Logistics System Assessment Tool

Publication date: 2002

Logistics System Assessment Tool [53 [image: image1.wmf] Logistics System Assessment Tool Portions of “Organizational Support for Logistics System” Copyright 2001 Synaxis, Inc. Limited Rights per Government Contract HRN-C-00-00-00010-00 Contents INTRODUCTION 3 Background information 5 SECTION I-ORGANIZATION 7 Organizational context 7 SECTION II-LOGISTICS MANAGEMENT INFORMATION SYSTEM (LMIS) 10 Basic elements of an LMIS 10 Use of LMIS information 13 SECTION III-PRODUCT SELECTION 15 National drug policy 15 National essential drug list 16 SECTION IV-FORECASTING 18 National level forecast preparation 18 SECTION V-Obtaining Supplies/Procurement 21 Procurement planning 21 SECTION VI-INVENTORY CONTROL PROCEDURES 24 Stock management 24 Stockouts 27 SECTION VII-WAREHOUSING AND STORAGE 29 Adequacy of storage capacity and conditions 29 Assuring product quality at the storage facilities 31 SECTION VIII-TRANSPORT AND DISTRIBUTION 33 Distribution system 33 SECTION IX-ORGANIZATIONAL SUPPORT FOR LOGISTICS SYSTEM 36 Organizational processes for logistics 36 Supervision (Individual performance management) 39 Staff development in logistics 41 SECTION X-PRODUCT USE 42 Standard treatment guidelines and universal safety precautions 42 SECTION XI-FINANCE 44 Program financing 44 Donor coordination 46 Introduction The Logistics System Assessment Tool (LSAT) allows for a comprehensive system-level assessment of the performance of a logistics system for any health program managing any health commodity. The tool follows the logistics cycle (see figure 1) and includes questions on all components of the cycle. It can be used with the Logistics Indicators Assessment Tool (LIAT)* to provide an overall assessment of a program’s ability to ensure the continuous availability of health commodities at service delivery points (SDPs). Figure 1. Logistics Cycle [image: image2.wmf] The background and use of the logistics cycle, and the overall process and analysis, are described in this guide. The overall purpose of the LSAT is to—  diagnose areas that need improvement.  monitor system’s performance.  raise stakeholders collective awareness about system performance.  gather informants’ (logistics) knowledge, and use results of the analysis for work planning. Note: Some of the questions in the LSAT are shaded. Before the exercise with participants, complete the shaded questions. The information gathered prior to the exercise can be verified by participants if necessary. Make these inquiries from your home office and/or in-country. * The LIAT is a quantitative evaluation tool that measures five logistics indicators: stock status, stockout frequency, storage condition, forecast accuracy and data quality. It can be accessed at www.deliver.jsi.com Logistics System Assessment Tool (LSAT) John Snow, Inc./DELIVER Background information Date: 06/14/02 (DD/MM/YY) Facilitator: Tim Williams and Lea Teclemariam Country: Nigeria Notetaker: Name of program: Federal Ministry of Health/Department of Community Activities and Population Activities Type of program:  Government  NGO  Social marketing  Private  Other (specify): Number of facilities visited: 4 Before the exercise: 4 After the exercise Levels visited:  Central  Regional  District  Service delivery point  Other Pharmacies and Patent Medical Stores Product categories covered in this assessment: (Check all that apply)  Contraceptives  STI drugs  HIV test kits  Essential drugs  Essential drugs kits  TB drugs  Vaccines Total number of products managed in the system being assessed: List all the products managed by the supply chain being assessed (or attach a copy of the list): ___________________ ___________________ _______________________ ___________________ ___________________ _______________________ ___________________ ___________________ _______________________ ___________________ ___________________ _______________________ ___________________ ___________________ _______________________ List the name and title of participants: Name Title Name Title General notes: SECTION I—ORGANIZATION Attach a copy of the organizational chart that describes the logistics personnel for the supply chain being assessed. Organizational context 1. Does the national level have a logistics management unit?  Yes  No  NA Comments Contraceptive Logistics Management System-DCDPA If no, please note in the comments section (questions I.2 a-i) the departments or positions responsible for each logistics task. 2. Is the logistics management unit fully responsible for the following activities: a. managing and using the logistics management information system?  Yes  No  NA Comments: b. forecasting quantities needed?  Yes  No  NA Comments: c. procurement?  Yes  No  NA Comments: UNFPA as a procurement agent d. inventory management, storage, and distribution?  Yes  No  NA Comments: e. product selection?  Yes  No  NA Comments: f. determining the organizational structure and processes?  Yes  No  NA Comments: g. staffing of logistics positions?  