Supply Chain Management

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Learning Objectives (1)

By the end of the session, participants should be able to:

 Describe in detail the process of managing the supply chain
for test kits
 Explain the key critical processes of supply chain
management
 Describe best practices of stock management
 Explain the importance of stock status assessment
 Describe how to complete:
 LMIS Requisition and Issue Voucher (RIV) Forms
 Daily and monthly activity registers
 Relocation form
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 Learning Objectives (2)

 Explain the importance of inspecting supplies upon delivery

and before acceptance/receipt

 Explain the process for reporting to the Ministry of Health on

HIV test kits, Syphilis test kits and Hepatitis B test kits logistics
 Supply chain management (1)
This involves:
 Consistent availability of testing kits and related supplies
 Monitoring, management, control and support of
commodities to the last mile
 Estimating needs, ordering, receipt planning & monitoring,
storage, distribution
 Health facility stock management, system strengthening,
support supervision, recording (accountability) & reporting

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 Supply chain management (2)
This involves:
 Proper storage of supplies to ensure uninterrupted,
quality service for clients.

 Knowing which supplies and consumables are on

hand
 Performing a physical inventory/stock count

 Knowing when to report on stock imbalances (over

or under stocked)
 Maintaining proper inventory records
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 Critical Processes of SCM

 Estimating Needs
 Quantification and Procurement planning
 Warehousing and Distribution
 Inventory management
 Supportive supervision and Mentorship
 Recording & reporting
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 Estimating Needs
 Testing kits that are required for a specific period (1
- 3 years) must be known.

 Monthly and Quarterly data collected guides the

future needs of the program.

 DHA uses the data collected from various testing

points to estimate the future needs of the program.

 DAR provides the testing kits usage for all testing

sites which is used to estimate the future needs
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 Daily Activity Register
Purpose: Track test kit consumption rate
 Summary of tests used per day
 Opening balance (Physical Inventory)
 Quantity received (Receipts)
 Number of tests used and losses
 Closing balance

 Page summary of tests

 Record all tests used
 Helps MOH track consumption for tests
Quantification & Procurement
 Quantification is the process of estimating the
quantity and cost of a product required to ensure an
uninterrupted supply of commodities for the program.

 MOH collates the required quantities and costs of

each product (test kits) in the program.

 Procurement of commodities is managed by DHA to

enable availability without wastage due to expiry,
overstock or damage
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 Warehousing and Distribution
 Central level storage of commodities is managed by
DHA.

 The maximum stock at central level is 9 months

while the minimum stock level is 6 months.

 On a bimonthly basis, commodities are supplied to

health facilities based on consumption data obtained
at quarterly supervision
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Maximum-Minimum Stock Levels

Term Definition
Maximum Maximum stock level maintained at central &
stock site level stores
Central = 9 months
Health facility = 4 months
Minimum Minimum stock level maintained at central &
stock site level stores
Central = 6 months
Health facility = 2 months

Lead time Time between placing an order and receiving it

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Supportive Supervision &
Mentorship (1)
Onsite mentorship will
The role of supporting
be done on a quarterly
providers to improve
basis and classroom
quality of service will be
mentorship will be done
done by the DHMT or
whenever funds are
their designates.
available/need arises.

Data Quality review

Targeted Supervision &
must be done on a
mentorship will be
monthly basis and
offered to poor
corrective action taken
performing facilities
whenever issues are
(supply chain trail).
identified.
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 Recording & Reporting (1)
 Clients who are accessing testing services must be
recorded in the various forms and registers.
 Ensure that all test kits used for QCs and any losses
are captured in the various logs to enable 100%
accountability for test kits.
 Monthly reports must be prepared and entered in
DHIS2 on time.
 For facilities with Scanform, real-time submission is
encouraged

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Essentials of Stock Management(1)
Ensuring availability of adequate supplies, properly
stored, to ensure uninterrupted, quality service for
clients.
Test Kits
Test 1 – Determine HIV Test II – Unigold HIV Test III – SD Bioline HIV

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Essentials of Stock Management
(2)
Stock management of rapid diagnostic test kits is
integrated with other health facility commodities

Test Kits
Hepatitis B Test kit Syphilis Test kit HIV Self Test

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Packaging of Testing Kits (UOM)
Kit Pack Size (tests in a
pack)
HIV 1/2 Determine 100
HIV 1/2 Unigold 20
HIV 1/2 SD Bioline 25
Determine Hepatitis 100
Syphilis SD Bioline 30
HIV 1/2 OraQuick 50 16
Determine Hepatitis B Test kit with
Accessories
Available in 100 pack
kit with accessories.

