26 is also
rounded up to 3.0
MOS Rounding:
In MOS calculations round up or down to one point after the decimal.
Example: 2.48 equal 2.5 also 2.44 equals 2.4 Note: normal
mathematics rounding rules apply here. 0.4 round down, 0.5 round up.
Formula for Assessing Stock Status: Example
Stock on Hand
Months of Stock
Average Monthly =
Consumption On Hand
(Quantity Dispensed-to-users)
Assume that the stock on hand is 4,300 units

(determined by a physical inventory).
Assume that the average monthly consumption is 1,300 units

(determined from consumption records).
Divide 4,300 by 1,300 and get 3.3.
As a result of this calculation we know that the current stock on hand

will last for 3.3 months, if the consumption rate remains the same.
4,300 = 3.3 Months of Stock on Hand

1,300

Assessing Stock Status for a Treatment Regimen
Some commodities are dispensed in combination with others. For instance,
HIV regimens can include a combination of three drugs: 3TC, d4T and AZT.
There must be sufficient quantities of all three drugs in stock in order to have
sufficient quantities to dispense the treatment.
For instance, if there are 3.4 months of stock of 3TC, 3.3 months of stock of
d4T, and 1.4 months of stock of AZT, there is really only 1.4 months of stock
for this regimen since patients cannot be treated without all three drugs being
available.
When to assess stock status

Stock status should be assessed:
1. Regularly, generally according to how often products are being ordered.
2. For new programs, we might choose to assess stock status more

frequently, to ensure that rapid increases in consumption are not missed
and so that stocks can be replenished before stockouts.
3. Monthly – even if you only report or order quarterly, you should assess
stock status more often to ensure that you are not at risk of a stockouts.
4. During quantification exercise.

Assessing Stock Status Exercise
Exercise 1: Calculating Months of stock on Hand at

clinic level
Instructions: In these exercises, you are given the SOH, but you have to first
calculate the AMC to find your MOS.
The first three are done for you as examples. Round the AMC numbers up to
the next whole number and MOS to one number after the decimal point as
before. Check your calculations twice.
Be ready to defend your answers when your Lecturer asks you to compare
your answers with the answers of other students.
RECENT WHAT IS SOH AT FACILITY WHAT IS WHAT IS

MONTLY AMC? (Total of all TOTAL MOS?
CONSUMPTION testing sites) SOH?
Oct Nov Dec

Ex. 18 15 19 18 7 6 3 16 0.9
Ex. 457 415 440 438 - 442 111 553 1.3
Ex. 54 67 78 67 - - 234 234 3.5
1. 152 208 239 69 949 219
2. 483 444 396 396 1299 400
3. 13 0 17 100 - -
4. 585 629 703 177 349 545
5. 283 199 263 - 989 -
6. 19 12 17 15 - -
7. 116 135 249 217 589 -
8. 873 905 789 370 532 -
9. 287 40 16 104 - 15
10. 198 203 256 21 34 12
62
Exercise 2: Assessing Stock Status at District Level
SITUATION:
You are Ama, District Pharmacist for Hohoe District. There are three health
centres in your district: Akpafu Odomi, Alavanyo Wudidi and Have.
It is July 6, 2013 and you must calculate the stock status of Doxycycline and
Erythromycin for your health centres, as well as the district, as of June 30,
2013. Use a 3 month average, as appropriate.
ATTACHED YOU WILL FIND:
 Twelve (12) completed Health Centre Monthly Reports for the months of
March 2013, April 2013, May 2013 and June 2013
 District pharmacy inventory control cards for Doxycycline and erythromycin
INSTRUCTIONS:
Enter your calculations in the appropriate columns below:
63
1. Doxycycline
Akpafu Odomi
Stock on Consumption
Date Hand this month
April 30, 2013

AMC for June 30 MOS for June 30
May. 31, 2013
June 30, 2013
Alavanyo Wudidi
April 30, 2013

May. 31, 2013
June 30, 2013
64
Have
April 30, 2013

May. 31, 2013
June 30, 2013
Hohoe District
Stock on Stock Consumptio
Hand on n this
Date (District Hand month
pharmacy) (Clinics)
April 30, 2013 AMC for June
30, 2013
May. 31, 2013 MOS for June MOS for June