Yes  No  NA Comments: Department of Personnel h. budgeting for the logistics system?  Yes  No  NA Comments: i. supervision and logistic staff development?  Yes  No  NA Comments: 3. Are there documented guidelines for— a. logistics information management systems?  Yes  No  NA Comments: b. forecasting quantities needed?  Yes  No  NA Comments: c. procurement?  Yes  No  NA Comments: d. inventory management, storage and distribution?  Yes  No  NA Comments: e. product selection?  Yes  No  NA Comments: f. staffing of logistics positions?  Yes  No  NA Comments: g. budgeting for the logistics system?  Yes  No  NA Comments: h. supervision and staff development?  Yes  No  NA Comments: 4. Is there a dedicated logistics officer-in-charge?  Yes  No  NA Comments: Dr. Dada partly If no, skip to question I.6. 5. Does the logistics officer(s)-in-charge have the same level of authority for decision making as other functional unit heads?  Yes  No  NA Comments: Dr. Dada partly 6. What mechanisms are used to coordinate key logistics tasks among those responsible for logistics?  None  Formal meetings  Joint work plans  Written communications  Department meetings  Other______________________________ Are the coordination mechanisms effective? Meeting with donors 8. How many positions are there with key logistics tasks 9. How many of the positions with key logistics tasks are currently filled? If they are not filled, why? Describe the relationships among key stakeholders, including donors, other cooperating agencies, government units, other relevant entities, and other supply chains. Through stakeholders’ meeting (October last year). Just starting to move it- coordination of donor support and plan of actions. 11. Is there a logistics system strategy or improvement plan that guides the activities of the system?  Yes  No  NA Comments: If no, skip to question I.13. Describe the strategy/plan. Forecasting, procurement, LMIS, staff development-monitoring and supervision and equipment- a 3 year plan. What issues outside the supply chain impact the functioning of the supply chain? (Note: Include major political, cultural, or economic factors such as political events, labor disputes, etc.) Economic issues/ Budgetary constraints 14. Other comments on organizational context: Section II—Logistics management information system (LMIS) Basic elements of an LMIS 1. Is there a logistics management information system?  Yes  No  NA Comments: If yes, go to question II.3. Is logistics information collected through another information system (e.g., HMIS)? Describe briefly. NHMIS 3. Does the information system include: a. stockkeeping records (e.g., inventory control cards, bin cards, stock registers) at all levels?  Yes  No  NA Comments: UNFPA-revised forms FPMIS b. requisition and issue records (e.g., bills of lading, shipping records, requisition/issue vouchers) at all levels?  Yes  No  NA Comments: Old forms c. dispensed-to-user records at service delivery points?  Yes  No  NA Comments: d. summaries of consumption data at levels above service delivery points (e.g., districts, regions, central, etc.)?  Yes  No  NA Comments: not at the zonal and central level 4. Do information system reports at all levels of the system show: a. the inventory balance (stock on hand)?  Yes  No  NA Comments: b. quantity dispensed or issued during a specified reporting period?  Yes  No  NA Comments: c. losses and adjustments?  Yes  No  NA Comments: 5. What indicators related to logistics and/or product availability does the information system track (e.g., stockout rate, percentage of reporting, rational prescribing practices, etc.)? None- except reporting rate is collected at the state level (coordination unit) Who tracks these indicators? State FP coordinator 6. Do facilities follow this reporting schedule? Map the report flow.  Yes  No  NA Comments: State Zone Central How do managers monitor reporting rates and follow-up to obtain missing logistics reports? Dysfunctional monitoring-UNFPA monitoring visits-used to replenish forms and collect records. In some areas, reports were brought during quarterly meetings. 8. Are information system records reconciled against physical inventories at each level?  Yes  No  NA a. If yes, How is this done? Through a USAID funded group TAG (Technical Assistance Group). There has been no funding so not being done b. How often?  Monthly  Quarterly  Semi-annually  Annually  Other 9. What is the approximate percentage of information system reports received in time to be used for logistics decisions at the following levels: a. central? 0% b. Zonal? 0% c. State? 50% 10. Is the information system automated at the following levels: a. central?  Yes  No  NA Comments: b. regional?  Yes  No  NA Comments: c. district?  Yes  No  NA Comments: d. service delivery points?  Yes  No  NA Comments: If no to questions 10 a - d, skip to II.12. 11. Briefly describe the functions and processes that are automated. 