Yemen Situation Analysis Assessment of the Contraceptive Logistic System in 5 Governorates

Publication date: 2006

YEMEN SITUATION ANALYSIS ASSESSMENT OF THE CONTRACEPTIVE LOGISTIC SYSTEM IN 5 GOVERNORATES SEPTEMBER 2006 This publication was produced for review by the United States Agency for International Development. It was prepared by the DELIVER project YEMEN SITUATION ANALYSIS ASSESSMENT OF THE CONTRACEPTIVE LOGISTIC SYSTEM IN 5 GOVERNORATES Survey Data Interpretation and Discussion of the Contraceptive Logistics System in Amran, Marib, Shabwah, Sa’adah, and Al-Jawf The authors’ views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development or the United States Government. DELIVER DELIVER, a six-year worldwide technical assistance support contract, is funded by the U.S. Agency for International Development (USAID). Implemented by John Snow, Inc. (JSI) (contract no. HRN-C-00-00-00010-00) and subcontractors (Manoff Group, Program for Appropriate Technology in Health [PATH], and Crown Agents Consultancy, Inc.), DELIVER strengthens the supply chains of health and family planning programs in developing countries to ensure the availability of critical health products for customers. DELIVER also provides technical management of USAID’s central contraceptive management information system. Recommended Citation DELIVER. 2006. Yemen Situation Analysis: Assessment of the Contraceptive Logistics System in 5 Governorates. Arlington, Va.: DELIVER, for the U.S. Agency for International Development. Abstract Recognizing that sound and functional logistics systems will ensure the continuous availability of reproductive health commodities, the Ministry of Public Health and Population and its partners intend to further develop Yemen’s contraceptive management logistics system. A logistics situation survey was conducted in all governorates to assess the strengths and challenges of the system, offering inputs to help guide strategies and identify opportunities for improvement. To improve the consistency and quality of data collection nationwide, UNFPA, USAID / DELIVER, GTZ, and the Ministry of Public Health and Population partnered to develop and implement this activity. Trained local representatives collected qualitative and quantitative data nationwide using a standardized tool. This document includes analysis and finding for only the 5 governorates which USAID assists, namely Amran, Marib, Shabwah, Sa’adah, and Al-Jawf. Seventy-six facilities were visited in these governorates. A number of strengths and weaknesses were identified on topics ranging from Human Resources supporting the system to Supply Chain Management activities. Recommendations are presented, providing input for key improvements for the central policymaking level, the central warehouse, and governorate level activities. DELIVER John Snow, Inc. 1616 North Fort Myer Drive, 11th Floor Arlington, VA 22209 USA Phone: 703-528-7474 Fax: 703-528-7480 Email: deliver_project@jsi.com Internet: www.deliver.jsi.com CONTENTS Acronyms . v Acknowledgements .vii Executive Summary.ix Chapter titles Introduction. 1 Assessment Objectives . 3 Study Design. 5 Methodology and Study Design. 5 Technical Design and Analysis. 7 Findings and Discussion of Data . 9 Conclusion . 29 Recommendation . 31 References . 33 Annexes 1. Detailed results of skills and practice of storage per governorate. 35 2. Questionnaire/Survey tool: Family Planning Logistics Situational Analysis . 47 Yemen Situation Analysis iii Figures 1. Content of Training .12 2. Commodity Flow within the Yemeni Public Sector System .13 3. Monthly Order Intervals .14 4. Order Response Time .14 5. Preferred Method of Delivery of Contraceptives by Facility Type .16 6. Distance From the Supply Facility .16 7. Percent of Facilities with Contraceptive Available at Time of Visit .22 8. Contraceptive Logistic Data Type .26 9. Percent of Supervision Visits by Level of Responsibility .26 10. Visited Facilities with Available Copy of Contraceptive Logistics Manual .28 Tables 1. Sections and Content of the Assessment Tool.7 2. Type of surveyed facilities according to governorates .9 3. Category and number of family planning logistic working staff.10 4. Average Number of Years in Service for FP Logistic Staff by Governorate .11 5. Communication Method When Ordering Contraceptives .15 6. Transport of Contraceptives .15 7. Means of Transportation of Contraceptives from the Supply Point .15 8. Mean Cost of Transportation from Supplier to Facility by Facility Type .17 9. Mean Cost of Transportation from Supplier to Facility by Governorate.17 10. Current Storage Conditions According to Facility Type .17 11. Management of the stock and store commodities.19 12. Quality Control for the Contraceptive Products .20 13. Knowledge of Signs of Damage for Contraceptive Products .20 14. Action Facility Manager Takes if Damaged Contraceptives are in the Store.20 15. Existence of Expired Products.21 16. Oral Contraceptives Available at Time of Visit .21 17. Availability of contraceptive methods per Facility Type .23 18. Mean days of Stock outs in last 6 months .24 19. Type of Report on Contraceptive Logistics.25 20. Type of Report by Facility Type .25 21. Supervision Visits in last 6 Months per Facility Type . 