30, 2013 30, 2013
(District Only) (District +
Clinic)
June 30, 2013
65
2. Erythromycin
Akpafu Odomi
April 30, 2013

May. 31, 2013
June 30, 2013
Alavanyo Wudidi
April 30, 2013

May. 31, 2013
June 30, 2013
66
Have
April 30, 2013

May. 31, 2013
June 30, 2013
Hohoe District
Stock on Stock Consumptio
Hand on n this
Date (District Hand month
pharmacy) (Clinics)
April 30, 2013 AMC for June 30,
2013
May. 31, MOS for June 30, MOS for June

2013 2013 30, 2013
(District + Clinic)
(District Only)
June 30,
2013
67
MONTHLY REPORT & REQUEST FORM
District: Hohoe Facility: Akpafu Odomi
Other:
Report for: Month March Year 2013
Product Beginning Received Dispense Losses/ Ending Quantity

Balance This d/ Adjust- Balance Needed
Month Issued ments
Doxycycline 230 100 110 220
Erythromycin 265 90 130 225
Submitted: Kofi Mensah Explanation of losses:
Date: April 2, 2013
Fac
Other:
Report for: Month April Year 2013

Month Issued ments

Date: May 3, 2013
68
Facili
Other:
Report for: Month May Year 2013

Month Issued ments
Date: June 4, 2013
District: Hohoe District Facility: Akpafu Odomi
Fac
Other:
Report for: Month June Year 2013

Month Issued ments

Date: July 2, 2013
69
District: Hohoe Facility: Alavanyo Wudidi
Fac
Other:

Month Issued ments
Submitted: Afwa Serwah Explanation of losses:
Date: April 2, 2013
Other:

Month Issued ments

Date: May 3, 2013
70
Other:

Month Issued ments

Date: June 4, 2013
Other:

Month Issued ments
271
Doxycycline 245 170 144

Date: July 2, 2013
71
District: Hohoe Facility: Have
Facility type:
Other:

Month Issued ments

Submitted: Johnnie Kwesi Explanation of losses:
Date: April 2, 2013
Other:

Month Issued ments

Date: May 3, 2013
72
Facility type
Other:

Month Issued ments

Date: June 4, 2013
Other:

Month Issued ments

Date: Juky 2, 2013
73
Commodity Number: Description: Doxycycline
Unit: 100mg tablets Maximum Stock: Minimum Stock: Location:
6 months 3 months Hohoe District
Transaction Quantity Quantity Losses/ Quantity Quantity on Order
Date Reference Received Issued Adjustments on Hand
11 March Akpafu Odomi 100 1020

2013 HC
11 March Alavanyo 150 870
2013 Wudidi HC
11 March Have HC 50 820
2013
28 March District Store 1200 2020
2013
30 March Physical 2020
2013 Inventory
9 April Akpafu Odomi 100 1920

2013 HC
9 April Alavanyo 160 1760
2013 Wudidi HC
9 April Have HC 170 1590
2013
30 April Physical 1590
2013 Inventory
13 May. Akpafu Odomi 125 1465

2013 HC
13 May. Alavanyo 150 1315
2013 Wudidi HC
14 May. Have HC 160 1155
2013
31 May Physical 1155
2013. Inventory
7 June. Akpafu Odomi 100 1055

2013 HC
10 June. Alavanyo 170 885
2013 Wudidi HC
24 June. District Store 1200 2085
2013
28 June Physical 2085
2013 Inventory
74
Commodity Number: Description: Erythromycin
Unit: 250mg tablets, 1000 tablets Maximum Stock: Minimum Stock: Location:
per tin 6 months 3 months Hohoe District
Transaction Quantity Quantity Losses/ Quantit Quantity on
Date Reference Received Issued Adjustm y on Order
ents Hand
11 March Akpafu Odomi HC 90 1050
2013
11 March Alavanyo Wudidi 130 920
2013 HC
11 March Have HC 100 820
2013
28 March. District Store 1000 1820
2013
30 March. Physical 1820
2013 Inventory
9 April 2013 Akpafu Odomi 140 1680