12. How is logistics data recorded, managed, and analyzed at each level? Is external assistance provided to manage the information system? Assistance in revision forms (UNFPA) Training for MIS officers Computers for central and zonal levels Use of LMIS information 15. Is the information system used to monitor and evaluate the program’s performance?  Yes  No  NA Comments: up to the states 16. What decisions are based on information system reports?  Forecasting  Procurement  Transport/delivery  Scheduling supervisory visits  Inventory management  How much to resupply  Other some level-skeletal 17. Are logistics data used at each level of the system as appropriate for continuous monitoring of stock balances?  Yes  No  NA Comments: 18. What feedback mechanisms are in place to channel logistics information back to the lower levels? None- supposed to have meetings (none since 1997) If no, skip to II.20. 19. How is information fed back to lower levels?  Telephone  Reports  Meetings  Supervisory visit  Other 20. Are issues data or dispensed-to-user data cross-checked against other data sources?  Yes  No  NA Comments: If none, skip to II.22. 21. a. What type of data are they checked against?  Service statistics  Demographic statistics  Survey data  Field audit data  Other b. How often are they checked?  Quarterly  Semi-annually  Annually  Other c. Who is responsible for cross-checking? 22. a. Is logistics information provided to appropriate decision makers for logistics planning (e.g., Ministry of Health, Ministry of Finance, UNFPA, USAID, World Bank, NGOs)?  Yes  No Comments: b. What information is provided? c. Who provides the information? d. How often?  Monthly  Quarterly  Semi-annually  Annually  Other e. How is the information used? Other comments on LMIS and use of LMIS information: LMIS forms in need of revision STRENGTHS WEAKNESSES Guidelines exist (structure and unit) Human resources Donor participation and collaboration Increasing government commitment LMIS forms exist Lack of funds Staff development and training inadequate Poor record keeping and reporting Inadequate monitoring and supervision Poor feedback mechanism SECTION III- Product selection National drug policy 1. Is there a National Drug Policy document?  Yes  No  NA Comments: NAFDAC (National Agency for Food, Drugs Administration and Control) If no, skip to question III.4. 2. a. When was the document published? Attach a copy. Date b. Who developed it? c. How often is it updated? d. Who receives it? e. How is it used? 3. Does the National Drug Policy contain written guidelines for donation of products?  Yes  No  NA Comments: 4. Is duty tax imposed on imported drugs or products?  Yes  No  NA Comments: exemption 5. Are donated commodities exempt from duty tax?  Yes  No  NA Comments: How are new drugs or products registered? NAFDAC 7. Does the program have a written policy for maintaining continuity of brands and avoiding unnecessary duplication of interchangeable products (e.g., hormonal formulations of contraceptives and socially marketed products)?  Yes  No Comments: 1997 duofem provided by a contractor from FMOH- 1998 Lo-femenal (UNFPA) 8. a. Is there an essential services package?  Yes  No b. If yes, what services are included? National essential drug list 9. Is there a national essential drug list?  Yes  No  NA Comments: If no, skip to section IV. 10. What categories of products does the list include? (check all that apply)  Family planning  STI  HIV/AIDS  Essential drugs  TB  Malaria  Vaccines  Vitamin supplements  Other _______________ 11. List all contraceptives that are available in the country and specify which contraceptives are on the essential drug list. 12. How many products, including contraceptives, does the list contain? (Provide a copy of the list.) What criteria is used to select a product for the list? NAFDAC- essential drugs list 14. To which levels of the system is the national essential drugs list officially distributed?  Central  Regional  District  Service delivery point 15. Is the list used for product selection and ordering commodities? If yes, explain how it is used. Other comments on product selection: Last procurement was done based on the few reports. Donors have decided what to provide. STRENGTHS WEAKNESSES SECTION IV- Forecasting If DELIVER has prepared CPTs for the past 2 years, the DELIVER advisor can complete this section prior to the LSAT workshop. National level forecast preparation 1. Are forecasts developed using: a. logistics-based data?  Yes  No Comments: b. demographic data or disease prevalence/morbidity?  Yes  No Comments: c. service statistics?  Yes  No Comments: 2. If forecasts are prepared and updated using the most recent logistics data, do they include: a. stock on hand?  Yes  No  NA Comments: b. dispensed-to-user data?  Yes  No  NA Comments: c. losses and adjustments?  Yes  No  NA Comments: 3. Are forecasts validated by comparing previous estimated consumption with actual consumption?  Yes  No  NA Comments: What other factors are considered in the preparation of forecasts? (e.g., consolidating decentralized forecasts or quantifications, seasonal and regional variations, standard treatment guidelines, national essential drug list, etc.) CPR, standard treatment guidelines, forecasting for public and private sector (mainly social marketing) Do forecasts take into account programmatic plans (e.g., expansion of service outlets, training, IEC or behavior change campaigns, other organization’s activities, etc.)