27 Yemen Situation Analysis iv ACRONYMS CLMS Contraceptive Logistics Management System DHO District Health Office FP Family Planning GHO Governorate Health Office HC Health Center HF Health Facility HU Health Unit IUD Intrauterine Device MPH&P Ministry of Public Health and Population RH Reproductive Health TST Training Support Teams UNFPA United Nations Population Fund USAID United States Agency for International Development VFT Vaginal Foaming Tablets YFHS Yemeni Family Health Survey YG-RHP Yemen German Reproductive Health Program Yemen Situation Analysis v Yemen Situation Analysis vi ACKNOWLEDGEMENTS We would like to extend our appreciation for the support and partnership of our colleagues at GTZ, the Ministry of Public Health and Population, UNFPA, and USAID. Special thanks should also be extended to Dr. Jamal, who oversaw the initial data analysis and report-writing, and the many participants in the Yemeni health system who shared their experience with us. Yemen Situation Analysis vii viii Yemen Situation Analysis EXECUTIVE SUMMARY The Ministry of Public Health and Population (MPH&P) and its partners believe that functional logistics systems will help ensure the continuous availability of reproductive health (RH) commodities in Yemen. To better understand the current status of these systems, significant thought and resources have been devoted to the evaluation and analysis of the current contraceptive logistics management system. To develop clear and comparable findings, the MPH&P, GTZ, UNFPA, and USAID worked closely together to develop survey tools to be implemented nationwide. The group primarily focused on identifying the strengths and weaknesses of the current logistics system, looking for problem areas and other findings that could inform strategic recommendations, as well as provide baseline data for key performance indicators. Although the survey was conducted countrywide, this report focuses only on the governorates in which USAID has activities, including Amran, Marib, Shabwah, Sa’adah, and Al-Jawf. For this study, four-person teams conducted structured interviews at seventy six facilities that provide reproductive health and family planning services in rural, semi-urban, and urban areas. Each team included staff from the Governorate Health Office (GHO) RH Training Support Teams and the GHO Medical Supply Directorate. Interviewers posed closed- and open-ended questions to a total of 111 contraceptive logistics staffers working at GHO warehouses, District Health Office (DHO) warehouses, district hospital warehouses, health centers, and health units. Retention and job satisfaction were found to be generally quite high across the five governorates. In these areas, nearly 70 percent (69.7 percent) of the staff interviewed answered being satisfied regarding their professional interest. Staffers were found to have remained in any one post for an average of 4.6 years. One key challenge involves knowledge about contraceptive logistics, with 68.4 percent of staffers interviewed reporting insufficient contraceptive logistics knowledge for meeting their daily work requirements. Only about half of the health personnel receiving, ordering, and storing contraceptives reported receiving specific training related to the tasks mentioned; the main beneficiaries from logistics training were in charge of RH at the GHO and DHO levels. At the sites visited, supervisory visits seemed to be quite limited and the national manual for contraceptive logistics was often not available for reference. These findings and strong retention rates suggest an opportunity for future training that focuses on (1) training service providers and (2) ensuring that GHO/DHO management staff is able to pass on their knowledge to lower level facility staff and receives the necessary resources to do so. Findings suggest that training needs and requirements likely vary between governorates. The majority of facilities visited regularly submit routine reports either quarterly or monthly. Report formats and content are currently not standardized, which limits one’s ability to use facility data for logistics purposes (e.g. monitor pipeline, inform forecasting). At the time of the visit, none of the facilities had 100 percent availability of the full mix of contraceptive methods—not surprising given the stockouts of certain contraceptives at the GHO level. Availability was the most problematic at the peripheral health centers and health units. Where data was available, contraceptive stockout durations ranged from 12 to 16 days. Although knowledge of basic issues of physical storage was satisfactory, researchers identified gaps in knowledge about basic stock management (e.g. FEFO, labeling of cartons, etc.). In addition, approximately 85 percent of the health facilities reportedly determine their own order quantities, even though survey results showed that 46.1 percent of surveyed staff did not know how to calculate their contraceptive needs. Quality control procedures also proved difficult for staffers, and systematic quality Yemen Situation Analysis ix control is not generally practiced. The lack of consistent use of standard receipt and order forms poses additional store management challenges. Along with strengths, such as retention, the study revealed aspects of the contraceptive logistics system that could be significantly improved. Knowledge sharing is one key way to improve the system; examples include widely disseminating a clear, well-supported, nationwide