Supply Chain Management in Equatorial Guinea
In Equatorial Guinea under the Bioko Island Malaria Control Project (BIMCP), MCDI procures and manages malaria supplies for the National Malaria Control Program following international guidelines; these supplies include ACTs (Artesunate + Amodiaquine) and Quinine for the treatment of uncomplicated and severe malaria, Sulfadoxine-Pyrimethamine (SP) for prevention of malaria in pregnancy, microscopes and reagents for facilities with laboratories, and Rapid Diagnostic Tests (RDTs) for those without.
The BIMCP has developed and implemented systems for international procurement, involving: shipment to Equatorial Guinea; storage (in BIMCP warehouses); inventory management (using an Excel-based software program called Malaria Inventory and Supply Management - MISM), which includes calculation of reorder points) and regular rounds of distribution to health facilities.
Supplies are procured from registered vendors, based on international competitive bidding and following quality controls ensuring compliance with international standards and ensuring that labeling and instructions are in local language. Medicines are stored in the BIMCP warehouses under temperature-regulated conditions, with stock controls and security measures. The distribution is conducted by the project via monthly distribution rounds to all Government and participating private health facilities to monitor leakages.
Health facilities are re-stocked based on a physical check of their inventories and verification of expiration dates. Health facility records (patient registers and prescription forms) are checked to ensure consistency with the consumption of antimalarial treatments. RDT consumption is monitored through laboratory registers at hospitals and health centers and through other registers at health posts. Health facility staff are trained in the usage of the MISM to support recordkeeping and in the use of the “first expiry, first out” system, to ensure that no products are used beyond their expiration dates. Stock-outs, previously common, are now extremely rare at all public health facilities.
Supply Chain Management in Benin
In Benin, since the beginning of ARM3 Project Year 5, MCDI has assumed the lead role of supply chain management, including the quantification of ACTs and malaria related supplies, conducting supervision of stock management personnel at health facilities, ensuring logistical data quality assurance (QA), implementing End User Verification surveys and providing technical assistance to the NMCP to solve key problems contributing to stock-outs.
The ARM3 project implemented the integrated community case management component in five health zones (HZs) in the north. ARM3 worked with local authorities, health zone directors and zone warehouses to establish a mechanism to ensure the availability of iCCM supplies to manage diarrhea, pneumonia and malaria (ACTs and RDTs), jointly with the community health workers (CHWs) that were selected, trained and assigned to health facilities for supervision and monthly restocking. These CHWs conducted household registration, household visits and campaigns at the communities, where they managed and referred cases to health facilities. MCDI introduced an mHealth reporting system to allow CHWs to track inventories and notify district warehouse managers when stock-outs threatened.
Reporting was conducted using national MOH forms programed into Android phones using the CommCare application.