? No 6. Describe the forecasting process. Who initiates it? FMOH (DCDPA) using distribution data, population data, CPR and forecast HIV/AIDS condoms When does it takes place? Last one took place in 1999. 2001 (DELIVER) How long does the process take? 2 weeks 7. a. Is technical assistance provided to develop correct forecasts?  Yes  No b. If yes, by whom? 8. What is the role of regional or lower levels in the forecasting process? 9. Are forecasts updated at least annually?  Yes  No Comments: 10. Are forecasts prepared on a schedule coinciding with local budgeting and procurement cycles?  Yes  No Comments: 5 year forecasting-refer to the budget annually- 2004 inadequate funds 11. How frequently are forecasts prepared? a. Short-term (e.g., annual)  Yes  No  NA Comments: every 2 years- 2001 and 2003 (DELIVER) b. Long-term (e.g., three or more years)  Yes  No  NA Comments: 12. Are forecasts costed out and incorporated into budget planning by the MOH and/or donors? Explain. 13. a. Are there funding shortfalls?  Yes  No  NA Comments: b. If yes, how are they resolved? 14. Other comments on forecasting: STRENGTHS WEAKNESSES SECTION V-Obtaining supplies/procurement Procurement planning Who is responsible for procurement planning, ordering and scheduling of shipments (e.g., logistics unit, procurement unit) at appropriate levels? Forecasting and Procurement Committee-no point person Describe the coordination between persons or unit(s) responsible for logistics activities and procurement staff. UNPFA and DCDPA 3. Are short-term procurement plans based on forecasted needs?  Yes  No  NA Comments: 5 year procurement- revised every year 4. Do these procurement plans take into account the following logistics system elements: a. current inventory levels (stock on hand)?  Yes  No  NA Comments: b. losses and adjustments?  Yes  No  NA Comments: c. required order lead times of suppliers/donors?  Yes  No  NA Comments: d. established stock levels, if relevant?  Yes  No  NA Comments: e. shipment and handling schedules?  Yes  No  NA Comments: local supply f. the need for a safety stock?  Yes  No  NA Comments: 5. Are procurements limited to— a. pre-qualified suppliers?  Yes  No  NA Comments: b. products on the national essential drugs list?  Yes  No  NA Comments: only oral pills 6. In general, are the correct amounts of all products procured and obtained at the appropriate time at the following levels: a. central?  Yes  No  NA Comments: b. regional?  Yes  No  NA Comments: c. district?  Yes  No  NA Comments: d. service delivery point?  Yes  No  NA Comments: Specify the products, if any, that do not arrive in a timely manner, in appropriate amounts, and why. System not functional-no funds 7. a. What are the procedures and time frames for ordering products from suppliers and donors? Do these take into account trade, regulatory, and currency restrictions? How? Local contractor 8. What is done to monitor/manage the coordination of procurement plans among suppliers/donors? 9. a. Is pipeline status regularly monitored so that procurement decisions can be made and actions can be initiated in time to avoid stockouts?  Yes  No  NA Comments: central and zonal-lack of funds b. If yes, who does this and how? 10. Does the procurement unit or persons responsible for procurement— a. write and issue tenders?  Yes  No  NA Comments: b. evaluate bids?  Yes  No  NA Comments: c. monitor supplier performance? Yes  No  NA Comments: Does the program have written procedures for ensuring that products received meet defined standards of quality? Quality Control Unit-NAFDAC .Should be doing it but not happening 12. What are the procedures for quality assurance, who is responsible, and how often are they done? 13. Is there a procedure for recording and reporting complaints regarding product quality to suppliers? 14. What other actions are carried out to ensure product quality? Other comments on procurement: STRENGTHS WEAKNESSES SECTION VI-Inventory control procedures Stock management 1. Specify what type of inventory control system is used (e.g., push, pull, etc.) and describe the system. 2. Are there guidelines and established policies for maximum and minimum stock levels at which full supply products should be maintained (please note current max and min levels in comments section) a. at the central level?  Yes  No  NA Comments: b. at the regional level?  Yes  No  NA Comments: c. at the district level?  Yes  No  NA Comments: d. at the service delivery point level?  Yes  No  NA Comments: a. Are the inventory control guidelines for full supply products respected at all levels so stock levels generally fall between maximum and minimum?  Yes  No  NA b. If no, why? Not enough contraceptives 4. a. Are stock levels (min/max) for full supply products reviewed periodically?  