HC
9 April 2013 Alavanyo Wudidi 100 1580
HC
9 April 2013 Have HC 100 1480
30 April 2013 Physical 1480
Inventory
13 May. 2013 Akpafu Odomi HC 130 1350
13 May. 2013 Alavanyo Wudidi 140 1210
HC
14 May. 2013 Have HC 100 1110
31 May 2013 Physical 1110
Inventory
7 June. 2013 Akpafu Odomi 120 990

HC
10 June. 2013 Alavanyo Wudidi 100 890
HC
10 June. 2013 Have HC 120 770
24 June. 2013 District Store 1000 1770
28 June 2013 Physical 1770
Inventory
75
76
Session 9:
Facilities, Staffing and Procurement

Logistics Roles by Level of Health Facility
Logistics Roles: Health Facility Level
Requisition the products that are needed to treat patients

Provide the RMS with the information it needs to fill the orders
Once the ordered products are received at facility, store them until
issued to service providers
Dispense the products to the patients
Logistics Roles: District Level
Review health facility requisition quantities

Transmit requisitions to the RMS
Assist facilities to process their payment cheques
Follow up to ensure that payments are sent to the RMS
Assist facilities with discrepancies or other problems with received
commodities
Logistics Roles: Regional Level
Provide price lists to facilities

Set the schedules for commodity deliveries and related activities
Deliver commodities to facilities
Work with facilities and districts to resolve discrepancies
Collect, collate and distribute commodity data that are needed for
decision-making by stores managers and program personnel at various
levels
Logistics Roles: Central Level
Procurement and Stores Division (PSD) supervises and guides:

o Storage and distribution functions (delegated to the CMS)
o Procurement (delegated to the Procurement Unit)
o All activities on the lower levels of the system
Logistics Roles: Multiple Levels
Re-order commodities from their suppliers

Perform inventory control to manage their stocks
Monitor the condition of commodities in the stores

Activity 1 Logistics Roles/Responsibilities by Health System
Level
Identify which level of the health system is responsible for the duties described in
each statement below Use the table on “Functions and Areas of Responsibility
by Level” in the SOPs Manual to find the answers.
1. Compiles health facility logistics data; aggregates logistics data with regional data
and forwards to central level.
2. Assures on-going staff development based on nationally identified need.
3. Conducts regular quality checks of health facility stocks during supervision visits
and ensures that health facilities follow procedures governing unusable
commodities.
4. Monitors and assures health facilities are adhering to established inventory control
procedures.
5. Orders all products based on the essential drugs list and standard treatment
guidelines defined by the central level.
6. Procures from international, national and local sources.
7. Solicits and reviews client feedback to gauge client satisfaction.
8. Reports stock on hand, dispensed-to-user, average monthly consumption and

order quantities using centrally produced reports and forms and using centrally
defined procedures.

Activity 2: Roles and Responsibilities: Health System Staff
Instructions: In group of 2-4 people, match each of the logistics activities below with
the most likely staff person responsible for that activity. Write the number of the
activity in the column to the left of the corresponding staff person.
Activity Staff
1. 1. Reviews orders from dispensaries, health o Facility in-charge

centres and district hospital and submits them
to the District Health Administration (DHA) for
authorization.
2. 2. Reviews/authorizes quarterly reports/orders o Procurement and

for the health facility. o Supplies Division (PSD)
3. 3. Conducts physical inventory at specified RMS

times.
4. 4. Compiles annual forecasts of supplies District Pharmacist

needed nationally based of facility and program
data and works with CMS to ensure timely
procurement of supplies.
5.
6. 5. Receives and stores medicines and related o Warehouse Manager
supplies following the recommended
procedures and guidelines.
7. 6. Procures medicines, medical supplies and Dispenser/Store In-Charge

equipment; stores and delivers supplies for
dispensaries or health centres.
8.
Sample Logistics Roles and Responsibilities of Staff
Health Facility: Center or Clinic

Dispenser:
o To keep and record consumption data after dispensing to
clients/patients.
Store keeper:
o To store medicines according to the guidelines
o To receive and issue medicines to various sections
o To conduct physical inventory and visual inspection routinely
o To record and keep storekeeping and transaction records
o To prepare quarterly report and requisition
Health Facility’s In-Charge:

o To request and approve the facility’s order before submitting
to the district for review
o To oversee and ensure quality of data and storage of health
commodities at the facility is up to standards.
Health Facility: Hospital