Usable in Laboratory
and non laboratory
settings
Essentials of Stock Management (3)
Other Supplies

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Stock Management Involves
Knowing (4)
 Which test kits and consumables are on hand (stock
available at the review point).
 Calculating the average monthly consumption (AMC)
based on previous consumption.
 When to report on stock imbalances (over or under
stocked).

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 Stock Management Involves (5)
 Performing a physical inventory/stock count.

 Maintaining proper inventory records.

 Timely reporting of consumption data through

monthly reports and LMIS forms.

 Inspecting received products for integrity and

expiry dates.

 Ensuring proper storage of testing kits 20

Perform a Stock Count
What is it? Physically counting each item in the
stock
When is it Recommended end of every
done? day/week/month (HSAs and clinic to
conduct PI daily. Pharmacy at
minimum monthly)

Who does it? Personnel storing the test kits

All items must be accounted for. Everything that

comes in and goes out must be recorded.
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 Reconcile Stock with Records

Ideal # Tests Performed = Stock Depletion

Reality # Tests Performed + loss = Stock Depletion

How can loss be minimized?

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Logistics Management Information
System (LMIS) Forms
 Stock cards must be  Requisition and Issue
kept with commodities in Vouchers must be filled
the store out when ordering Test
 Stock cards track the kits and must be signed
following information: by DHSS/facility-in-
 Receipts charge.
 Issues

 Losses  Relocation Forms must

 Adjustments be used to track inter
 Stock on hand
facility test kits
relocations.
Stock Card

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Relocation Form

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Daily Activity Register

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Monthly Site Report

Objective: To create a consolidated monthly

summary page by testing sites
• Summary of clients by:
• Gender, Age
• HIV test results
• Syphilis test results
• Hepatitis B test results
• Testing point
• Summary of Test Kits Used

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 Assessing Stock Status

Use the following formula to determine

current stock status:

Stock on Hand
(amount we have now)
Months of Stock on
Hand
Average Monthly
(how long it will last)
Consumption
(amount we use)
Calculating Average Monthly
Consumption
Average Units Issued for 3
Monthly /
Consumption
= the most recent
3 months
(AMC)

AMC is calculated based on an existing product in an

existing program.

For new products such as SD Bioline: Use service

data to forecast consumption.
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Calculating Minimum Stock Level

Minimum Stock Average Monthly

Level = Consumption
X 2 months

Example: Determine
Based on the Monthly Consumption for this year : Jan
= 200 tests, Feb = 300 tests Mar =100 tests
Average monthly Consumption (AMC) = 200 Tests
Minimum stock level = 200 x 2 = 400 tests
Minimum stock level in kits = 400/100 = 4 kits
Notify the HIV department logistics team when stock
reaches minimum level.
Exercise: Calculating Minimum
Stock Level (1)

Minimum Stock Average Monthly

Level = Consumption
X 2 months

 Example: UniGold
 On average, you use 100 UniGold tests in a month
(100 tests/20 = 5 UniGold kits).
 You should request for more UniGold kits when you
have ____ kits left in the inventory 33
Exercise: Calculating Maximum
Stock Level (2)

Maximum Stock Average monthly

Level = consumption X 4 months

Example: SD Bioline HIV

 On average, you use 100 SD Bioline tests in a
months (100 tests/25 = 4 SD Bioline kits)
 Maximum stock = …… x 4 =……Kits x 25
=…..Tests of SD Bioline
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Calculating Maximum Stock Level
(3)
Maximum Stock Average Monthly
Level = Consumption X 4 months

Example: Hepatitis B Test kits

Based on the Monthly utilization for this year : Jan =
150 tests, Feb= 300 tests Mar = 90 tests
Average monthly Consumption (AMC) = 180 Tests
Maximum stock level = 200 x 4 = 720 tests
Maximum stock level in kits = 720/30 = 24 kits
If the max stock is available but with a shelf life of
less than 4 months, notify the HIV dept logistics
team
Exercise: Determining Stock
Levels (4)
AMC /Week = 100 tests  Minimum stock level =
How many tests are used per _____ kits
month?  Maximum stock level =
_________ tests/month ______ kits
Using Determine,100 tests
per kit, how many kits are
used per month?
_________ kits/month

• What is the minimum stock level?