Yes  No  NA Last review 1994-95 b. Do reviews take into account changes in transport and information availability? 5. How are products that cannot be maintained in full supply allocated at the following levels: a. central? Rationing at every level b. regional? c. district? d. service delivery point? 6. Are there written provisions for the redistribution of over-stocked supplies?  Yes  No Comments: States are advised to exchange 7. How are stock imbalances handled by supervisors/managers at the following levels: a. central? b. regional? c. district? d. service delivery point?__________________________________________________________ 8. Does the program have a policy of storing and issuing stock according to first expiry/first out inventory control procedures at all levels?  Yes  No Comments: If no, skip to question VI.10 In practice, does the program manage and issue stock according to first expiry/first out inventory control procedures at all levels? Describe. Yes Are damaged/expired products physically separated from inventory and removed from stock records at all levels? Note the approximate quantities of products expired within the past two years. Yes. Policy exists 11. Does the program have a system for tracking product losses and other adjustments?  Yes  No Comments: Should write on the back of the form 12. a. Are there losses and significant adjustments?  Yes  No  DK (don’t know) Comments: If yes, how are they investigated and are appropriate actions taken to prevent recurrence? Person apprehended and being prosecuted How does each level of the system calculate resupply quantities? Ration-not enough Stockouts 14. Have stockouts occurred for any product in the last 12 months at the following levels: a. central?  Yes  No  NA Comments: b. zonal?  Yes  No  NA Comments: Noristerat and Exluton c. LGA?  Yes No  NA Comments: d. service delivery points? Yes  No  NA Comments: If no to 14 a-d, skip to question VI.17. a. Which products stock out most frequently and for the longest period? Noristerat, Exluton, Depo-Porvera b. For how long? For which products? What are the causes of these stockouts? Purchased in small quantities- due to lack of funds a. How did the stockouts affect program services and performance? They affected program’s performance greatly b. For how long? For which products? 17. Are there established procedures for placing emergency orders?  Yes  No  NA Comments: 18. How often are emergency orders filled at the following levels: a. central? Yearly- locally procurement-emergency orders b. regional? c. district? d. service delivery points? 19. Other comments on inventory management and stockouts: STRENGTHS WEAKNESSES Existing policy LMIS forms System works in theory (on paper) Trainable staff FEFO followed Funds-not enough contraceptives Lack of trained personnel Stockout of injectables and exluton Forms need small revision Uncertain how system would respond to full supply SECTION VII-Warehousing and storage Adequacy of storage capacity and conditions 1. Does the program have written guidelines for storage and handling of all products at all levels of the system (e.g., manuals, posters, etc.)?  Yes  No  DK (don’t know) Comments: 2. Are there written guidelines for disposal of sharps, biohazardous material, and other medical waste?  Yes  No  DK (don’t know) Comments: 3. Is there a policy that requires at least one physical inventory of all products per year at each storage facility?  Yes  No  DK (don’t know) Comments: 4. Are cold chain storage resources (e.g., refrigerator, paraffin/kerosene, and temperature chart) available at all levels of the system, where appropriate?  Yes  No  DK/NA Comments: 5. If applicable, how is the cold chain monitored to ensure that products are consistently maintained at appropriate temperatures? (check all that apply)  Written guidelines  Supervision  Temperature log sheets  Other____________________________ 6. Is the existing storage capacity adequate to handle the current quantities of products at the following levels: a. central?  Yes  No  DK/NA Comments: b. zonal?  Yes  No  DK/NA Comments: c. LGA?  Yes  No  DK/NA Comments: d. service delivery point?  Yes  No  DK/NA Comments: 7. Can the existing storage capacity handle all the quantities needed to ensure no stockouts occur at the following levels? a. central?  Yes  No  DK/NA Comments: b. regional?  Yes  No  DK/NA Comments: c. district?  Yes  No  DK/NA Comments: d. service delivery point?  Yes  No  DK/NA Comments: If yes to all, skip to question VII.9. 8. How does the program cope with inadequate storage space at the following levels: a. central? b. regional? c. district? d. service delivery point? 9. Does the program have plans for meeting storage requirements for at least the next five years?  Yes  No  NA Comments: Describe the program’s plans for accommodating growth (e.g., infrastructure, distribution, etc.). Joint action plan Specify storage conditions in need of improvement, if any (e.g., cleanliness, organization, temperature, building structure, etc.). Zonal warehouses need space-except for Kaduna Assuring product quality at the storage facilities 12. a. Is there a procedure for recording complaints regarding product quality at all levels?  