Pharmacist In-Charge
o To keep and record consumption data after dispensing to
clients/patients
o To store medicines according to the guidelines
o To receive and issue medicines to various
sections/departments
o To conduct physical inventory and visual inspection routinely
o To record and keep storekeeping and transaction records
o To prepare quarterly report and requisition form for all
managed commodities
(Some of the tasks are usually delegated to junior pharmacists or other

pharmaceutical personnel).
Medicines Therapeutic Committee:
o To review hospital order before being approved by Hospital
In-Charge
o To recommend which additional commodities should be
bought from RMS using additional funds
o To review and recommend for approval for buying health
commodities from other sources when they are unavailable at
the RMS
Supplies Officer:
o To procure health commodities from other sources apart from
RMS
Hospital In-Charge (Director/Medical Officer In-Charge) :
o To review and approves the hospital’s order before
submitting to RMS
o To approve buying from other sources apart from RMS
o To submit additional funding request to the health committee
o To appoint members of medicine therapeutic committee
o To oversee and ensure quality of data and storage of health
commodities at the hospital is up to standards

District Level:
Pharmacists
o To review orders from health centres other peripheral
facilities before submitting to (RMS)
o To assist the health facilities to process their payment
cheques
o To facilitate distribution of consignments from RMS to health
centres and other periphery outlets in districts where there is
no direct delivery from the RMS
o To provide support supervision to health facilities
Other District Health Management Team members:

o To provide routine support supervision to health facilities
together with district pharmacist in all aspects of health
services provision
Regional Level:
RMS staff
o To procure, store and distribute medicines and other health
commodities not available from the CMS
o Provides price lists to the health facilities
o Sets the schedules for commodity deliveries and related
activities
o Delivers health commodities to the health facilities
o Works with the health facilities and the district to resolve any
discrepancies
o Collects, collates and distributes the health commodity data
are needed for decision-making by stores managers and
program personnel at various levels of the system
o Regional level program focal persons send reports to central
level
Central Level:
CMS staff:
o To procure, store and distribute medicines and other health
commodities to RMS’s
o To receive, pack and deliver RMS’s orders
o To prepare and disseminate reports to PSD and SSDM and
price list to RMS

o To send financial reports regarding facility’s account
balances to respective facilities
o To distribute LMIS tools
o Carry out quantification together with other stakeholders
Program managers:
o To provide programmatic inputs during quantification of
program commodities
o To participate in drug selection for programmatic
commodities
o To share implementation and progress reports with
stakeholders
o To monitor and evaluate progress towards program goals
Donors:
o To provide funds for procurement of health commodities
o To review progress reports.
NGOs (e.g. JSI, MSH, FHI):
o To provide technical support
o To participate as stakeholders in the product selection and
quantification of health commodities
Logistics Duties of Nurses

Calculate the quantities of commodities needed (assess stock)
Request these commodities via the RRIRV
Place the order by:
o taking the RRIRV to the district for verification
o submitting the RRIRV to the RMS so the order can be processed
and the commodities packed/delivered to health facility
Receive commodities at the health facility:
o Verify the quantities received
o Sign the Way Bill and submit the documents to the driver
o Unpack the commodities and enter quantity received in the
RRIRV
o Arrange commodities in the store and update stock keeping
records
Issue commodities as needed to service delivery staff and record on
bin cards

Dispense commodities to patients as needed, recording on dispensed-
to-user forms
Procurement
Definition of Procurement:
The decision-making process that is followed when purchasing

products, including preparation and processing of the demand as well
as receipt and approval of payment.
Procurement on the Health Facility Level
Do annual procurement plan based on calendar defined by central

level
Provide the plan to the district and regional levels
Order their supplies from the RMS, with priority given to the
commodities list

Session 10:
Monitoring and Supervision of the
Logistics System

Key Terms in Logistics Monitoring and Supervision and On-the-
Job Training (OJT)
MONITORING: comes from the verb “to monitor.”
Checking on a regular basis to ensure that assigned activities are

carried out
Maintaining regular surveillance over: "monitoring his progress was
easy."
We monitor activities
Reasons for monitoring logistics functions:

• To ensure that patients are getting the commodities they need when
they need them
• To ensure that planned logistics activities are carried out according
to schedule
• To ensure that all records are correctly maintained and reports are
submitted in a timely manner
• To ensure that re-supply of commodities occurs according to needs
SUPERVISION:
The process of ensuring that personnel have the knowledge and skills
required to carry out their responsibilities effectively and providing
immediate on-the-job training as needed.
We supervise people
Reasons for supervising personnel managing commodities:

• To ensure they have the knowledge and skills to effectively manage
the logistics system
• To identify performance weaknesses and to improve performance by
providing immediate on-the-job training as needed
• To ensure that established logistics guidelines and procedures are
followed
ON-THE-JOB TRAINING:
Training that takes place on the job, in close collaboration with the
worker
Helping worker improve his/her performance as soon as problem is
noticed by demonstrating correct way to do task

SUPPORTIVE SUPERVISION:
The process of guiding, helping and encouraging staff to improve their

performance so that the organization’s defined standards of
performance are met.
Characteristics of supportive supervision:

Focuses on problem solving
Encourages participatory decision making
Empowers supervisees to improve their own performance
Emphasizes teamwork
Provides feedback and recommendations
Motivates and empowers staff
Small Group Activity

Scenario 1: Traditional Supervision
Grace, a district nurse supervisor, spent the previous day on a supervisory

visit to one of the health facilities in her district.
She completed all the regular supervisory checklists and met individually with
each staff member to check their progress on their workplans and objectives.
If items had not been accomplished, she asked why but did not get clear
answers. She reminded the workers that they could lose their jobs if they did
not improve their performance. Overall, she found staff morale to be low and
the workers seemed nervous during their meetings.
She then met with the clinic manager, told him about the problems that she
found and told him what the best solutions to them would be. The clinic
manager told her that he was having problems with staff motivation and that,
at times, their behavior toward patients has been disrespectful.
Scenario 2: Supportive Supervision
Grace, a district nurse supervisor, spent the previous day on a supervisory

visit to one of the health facilities in her district.
She met with the staff as a group, including the clinic manager.
Representatives from each of the various Clinic Improvement Committees
reported on the progress of their teams. They each mentioned the previously-
agreed upon goals and whether each one had been met since the last
meeting. For the goals that had not been met, the supervisor facilitated a
discussion on what the possible barriers have been that prevented attainment
of the goals. The workers brainstormed about possible barriers and developed
action plans to address them.

Grace praised the group on their leadership and progress in meeting the clinic
goals. She noted a high level of interest and motivation among the staff and
noted that, by working in teams, problems on-site were slowly being
addressed. Since one of the identified challenges was a lack of continuity in
completing the Bin Cards, she took the opportunity of being on-site to conduct
a brief OJT session on how to correctly complete the form.
What are the differences between these two types of supervision, as depicted
in the scenarios?

Guidelines for Planning and Conducting a Site Visit
Plan actions to take place during visit (in advance)

Liaise with high level for transport and allowances at least 1 week prior to
visit.
Notify health centre of your visit after confirming transport.
Review the report from your previous visit and the recommendations
made.
Review the previous LMIS reports for the health centres to be visited and
other reports, such as the Non-Reporting Facilities Report.
Collect your tools for supervision: checklist, stationary, procedures
manual, and calculator.
Review the checklist.
Establish rapport
Meet with the health centre person in-charge, make introductions, explain
your objectives for the visit, and ask for permission to visit with the service
providers and medical assistants.
Assemble the team (service providers and medical assistants) when
schedules permit.
Make any necessary introductions.
Explain the objectives of your visit.
Ask, "How are the programs going?"
Ask, "Do you believe you are able to serve the patients using the
guidelines?"
Ask, "Do you have any problems related to your work?"
Visit storeroom
Does the general condition of the medicine store meet the standards?
Is the storeroom clean and tidy?
Is there security in the room – windows, doors, ceiling, etc.?
Are all products and containers off the floor?
Are containers stacked in a secure manner?
Are different products mixed together?
Is FEFO being followed? (items with shorter expiration dates in front of
others)

Are there damaged, expired, or excess levels of stock?
Are medicines kept under recommended storage conditions?
Are the shelves labeled?
Count the stock