contraceptive logistics policy and distributing an updated version of the contraceptive logistics manual to all facilities in every governorate. System participants at all levels could also benefit from the compilation, analysis, and dissemination of findings from all current studies, noting regional differences and shared recommendations. It is important to identify training needs, particularly at the lower levels, and ensure that needed forms, products, and supplies are available. Unifying reporting forms, registers, and systems could help make the data collected more useful in informing logistics decisions. Expert leaders from the central warehouse are essential for actively managing the supply, regulations, and distribution of contraceptives. Key focal areas include ensuring appropriate forecasting and procurement, appropriate central storage, regular supply and supervision of GHO warehouses, and clear communication about policies relating to public contraceptives (e.g. not for public sale). To address chronic challenges at the governorate level, it is very important that realistic plans are developed for distributing commodities from the district level to all functioning health services, that necessary funds are provided to support these plans, and that quarterly supervisory visits are undertaken. Improvements in the regular supply systems in governorates would help avoid stockouts in districts. Governorates should revisit storage and quality control at the district level, implementing improvements to previously deficient areas of the system. In addition to commodity availability, governorates should also be aware of the availability of needed forms and registers at the district level, as well as any skills gaps, and address them appropriately to help facilitate movement of contraceptives through each level of the system. Yemen Situation Analysis x INTRODUCTION BACKGROUND The Ministry of Public Health and Population (MPH&P) and its partners have recognized that sound and functional logistics systems will ensure the continuous availability of reproductive health (RH) commodities. As a result, increased attention and resources have been put forth to help evaluate and analyze the current contraceptive logistics management system (CLMS) in Yemen. Current utilization of modern and traditional family planning methods is 40.8% in the urban areas and 17.6% in the rural areas. Use of modern family planning methods is 27% in the urban areas and 9.2% in the rural areas.1 The unmet reproductive need in Yemen is estimated to be 50.9% of currently married women aged 15-49. Statistics from the MPH&P Reproductive Health Directorate suggest that provision of modern family planning methods is increasing. Early in 2005, for example, 45% of the health facilities were providing reproductive health services (89% of the general hospitals, 72% of the health centers and 34% of the health units). The MPH&P also showed that with the increase in demand, family planning service is becoming constrained by the lack of trained female providers. FP service provision is further constrained by insufficient and irregular supply of contraceptives to the health facilities. Family planning service delivery interventions are guided by the National Population Strategy which the government of Yemen adopted in August 1991 to address its national economic development targets. The improvement of the social and economic status of Yemeni women though education and health interventions was central to this strategy. In October 1991, a Population Action Plan was developed to guide the implementation of the strategy. In July 1992, the government established an inter-ministerial National Population Council as the coordinating and supervising body for the implementation of the national population strategy. Under the national population strategy in Yemen, utilization of family planning methods is to increase from 13.4% to 35%. The national population strategy identifies a number of interventions for achieving increased family planning utilization, including: • Extending family planning services into all health facilities within Yemen (90% of the health facilities to provide quality reproductive health services by the end of 2010) • Expanding the mix of contraceptive methods available to clients • Improving the family planning logistic system. • Providing qualified service providers to service delivery points and strengthening supervision. • Providing routine refresher training for services providers and training for midwives in order to ensure quality service and expanded coverage • Strengthening of social marketing program • Expanding health education and awareness within the community to increase demand for family planning methods 1 YFHS 2004 Yemen Situation Analysis 1 • Conducting studies and researches for improving the quality of the service To support these interventions, the MPH&P and its partners (USAID, UNFPA, GTZ)2 conducted a national logistics “Situation Analysis” survey. The “Situation Analysis” exercise was conducted in a total of 15 Governorates, which covered approximately 130 facilities. The DELIVER team surveyed 3 of the 5 focus USAID governorates (Al-Jawf, Sa’adah and Shabwah). GTZ agreed to conducted survey activities in the remaining two USAID governorates (Amran & Marib) because they were also working in these governorates. This report includes the survey results from all five USAID governorates: those surveyed by GTZ and USAID. This close collaboration on this survey stands as an example of the commitment of the government of Yemen and its development partners in working together to support reproductive health services and contraceptive logistics system improvement. 