Yes  No  NA Comments: b. If yes, how are they handled? Send condoms to the lab 13. Are visual quality assurance inspections of products conducted at the storage facility at the following levels: 14. Are there written procedures or guidelines for destroying damaged and expired products?  Yes  No  NA Comments: If no, skip to question VII.17 15. Describe the procedures/guidelines. Send it back up the pipeline –zones destroyed the products in the presence of authorized personnel (auditing unit, NAFDAC, etc) 16. In practice, are damaged and expired products destroyed according to the program’s disposal guidelines at the following levels: a. central? b. regional? c. district? d. service delivery point? Other comments on warehousing, storage and ensuring product quality: Warehouses built for FP, gifted to EPI as that program grew. STRENGTHS WEAKNESSES SECTION VIII-Transport and distribution Distribution system 1. Does the program’s budget have a line item for: a. vehicles?  Yes  No  NA Comments: b. fuel?  Yes  No  NA Comments: c. spare vehicle parts?  Yes  No  NA Comments: d. vehicle maintenance and repair?  Yes  No  NA Comments: Common pool for the whole ministry-difficult to access e. per diem?  Yes  No  NA Comments: f. salaries for drivers?  Yes  No  NA Comments: 2. a. Are any of the above items supported by external funds?  Yes  No UNFPA-central to zonal b. If yes, how much? By whom? UNFPA-assisted by hiring c. If yes, are there plans to phase out or end this support? 3. Do written procedures specify what type of distribution system should be used to distribute products between each level?  Yes  No  NA Comments: Central-zone-hiring State-hire to collect or their own vehicle 4. How are products delivered between each level of the system (include means of transportation)? Specify between which levels. 5. Is there a documented distribution schedule for all levels?  Yes  No  NA Comments: transportation is done as funds are available 6. Which essential health products are distributed together, (e.g., contraceptives, essential drugs, TB drugs, STI and HIV test kits and drugs, laboratory supplies, etc.)? Specify by level. a. Are a sufficient number of functioning vehicles available, with available petrol and drivers, at appropriate levels, to meet the desired distribution schedule? No b. Are vehicles regularly available for transport and other activities, such as supervision? Are vehicles used effectively for routine and emergency deliveries at all levels? Explain (e.g., maximum use of vehicle capacity, coordination of distribution routes, etc.) No 9. a. Are all vehicles in running order? No vehicles yet-2 coming- not yet commissioned b. How is vehicle maintenance handled at the different levels? 10. Where are the vehicles kept (at what levels of the system)? 11. In general, are orders delivered as scheduled at the following levels: a. central? No b. zonal? No c. LGA? d. service delivery point? 12. a. Is transportation outsourced at any level of the system?  Yes  No Sometimes the PPFN (Planned Parenthood Federation of Nigeria is used) b. If yes, how effective has it been? 13. Other comments on transport and distribution: STRENGTHS WEAKNESSES Funds (central level-lack of vehicles; lower levels-cost recovery not uniform, no guidelines) Vehicles at the central level Lack of guidelines for distribution (redistribution ….) SECTION IX-Organizational support for logistics system Organizational processes for logistics 1. Do personnel between these different levels communicate at least quarterly? a. Central level logistics staff and next level (e.g. zonal) staff  Yes  No  NA Comments: There is some communication but some of it goes through parallel systems b. Zonal level of logistics staff with LGA level staff in their area  Yes  No  NA Comments: c. LGA level logistics staff with the SDP level  Yes  No  NA Comments: If no to question 1 a–c, skip to question IX.4. Describe the means of communication (e.g., regular meetings, phone calls, letters, radio, etc.) and what is usually covered. During monitoring visits Stakeholders meeting (Central and zones; Federal and states with State FP coordinators) Meeting covers the status of commodities, constraints and services Which communication methods used in question 2 are most effective and why? Meetings and letters (with a copy to desk office) In the past year, have logistics functions been affected by delays for decisions, approvals, information and/or guidance? If yes, how? Approvals from different levels have delayed decisions-bureaucracy is heavy. 5. Is there an established mechanism for improving logistics practices or procedures (based on what is learned from supervisory visits, feedback, assessments, etc.) at the following levels: a. central?  Yes  No  NA Comments: Not practiced b. zonal?  Yes  No  NA Comments: c. LGA?  Yes  No  NA Comments: d. service delivery point?  