• What is the required quantity of test kits at the
commencement of each re-order cycle?
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Exercise: Determining Stock
Levels (5)
AMC /wk = 10 tests
How many tests are used
 Minimum stock level =
per month? _____ kits
_________ tests/month  Maximum stock level =
______ kits
Using Unigold, 20 tests
per kit, how many kits are
used per month?
_________ kits/month

• What is the minimum stock level?

• How many test kits should you have in the
beginning of each re-order cycle?
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Exercise: Determining Stock
Levels (6)
AMC /wk = 5 tests  Minimum stock level =
How many tests are used _____ kits
per month?  Maximum stock level =
_________ tests/month ______ kits
Using SD Bioline, 25 tests
per kit, how many kits are
used per month?
_________ kits/month

• What is the minimum stock level?

• How many test kits should you have in the
beginning of each re-order cycle?
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Exercise: Determining Stock
Levels (7)
AMC /wk = 35 tests
 Minimum stock level =
How many tests are used _____ kits
per month?
 Maximum stock level =
_________ tests/month
______ kits
Using Oraquick, 25 tests
per kit, how many kits are
used per month?
_________ kits/month

• What is the minimum stock level?

• How many test kits should you have in the
beginning of each re-order cycle?
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Exercise: Determining Stock
Levels (8)
AMC /wk = 23 tests
 Minimum stock level =
How many tests are used _____ kits
per month?
_________ tests/month
 Maximum stock level =
______ kits
Using Hepatitis B,30
tests per kit, how many
kits are used per month?
_________ kits/month

• What is the minimum stock level?

• How many test kits should you have in the
beginning of each re-order cycle?
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 Exercise: Determining Stock
Levels (9)
AMC /wk = 30 tests
How many tests are used  Minimum stock level =
per month? _____ kits
_________ tests/month  Maximum stock level =
Using Syphilis, 30 tests per ______ kits
kit, how many kits are used
per month?
_________ kits/month

• What is the minimum stock level?

• How many test kits should you have in the
beginning of each re-order cycle? 41
Exercise: Stock Assessment (10)
Physical Inventory Questions
At the end of July this  What is your maximum
year, you conducted a stock level?
physical inventory and  What is your minimum
noted that you stock level?
had/have:  What would be your
 80 Kits of Determine
recommendation based
with an expiry date of on the previous
Dec this year exercise?
 30 kits of UniGold
with an expiry date of 42

Oct this year

Discussion: HIV Test Kits Logistics
System
 Who can describe the current reporting system that is
used in Malawi?
 What documentation needs to be completed related
to inventory and stock management?
 What is the contingency plan when stock is not
available?
 How are stock shortages communicated to the
Ministry of Health?

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Inspect Delivery of Testing Kits

Upon receipt of a delivery at the health facility, conduct

the following:
 Verify contents of the items being received

 Check integrity of received supplies

 Examine Lot Number & Expiry Date

 Create or update records (stock card)

 Store new shipment using FEFO

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Examine Lot Number & Expiry Date
Examine Lot Number & Expiry
Date
 Ensure Proper Storage of
Inventory

 Keep in a clean, organized, and lockable storeroom

 Store according to manufacturer’s instructions
 Place in well-ventilated room
 Store away from direct sunlight
 Place items on shelves/pallets
 Organize existing and new First expiry, first out
shipments by expiration date
 Do not store items on the ground!

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What is Wrong with this Picture?
 Key Points
 Always maintain an adequate inventory to ensure
uninterrupted services
 Perform:
 Physical inventory count regularly.
 Stock assessment to establish how long stocks will last to
minimize stock outs and expiries.
 All inventory items must be accounted for and
recorded.

 Always inspect new shipment before accepting.

 The Daily Activity Register helps the MoH track test 49

kit use and prevent pilferage.
 Logistics Feedback
 Department of HIV Toll Free Line

 Airtel 59191
 TNM 6882

 Email Address: hivdeptlogistics@gmail.com

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