2 Partners: United States Aid for International Development (USAID), United Nations Population Fund (UNFPA), and the German Technical Cooperation (GTZ)) Yemen Situation Analysis 2 ASSESSMENT OBJECTIVES In keeping with the National Population Policy, and in an effort to reduce the number of stock outs and increase the overall availably of contraceptives the primary focus of the study was to identify the strengths and weaknesses relating to the current logistics system, and to identify specific problem areas and to suggest recommendations and strategies that will help promote improvement of the contraceptive logistics management system (CLMS) for five USAID focus governorates. The assessment will also serve to provide baseline information on key performance indicators as discussed later in this document. Yemen Situation Analysis 3 Yemen Situation Analysis 4 STUDY DESIGN METHODOLOGY AND STUDY DESIGN A cross-sectional descriptive study was conducted in the 5 USAID target governorates. Data was collected through semi-structured interviews consisting of both closed and open questions (See Annex 1). The survey was implemented by small local research teams selected from their respective governorates. COMPOSITION OF ASSESSMENT TEAMS The survey assessment teams were composed of four members, two individuals from the Governorate Health Office (GHO) Reproductive Health (RH) Training Support Teams (TST), and two people from the GHO Medical Supply Directorate. Within the four member team, one member served as the supervisor and 3 individuals administered the survey tool. In addition, the MPH&P identified two individuals who served as the assessment coordinators, conducting “spot” checks on the survey teams, and collecting the survey tools upon completion of the exercise. UNFPA and DELIVER conducted a two-day intensive workshop to introduce and train 37 participants on the “Situation Analysis” survey instrument. The survey teams also completed a pre-test exercise in Sana’a before their field activity began. Following the pre-test, the survey teams were asked to identify their respective assessment sample, and finalize their field action plan for the implementation of the survey. The workshop participants tested and adjusted the survey tool before departing the workshop. SURVEY TARGET POPULATION AND ASSESSMENT SETTING The study targeted contraceptive logistics staff working at Governorate Health Office (GHO) warehouses, District Health Office (DHO) warehouses, District hospital warehouses, Health Centers, and Health Units within each selected governorate. SAMPLING METHODOLOGY The selection of facilities was guided by the decision to assess only facilities involved in RH/FP services. The survey teams took a random sample of facilities providing RH/FP services stratified by urban, semi- urban and rural classifications. A total of 76 facilities were identified and visited by the survey teams. CHALLENGES TO DATA COLLECTION The process of data collection in the target governorates clearly highlighted certain challenges, which included the following: • Coordination between the teams and the DHO’s • Communication with the facilities to inform them in advance of the assessment • Translation of the survey questions into Arabic • Comprehension of logistics terms and concepts both by survey team members and surveyed personnel • Record-keeping at the service delivery point level. • Training resources for survey personnel The participants felt strongly that the training time was to short. As a result, some survey teams faced a number of difficulties in dealing with certain assessment questions. Yemen Situation Analysis 5 At this point, it is important to note that the data collection process in the Al-Jawf Governorate was completely different than that in the other targeted areas. The Al-Jawf governorate is a special situation due continuous conflict among the different tribes, as well as the difficult geography. Within this Governorate, it is very difficult and unsafe to travel between districts. Yemen Situation Analysis 6 TECHNICAL DESIGN AND ANALYSIS The “Situation Analysis” tool was developed in a collaborative effort among the key partners (MPH&P, GTZ, UNFPA and USAID) Assessment data was collected through a semi-structured questionnaire divided into 11 parts as shown below. Table 1: Sections and Content of the Assessment Tool Topic Key areas of interest 1 Site Identification 1. Questionnaire Number. 2. Governorate name. 3. District name. 4. Facility name. 5. Facility type. 6. Name of interviewee. 7. Post of interviewee. 