Yes  No  NA Comments: 6. Are there written procedures and guidelines (e.g., manuals, job aids, standards) to help staff carry out their logistics responsibilities?  Yes  No  NA Comments: Storage guidelines down to states and some LGAs If no, skip to question IX.9. List all procedures/guidelines that cover logistics responsibilities. Storage guidelines 8. Are the procedures and guidelines distributed to staff at the following levels: a. central?  Yes  No  NA Comments: b. Zonal?  Yes  No  NA Comments: c. LGA?  Yes  No  NA Comments: Down to states and some LGAs; where training took place d. service delivery point?  Yes  No  NA Comments: 9. Do staff who manage commodities have a written job description that includes logistics responsibilities at the following levels? a. central?  Yes  No  NA Comments: b. Zonal?  Yes  No  NA Comments: c. LGA?  Yes  No  NA Comments: d. service delivery point?  Yes  No  NA Comments: 10. Do logistics staff have the tools and resources they need to do their jobs at all levels (e.g., job aids, forms, carbon paper, calculators, shelving, vehicles, funds for transport, etc.)? If not, which tools or resources are missing at the following levels: a. central? No resources-some vehicles in the UNFPA states. Needed calculators, funds b. zonal? c. LGA? No. Motorcycles and calculators d. service delivery point? 11. a. Is external assistance used to complete management and supervision activities?  Yes  No  NA Comments: UNFPA states (in some LGAs) b. If yes, describe the extent of the external assistance. 12. Other comments on organizational processes for logistics: Supervision (individual performance management) Describe supervisory relationships by job position/title and by level. Indicate if any position receives supervision from more than one person or unit. Provide a chart if possible. They have organograms-lines of supervision are pretty clear 14. Are supervisory responsibilities described in written job descriptions?  Yes  No  NA Comments: No job descriptions 15. Are guidelines available for how the supervisor is to conduct the supervisory visit (e.g., introductions, positive style of interaction, follow-up)?  Yes  No  NA Comments: But UNFPA has trained in segments in its states 16. Are tools available that describe what to cover when conducting a supervisory visit (e.g., a checklist)?  Yes  No  NA Comments: Yes at the federal level that applies to zones and states If no to 14, 15, and 16, skip to question IX.18. Are these guidelines and tools used by supervisors? Yes 18. Are supervisory visits conducted for staff at the following levels: a. zonal?  Yes  No  NA Comments: only in UNFPA states. In other states it depends on funds b. LGA?  Yes  No  NA Comments: c. service delivery point?  Yes  No  NA Comments: If no, to 18 a-c, skip to question IX.22. 19. What types of activities take place during the visits: a. Review procedures for forecasting needs  Yes  No  NA Comments: b. Review procedures for ordering products  Yes  No  NA Comments: c. Observe product storage  Yes  No  NA Comments: d. Conduct physical inventory  Yes  No  NA Comments: e. Review of logistics records and reports  Yes  No  NA Comments: some do/ most don’t f. Discuss budgeting for logistics activities  Yes  No  NA Comments: g. Review of changes made since last supervisory visit  Yes  No  NA Comments: h. On-the-job training to improve job performance  Yes  No  NA Comments: i. Discuss what is working and what is not  Yes  No  NA Comments: j. Discuss what help is needed (staff, equipment, forms, etc.)  Yes  No  NA Comments: 20. Is there a documented schedule for supervision?  Yes  No  NA Comments: If no, skip to question IX.22. Are supervisory visits conducted according to the established schedule? How often do they take place? Are there any constraints to conducting supervisory visits? No. UNFPA states, they’re given funds. In other states, there are no funds. 22. Are logistics staff periodically evaluated against job expectations (e.g., from their job description)?  Yes  No  NA Comments: No job description. Logistics functions are scattered all over 23. If a staff member’s performance in logistics is not satisfactory, is the person provided with: a. in-service training?  Yes  No  NA Comments: b. on-the-job training?  Yes  No  NA Comments: c. written instructions on how to improve?  Yes  No  NA Comments: d. a coach or mentor?  Yes  No  NA Comments: 24. Other comments on supervision: Staff development in logistics 25. Does the program conduct periodic staff development activities (e.g., classroom training, coaching, on-the-job training, etc.)?  Yes  No  NA Comments: When funds are available 26. Has training been given to current staff at all appropriate levels in the following areas: a. completion and submission of LMIS reports?  Yes  No  NA Comments: Yes for UNFPA states. Partially all levels-more at higher levels b. proper storage of health products?  Yes  No  NA Comments: c. maintaining proper stock levels?  Yes  No  NA Comments: d. determining order quantities?  Yes  No  NA Comments: e. determining issue quantities?  Yes  No  NA Comments: f. estimating annual needs?  