Verify that all pharmaceuticals and other health commodities are stored in
the same place.
Verify that health commodities are kept according to the storage guidelines
in SOPs Manual.
Verify that commodities are kept according to FEFO.
Verify that commodities are held securely but are accessible when
needed.
Conduct a physical inventory as described in the SOPs Manual.
Review the Stores Ledger.
Are stores ledgers available with the commodities?
Verify that ledgers are correctly/completely filled out (in units, dates, and
batch #).
Compare the results of the physical inventory with the Stores Ledger.
Write the physical inventory results on the stores ledger; make any
necessary adjustments.
Verify that physical inventories were recorded monthly.
Check the math.
Check to see if there are any stock-outs reported on the Stores Ledger.
Compare the receipt date of commodities with the dates you understand
supplies were shipped.
Check to see if issues match the delivery notes.
Ask the medicine store-in-charge or nurse if they have any questions
about completing the stock card.
Review local records and reports.
Verify that all records are filed and organized and accessible.
Does the provider have the job aids needed to assist in filling out forms?
Is the stock on hand at the clinic correctly reported from the Stores
Ledger?
Calculate the number of months of stock available to identify products that
are under stocked or overstocked.
Verify that the provider knows the day the report is due. (Does the date the
form was completed suggest that it was completed on time? Did you
receive it on time?)

If there are losses/adjustments, are these explained?
Who is the person completing the form? Ask this person if he or she has
any difficulty completing the form.
Interact with Staff

Offer words of encouragement, pointing out tasks that the person has
been doing well.
Use the SOPs Manual to provide OJT for any areas that need
improvement.
Make an agreement with staff on future performance.
Ask both the providers and medical assistants if they have any additional
comments or questions about logistics.
Give the providers any materials they need to do their jobs.
Sign the visitors' book.
Discuss the results of your visit with the health center person in-charge.
Actions after the visit

Document any problems, actions to be taken, and plans for follow-up.
Send the report to the providers and the higher level.
Keep a copy of the report for follow-up during the next visit.
Address any concerns found during the visit.

A Practical Experience: Field Trip
WHAT IT IS
At some point after the early sessions of this module have been presented,
students should be given the opportunity to visit a health service delivery point
to learn first-hand how logistics functions are performed. This will provide them
with real experience with the logistics tasks at the facility level, and provide
them with the opportunity to talk with workers and observe the systems in use.
AIM
The practicum in supply chain management should enable learners to gain
practical knowledge of the supply chain management system currently
operating in Ghana, ways in which it functions well and note possible
improvements to strengthen it.
BROAD OBJECTIVE
By the end of the practicum learners will have an understanding of how supply
chain management of health commodities operates in Ghana.
OBJECTIVES
By the end of this practical exercise the learners will be able to:
1. List the major activities within the health commodity supply chain
management system in Ghana
2. Identify the different levels of the supply chain in Ghana and staffing
involved
3. Recognize the type of system currently in operation (e.g. push vs. pull) at
different levels
4. Identify the LMIS records and reports currently in use at all levels
5. Identify decisions taken with data collected
6. Examine the storage practices of facilities and list areas where gaps may
exist
7. Conduct a physical inventory and stock assessment
8. Write a report that summarizes the facility’s LMIS, inventory control
system, distribution system and storage operations and make specific
recommendations for improvements

METHOD OF ASSESSMENT: FINAL REPORT
Instructions:
During the clinical practicum, students will observe and ask questions about
supply chain management of health commodities in Ghana.
Students will collect information and then write a report of their findings.
Two checklists are provided (see following pages) to assist with
information gathering.
General questions:
How many people work in the service delivery facility?

Who is responsible for managing the health commodities?
What data are collected on these commodities and for what use?
What tools are used for the collection of data?
How does the facility get their supplies?
Who decides on the quantity of commodities ordered?
How often are commodities ordered?
How often are commodities received?
Ask any other questions of interest to you.

TASK: Assessing Stock Status, Checking LMIS Forms
OBJECTIVES: Check if there are any stock outs.