8. Interviewer name 2 Site Staffing 1. Title and duration of working of the staff at the facility 2. Training received related to contraceptive logistics tasks 3. Staff satisfaction 4. Career path 3 Order quantities and requested supplies 1. Source of contraceptives supply 2. Mechanism of supply 3. Timing of order placement 4. Response to order 5. Timing of fixed allocation 6. Decision making on requested quantities 7. Knowledge of calculation needed quantities of contraceptives 8. Source of data for calculating contraceptives needs 4 Communicating with the supply source and transport of contraceptives 1. Physical sources of supply for the contraceptives 2. Communication type for sending the order of contraceptive 3. Delivery methods of contraceptives 4. Means of transportation used in delivering of contraceptives 5. Suggestion(s) alternatives of current way of transportation 6. Factors affecting the transportation of the contraceptives 5 Storage 1. Knowledge and skills of the interviewee staff member working at visited facility 2. Basic tasks of the staff member in charge for storage 3. Storage conditions 4. Products conditions Yemen Situation Analysis 7 6 Stock Management 1. Product availability for contraceptives 2. Stock record accuracy 3. Contraceptive consumption 4. Periods of out of stock 5. Knowledge of terms related to contraceptive logistics 7 Quality Control 1. Systematic check on the quality of contraceptives received from the supply point 2. Documentation of the check results 3. Awareness of the signs of damaged contraceptives 4. Action taken in case of damaged contraceptives in the store 8 Analysis of Records, Forecasting and Reporting 1. Responsibility for ordering/forecasting contraceptive needs? 2. Skills in ordering/forecasting contraceptive needs 3. Frequency of reports on contraceptives logistics 4. Content of reports 9 Complaints 1. Reporting complaints 2. Documentation (validation) of complaints 3. Dealing or managing complaints 4. Contraceptives side effect 10 Supervision 1. Frequency of Supervision 2. Type of supervisors 3. Availability of manuals 11 Overall Assessment by Researcher 1. Researcher overall assessment of the facility and the knowledge of the staff met 2. Researcher recommended for training in contraceptive logistics? Yemen Situation Analysis 8 FINDINGS AND DISCUSSION OF DATA SAMPLE CHARACTERISTICS Throughout the five USAID focus Governorates, seventy-six facilities were visited and assessed. The sample within each governorate was proportional to the total number of facilities within that governorate. The greatest number of facilities visited (25) were located in Amran Governorate because it has the largest number of facilities among the five governorates studied. The smallest number of facilities surveyed was in Al-Jawf. DISTRIBUTION AND TYPE OF FACILITIES SURVEYED BY GOVERNORATE Sampling was determined by the GHO teams. Types of facilities visited included GHO, DHO, District Hospital and Health Center. Due to time constraints, geographical and political considerations, the survey teams were not able to visit the following facilities: • District warehouse in Shabwah • District hospital warehouse in Al-Jawf • Peripheral health centers in Marib, Sa'adah and Al-Jawf The following table provides detailed information about the types and numbers of facilities visited in each Governorate. Table 2: Type of surveyed facilities according to governorates Facility type Governorate Name Total Amran Marib Shabwah Sa'adah Al- Jawf GHO Warehouse 1 1 1 1 1 5 District Warehouse 8 4 0 1 1 14 District Hospital Warehouse 3 5 7 5 0 20 Main Health Center 7 1 3 4 2 17 Peripheral Health Center 1 0 4 0 0 5 Health Unit 5 1 0 4 5 15 Total 25 12 15 15 9 76 Yemen Situation Analysis 9 HUMAN RESOURCES WORKING IN CONTRACEPTIVE LOGISTICS Type of staff The survey team conducted interviews with 111 facility staff. The interviewees mainly involved RH staff from the various levels of the system. A complete list of the number of people interviewed and the facility level they represented can be seen in table 3. Table 3: Category and number of family planning logistic working staff Staff Category Facility Type Total GHO Warehouse District Warehouse District Hospital Warehouse Main Health Center Peripheral Health Center Health Unit GHO RH Director 4 4 GHO RH Supply Individual 2 2 GHO Store keeper 1 1 DHO RH Individual 9 8 7 24 DHO RH supply Individual 1 1 DHO Store keeper 1 2 3 HF Director 1 1 2 1 5 RH Individual at HF 2 13 9 4 15 43 Dispenser 1 1 5 4 3 1 15 Store keeper 2 2 1 5 Others Individuals 1 5 1 1 8 Total 9 18 29 25 11 19 111 Staff Turnover In general, staff turnover does not appear to be a problem in the five Governorates. The average duration of staff, in any one post, was found to be 4.6 years. The longest duration of employment was in Amran, at 19 years. The shortest duration of employment was in Shabwah and Al-Jawf Governorates 0.3 years (see Table 4 for details). The primary reasons given for the short duration of employment in Al-Jawf and Shabwah were unstable tribal conditions, high rates of illiteracy and mandatory placement of health service staff in Governorates outside their primary residence. These insights into staff turnover have practical implications for government investments. For example, in training, the relative stability of staff in one place may make modular trainings a promising option. By Yemen Situation Analysis 10 comparison, in governorates with high staff turnover rates, trainings of longer duration covering many topic areas and issues simultaneously may be required. Table 4: Average Number of Years in Service for FP Logistic Staff by Governorate Governorate Mean Minimum Maximum Amran 6.1 .30 19.00 Marib 3.4 1.00 10.00 Shabwah 5.2 .30 15.00 Sa'adah 4.2 .50 10.00 Al- Jawf 1.3 .30 3.00 Total 4.6 .30 19.00 Job