Yes  No  NA Comments: g. reviewing reports and records?  Yes  No  NA Comments: Yes for UNFPA states h. providing feedback and inputs?  Yes  No  NA Comments: Yes for UNFPA states Other comments on logistics staff development: Need training STRENGTHS WEAKNESSES UNFPA States- good supervision and training in LMIS Training did take place 90-94 Stakeholder meetings occur at least at national level CLMS unit exist with logistics staff Central Central No job description No supervision tool No dedicated officer in charge Logistics management system is divided between 2 different divisions working on logistics Central Lower levels Communication issues Funds for training Low capacity of staff Funds for monitoring and supervision Tools-job aids-equipment- training manual SECTION X- Product use Standard treatment guidelines and universal safety precautions 1. Do written standard treatment guidelines exist for conditions treated with commodities in the supply chain being assessed?  Yes  No  NA Comments: If no, skip to question X.4. 2. Specify the commodities in this supply chain that are required to comply with the standard treatment guidelines. Attach the list. 3. Are guidelines distributed to all the service delivery points?  Yes  No  NA Comments: 4. Are there written procedures for monitoring and supervising prescribing practices (e.g., monitoring number of products/drugs prescribed/dispensed per prescription)?  Yes  No  NA Comments: If no, skip to question X.6. 5. Are they distributed to service providers at all levels?  Yes  No  NA Comments: 6. Do written universal safety precaution guidelines exist (e.g., disposing of used needles, washing hands before and after contact with patient)?  Yes  No  NA Comments: If no, skip to question X.8. 7. Are they distributed to service providers at all levels delivery points?  Yes  No  NA Comments: 8. a. What mechanisms and resources are in place to ensure the implementation of standard treatment guidelines and universal safety precautions? b. To what extent are they followed? c. If not followed, what are the barriers to putting them into practice? 9. Are commodities provided only to facilities that have staff trained and equipped to use them (e.g., TB drugs only to DOT-trained facilities, IUDs only to sites with trained providers)?  Yes  No  NA Comments: 10. a. Are drug use studies conducted?  Yes  No  DK Comments: b. If so, how often? c. By whom? 11. Other comments on product use: STRENGTHS WEAKNESSES SECTION XI- Finance Program financing 1. Does the program’s budget include line items for (specify the program): a. products?  Yes  No  NA Comments: b. warehousing/storage?  Yes  No  NA Comments: c. logistics management information system?  Yes  No  NA Comments: d. transportation?  Yes  No  NA Comments: e. logistics staff development?  Yes  No  NA Comments: f. salaries for logistics staff?  Yes  No  NA Comments: 2. What is the program’s annual budget for: Drugs? Reported year Contraceptives? Reported year Logistics? Reported year 3. Who finances the program’s annual budget? What percentage of the cost of products procured is locally financed? 4. What process is used to develop the program’s budget? 5. What was the program’s total annual expenditure for— (Also calculate the per capita expenditure) Drugs? Reported year Per capita expenditure Contraceptives? Reported year Per capita expenditure 6. Considering the last available year’s expenditure (capital and operating costs), is the budget sufficient? If not, why? 7. Estimate the percentage of products bought from domestic versus international suppliers. 8. Are clients charged for— a. services?  Yes  No  NA Comments: b. commodities?  Yes  No  NA Comments: If no to question 8 a and b, skip to XI.12. 9. Are revenues generated from the cost recovery system used for— a. commodity costs?  Yes  No  NA Comments: b. logistics costs?  Yes  No  NA Comments: c. other costs?  Yes  No  NA Comments: 10. What approximate percentage of costs is recovered? If possible separate by commodity versus logistics. 11. Where is the money physically kept and managed? What is it used for? 12. Other comments on financing: Donor coordination 13. Is there a process for coordinating with donors for commodity supply?  Yes  No  NA Comments: If no, skip to question XI.17. 14. Does this process occur at specified intervals?  Yes  No  NA Comments: 15. Describe the process and specify intervals. 16. Does the program initiate the coordination with donors?  Yes  No  NA Comments: 17. Is there a mechanism or a unit that currently coordinates procurement and product shipment with donors? 18. Are any products procured through a basket funding mechanism?  Yes  No  NA Comments: If no, skip to XI.21. 19. Specify which products are procured through basket funding. 20. Describe the process (e.g., timing, donors, etc). 21. What are the program’s future plans for local financing? Are there plans by donors to phase out or reduce donations during the next five years? 22. Other comments on donor coordination: STRENGTHS WEAKNESSES

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