Check the LMIS forms used.
Check if the information on reports matches the information on the Bin
Cards.
Mark
Performance Criteria Observations
Yes No
1. Do they have forms?
2. Do they record losses and

adjustments (theft, expiry and
damage)?
3. Do the quantities noted on the bin
cards correspond to the physical
stock?
4. Are physical inventory results noted
on the bin cards?
5. Is there a bin card for each brand,
form or presentation of a product?
6. Are the cards are filed out correctly
(no math errors)?
7. Are expired and damaged
commodities separated from usable
commodities?
8. Are estimations of expiration dates
done according to manufacturing
dates and shelf life?
9. Is the name of the facility and month
and year of the data filled on the
forms?
10. Are bin cards completed for every
entry, every issue, and every
inventory?
11. Does the facility show any stock outs
or overstocks?
12. Does the quantity on hand from the
report for each product match the
quantities on hand on the last day of
the month listed on the bin card?
13. Does the quantity used on the daily
register for each product match what
is reported on the Bin cards?

TASK: Storing commodities
OBJECTIVE: Verify that the storage room is in compliance with guidelines for
proper storage of health commodities
Mark
Storage Guidelines Observations
Yes No
1. Absence of insects and rodents
2. Ventilated (local temperature <

40 C)
3. Well lit
4. Products out of direct sunlight
5. Absence of water penetration in

the room
6. Safety equipment available (fire
extinguisher, sandbags …)
7. Latex products (gloves and
condoms) away from electric
motors and fluorescent lights
8. Cold chain equipment in place, if
required
9. Controlled substances locked up
10. Commodities stored by

therapeutic category or
presentation.
11. Cartons/boxes on the shelves or
pallets
12. Expiry dates visible
13. Cartons with arrows pointing up
14. FEFO applied
15. Commodities stored away from

insecticides, chemicals,
hazardous materials, old files,
office supplies and equipment

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Student Syllabus

Supply Chain Management

Developed by USAID | DELIVER PROJECT

Developed by USAID | DELIVER PROJECT i

Developed by USAID | DELIVER PROJECT ii

AMC Average Monthly Consumption

Developed by USAID | DELIVER PROJECT iii

Developed by USAID | DELIVER PROJECT 1

Reproductive health commodity security exists when every person is able

Commodity security exists when every person is able to ___________ and

Why does the word__________ not appear in the definition of Commodity

2. Doctors will prescribe medication in accordance the rational drug use

3. The MOH is not able to provide every medication available so it will

Developed by USAID | DELIVER PROJECT 2

Developed by USAID | DELIVER PROJECT 3

Commercial Sector, Public Sector, NGOs, and Social Marketing. In this

Logistics is Essential to Commodity Security

Logistics is essential to CS. A program is able to make progress toward

 FORECAST…accurately estimate commodity requirements

Developed by USAID | DELIVER PROJECT 4

Purpose of a Logistics System

General Categories of Health Commodities

During your instructor’s presentation it was mentioned that health commodities

Essential Medicines Non-Full Supply Consumables

________________ commodities are those for which the supply is almost

Which of the following programs would be categorized as Non-Full Supply since

Tuberculosis Essential Medicines Family Planning HIV/AIDS

The Six Rights

Write in the 5 rights of logistics that are missing.

Developed by USAID | DELIVER PROJECT 5

Quantification and Procurement Serving Customers

Components of the Logistics Cycle

Developed by USAID | DELIVER PROJECT 6

Inventory Management stores and distributes the products throughout the

The Logistics Management Information System (LMIS) is the means through

In the heart of the cycle we have:

Organization and staffing – a logistics cycle can only work if well-trained,

Budget – allocation and management of finances directly affect all parts

Monitoring and Evaluation – routine monitoring and periodic evaluation

Developed by USAID | DELIVER PROJECT 7

Policy Environment an organization or Government’s regulations and

Adaptability refers to the ability of the logistics system to successfully adapt to

Why Logistics Matters!

Logistics increases program impact – health programs cannot success unless

Logistics enhances quality of care – well-supplied health programs can provide

Logistics improves cost efficiency and effectiveness – an effective supply chain

Developed by USAID | DELIVER PROJECT 8

a. The time interval between when new stock is

What would be the lead time in the following example?

Place your answer here. ___________________________________

Developed by USAID | DELIVER PROJECT 9

Key Distinction between Dispensed-to-User Data and Issues Data

Remember that DISPENSED-TO-USER Data are Information about the quantity

Developed by USAID | DELIVER PROJECT 10

1) Where are the sources of dispensed-to-user data and issues data?

3) For each level, is it a pull or push system?

4) What are the lead times in this system?