Satisfaction and Career Plans Staff job satisfaction within the working environment appears to be high in most Governorates (72.4%). The highest results were recorded in Marib, and lowest were in Sa'adah. Overall, nearly seventy percent (69.7%) of the staff interviewed answered being satisfied regarding their professional interest in those governorates surveyed, the largest percentage of staff unsatisfied with their professional was found in Shabwah (53.3%). Interestingly to note, the lowest degree of satisfaction regarding professional interest related to tasks in the field of contraceptive logistics and was found among persons in charge of contraceptive supply at other (peripheral) health centers’ district warehouses. In part, this is due to some of the DHO’s dual responsibilities as both an RH service provider and as the dispenser responsible for family planning methods to the clients of the district’s HFs. From the perspective of unsatisfied interviewees, complaints include • Issues related to the physical infrastructure such as the inadequate buildings, lack of running water and/or electricity, lack of equipment, insufficient storage space and equipment • Insufficient staffing • Issues related to service management and budgets or minimal budgets for supervision and running costs • Lack of incentives • Insufficient reporting from lower levels of the system and “uncooperative” managers and superiors • Unavailability of contraceptives (repeated stock outs) • Long distances from residence of the staff and their workplace, and • Lack of funds for transport Professional development tracks appear to be available for about one third of the personnel interviewed. In Marib, 58.3% of staff felt positive about their professional development. Only 20% and 28% for staff in Amran and Sa'adah respectively felt that a “career path” is open to them. In Shabwah and Al-Jawf Governorates nearly no one felt positive about their “career path”. It should be noted here that this question was particularly difficult to communicate both to the interviewers during training and to the interviewees during the survey because “professional development” and “career path” are Western Yemen Situation Analysis 11 concepts somewhat alien in the Yemeni culture. Spot checks on the survey teams during the assessment confirmed that all teams experienced difficulties with this question. In contrast to the relatively high levels of general job satisfaction, 68.4% of all staff interviewed felt that their knowledge related to contraceptive logistics was insufficient to deal with the daily work required. This self-assessment of interviewees suggests that training might be an appropriate intervention to increase motivation and improve the logistics system performance. It also would correspond to an expressed need among service providers. Training on Contraceptive Logistic Tasks According to the survey results, about half of the health personnel receiving, ordering and storing contraceptives have received specific training related to the tasks mentioned. The main beneficiaries from logistics training were staff in charge of RH at the GHO and DHO levels. Health Facility Directors were rarely involved in this type of training. Only 44.3% of all staff involved in dispensing contraceptives to clients have ever received any kind of training related to this task. Again, the personnel in management positions (in charge) from the GHO and District hospital warehouses were the beneficiaries of the training. Staff in charge of RH tasks at Health Facility (54.5%) and dispensaries (86.8%) did not receive training. In addition, over two-thirds of staffers who have the first contact with clients and ensure direct access of contraceptives to clients were not trained. Based on these findings, it was suggested that future training should focus on: (1) Training service providers and (2) Ensuring that GHO/DHO management staff is able to pass on their knowledge to lower level facility staff and receives the necessary resources to do so. Data analysis also suggests that the training needs and requirements will be distinctive according to the different Governorates. Regarding the content of trainings, relatively little attention has been given to logistics. Dispensing contraceptives to clients and distributing contraceptives to other facilities got the least attention (44% and 37% of training content, respectively). Figure 1: Content of Training (Percentage of interviewees who have received training on respective subjects) 60% 50% 40% 30% 20% 10% 0% 53% 53% 50% 47% 44% 37% 50% 47% Distribute to other Any Dispense Calculate training Ordering Receiving Storing to needs Reporting clients Yemen Situation Analysis 12 Knowledge and Skills Survey results for staff regarding knowledge on calculating contraceptive needs showed that 46.1% did not know how to calculate their needs for contraceptives. However, 53.5% of people interviewed used their facility’s consumption data for calculation and 18.4% of staff used data related to population such as the target population, and the number of pregnant women in their catchments area. When asked to describe the process of calculating contraceptive reorder quantities, no individual could give the correct answer, and only 25% knew the correct data items and sources of data of need for calculating reorder quantities. According to the survey analysis, roughly 85% of the health facilities determine their own order quantities. DISTRIBUTION CHAIN (CURRENT SITUATION) Contraceptive Order and Distribution All of the GHO and district warehouses visited receive their contraceptive supplies from Ministry of Public Health and Population (Central level). Seventy (70%) percent of district hospitals receive RH supplies from the GHO, and a smaller amount (30%) from DHO. The majority of health centers receive their supply from the GHOs. 60% of Health Units get their supply from DHO and the remaining 40% receives supply from GHO. These data clearly reflect that there is no hierarchical distribution for contraceptives. Figure 2 provides a summary of these commodity flows. Figure 2: Commodity Flow within the Yemeni Public Sector System MPH&P GHO Warehouses HC HU HF District Warehouses 100% 100% 30% 60% More than 2/3 of the total contraceptive supply This study clearly demonstrated that the Yemeni contraceptive inventory control system is a requisition system at its heart: 91% of all facilities receive contraceptives based on the placement of an order to their supplier. Among the facilities visited, fixed monthly rationing of contraceptives is practiced only in Al- Jawf governorate. Yemen Situation Analysis 13 There is no fixed order period or ordering schedule in any governorate. 60% of the facilities visited place orders every 3 months while 26.2% of facilities place more than one order per month. In Amran, the largest governorate in the sample, 13.8% of the facilities place orders more than three months apart. District warehouses tend to place frequent orders as well, often more than one order per month. Figure 3: Monthly Order Intervals 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% > 3 months 1-3 months I month Amran Marib Shabwah Sa'adah Al- Jawf 91.2% of facilities receive response to orders within less than a week and 5.9% receive response between 1 and 4 weeks. In facilities that experience longer delays, these can be linked to lack of funds for transportation combined with the fact that staff generally have to travel in person to supply point to get the contractive re-supply. Transportation, therefore, is largely dependant on the facilities resources. There is almost no central support for distribution. Figure 4: Order Response Time 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 91.2% 5.9% 2.9% One week or > 1-4 weeks > 4 weeks less Communication Method When Ordering Contraceptives In the majority of facilities visited (85.5%), when an order is placed for contraceptives, a staff member from the requesting facility will travel to the supply point to pick up the commodities. As can be seen in Table 5, below, personal visits are the principal mode of communication with very few alternatives. Yemen Situation Analysis 14 Table 5: Communication Method When Ordering Contraceptives Method Percent Cumulative Percent Staff goes in person 85.5% 85.5% Phone 2.6% 88.2% Fax 2.6% 90.8% Other 9.2% 100.0% Total 100.0% Transportation of Commodities As discussed earlier, generally the person requesting the contraceptives also has to transport the requested supply from the distribution point. Survey results showed this in more than 84.2% of sites. Regular distribution by the supplier is rare. All GHO warehouses receive their re-supply of contraceptives from the Central level by providing their own means of transportation. Table 6: Transport of Contraceptives Distribution Percent Cumulative Percent Facility picks up their own re-supply 84.2% 84.2% Supplier delivers to the facility 10.5% 94.7% Some other form of delivery 5.3% 100.0% Total 100.0% Transportation of contraceptives generally involves the facility renting a car for picking up commodities (75%). Cars for this purpose are rarely available at the facility level (only in 8 facilities). GHO warehouses may have their own car (Amran, Shabwah and Sa’adah) or not (Marib and Al-Jawf). Cars are also available at District Hospitals in Amran and Marib. Means of contraceptive transportation are summarized in table 7, below. Table 7: Means of Transportation of Contraceptives from the Supply Point Mode of transport Total Facility Car Bus Rent a car Other Count Row % Count Row % Count Row % Count Row % Count Row % Amran 2 8.0% 0 0% 19 76.0% 4 16.0% 25 100% Marib 1 8.3% 0 0% 8 66.7% 3 25.0% 12 100% Shabwah 1 6.7% 0 0% 11 73.3% 3 20.0% 15 100% Sa'adah 4 26.7% 1 6.7% 10 66.7% 0 0% 15 100% Al- Jawf 0 0% 0 0% 9 100.0% 0 0% 9 100% Total 8 10.5% 1 1.3% 57 75.0% 10 13.2% 76 100% Yemen Situation Analysis 15 There is no agreement as to whether transportation should be by delivery or pick-up. More than 40% of the interviewees would prefer if the suppliers of commodities would deliver the contraceptives and 7 (6.3%) interviewees recommend obtaining commodities during regular supervision visits. 33.8% of the respondents would prefer to offer their own transportation 14.7% suggested receiving transportation cost allocations on a regular basis. Figure 5: Preferred Method of Delivery of Contraceptives (by facility type) GHO District District hospital Main Peripheral HUs Warehouse Warehouse warehouse HCs HC Offering car Supplier Providing transportation cost Supply during supervision visits delivers Transport, Distance, Road Conditions and Cost: Almost all staff, at every level, has knowledge about road conditions in their area of responsibility, as well as the time needed for transportation of commodities and the road variations throughout the seasons. Staffers at 65 facilities were also able to provide realistic estimations about transportation costs. About 40% of the facilities visited are further than 50 km from their supply source. Figure 6: Distance from the Supply Facility 15% 0 20 40 60 80 100 120 12% 30% 43% Distance to supply facility < 5 km Distance to supply facility is from 10 to 50 km Distance to supply facility is from 5 to 10 km Distance to supply facility is > 50km Of the 65 facilities that provided a transport cost estimate, the average cost per round trip from supplier to the facility was 4,750 YR. Facilities that could not provide an estimate are excluded from this calculation. Excluding the costs of transport from MOPHP to the GHO warehouse, the average cost for a facility would amount to 4,400 YR per round trip. Even though actual costs vary considerably among governorates, this cost calculating exercise clearly indicates that ensuring regular supply with contraceptives 2 or four times per year to all facilities would be a financially feasible and potentially sustainable option. Yemen Situation Analysis 16 Table 8: Mean Cost of Transportation from Supplier to Facility by Facility Type Facility Type Mean Cost (YR) N GHO Warehouse 12,233 3 District Warehouse 5,515 13 District hospital warehouse 2,820 15 Main Health Center 4,613 15 Peripheral Health Center 4,200 5 Health Unit 4,886 14 Total 4,758 65 Table 9: Mean Cost of Transportation from Supplier to Facility by Governorate Governorate Name Mean Cost (YR) N Amran 3,495 21 Marib 3,840 10 Shabwah 4,454 13 Sa'adah 3,969 13 Al- Jawf 11,000 8 Total 4,758 65 Storage For the most part, fundamental storage guidelines and storage procedures are not practiced. Only eight (8) facilities visited used First Expiry/First Out (FEFO). The survey results show that 94.7% (72) of the facilities do not apply FEFO correctly, and did not know the concept or its application. In additional to the above, in assessing the current storage facilities, major problems exist such as improper lighting, lack of electricity, and water leakage. The detailed table of current storage conditions per Governorate follows. Table 10: Current Storage Conditions According to Facility Type Facility Type GHO Wareho use District Warehouse District Hospital Warehouse Main Health Center Periphera l Health Center Health Unit Daily register of the temperature Yes 1 No 5 14 19 16 5 15 Is the store-in-charge familiar with the recommended storage conditions of the different contraceptives? Yes 2 6 9 3 4 No 3 7 11 13 5 11 Is the store-in-charge aware of maximum Yes 2 2 5 1 1 No 3 11 15 15 5 14 Yemen Situation Analysis 17 temperatures encountered in the store? Is the stock register kept inside or outside of the storage area Inside 4 8 7 9 1 5 Outside 2 2 1 No Records 1 3 10 7 4 9 Is it clean and free of debris? Yes 5 11 17 11 5 9 No 2 1 3 3 Indicator of infestation by insects or rodents? Yes 3 3 11 5 4 6 No 2 10 8 9 1 6 Evidence of water leakage Yes 4 3 12 6 4 6 No 1 10 7 8 1 6 Is there any ventilation facility Yes 4 6 15 9 4 7 No 1 7 4 5 1 5 Is there an electricity supply to the store? Yes 5 10 17 10 5 8 No 2 2 4 4 Are there tube lights or other lighting facilities? Yes 4 6 9 7 1 2 No 1 7 10 7 4 10 Is there more than one access door? Yes 2 2 1 5 No 3 13 17 13 5 7 Is the store locked when the facility is closed? Yes 5 12 18 13 5 8 No 1 1 1 4 How many persons are keeping the store key? One 3 13 17 11 5 11 >1 2 1 2 3 1 Is there any means to fight fire? Yes 1 1 No 5 12 18 14 5 12 Are there any cupboards or store shelves? Yes 3 9 16 11 5 6 No 2 4 3 3 6 Are the commodities in the store properly stacked ( off the ground by 10 cm) Yes 4 9 9 4 1 3 No 1 4 3 9 2 4 Are the commodities in the store with space (30 cm) between the walls and the stacks? Yes 3 9 7 3 2 1 No 2 4 5 10 2 5 Are the commodities in the store with labeled and expiry dates visible and cartons upright? Yes 3 5 7 1 1 No 2 8 5 12 3 5 Are there any expired contraceptives in stock now? Give name(s) of product(s) and expiry date(s) Yes 1 1 1 1 No 4 14 19 15 5 14 Yemen Situation Analysis 18 Stock records Differences in stock record and physical counts were prevalent in (96.1%) almost all facilities visited. (Facilities with correct records were identified in Marib (GHO warehouse and one district warehouse), in Sa'adah one main health center. Staff from those facilities might be further assessed to join the team of trainers for future quality improvement tasks. In order to test whether staff was actively managing their stock and store commodities in a systematic way, staff was asked to locate units of Microgynon (as an example of any contraceptive commodity). While almost 83.1% of staff interviewed was able to locate Microgynon units in their facility, 4.6% of staff interviewed was not able to do so in their own facility (no such problems in Marib and Sa'adah). During the situational analysis, Microgynon was not available at all in 1 district warehouse and in one main health center. Half of all staff in charge of storage were able to give the exact amount of Microgynon currently available from the records (correct or error less than 10 cycles). Table 11: Management of the stock and store commodities Governorate Ask the staff member responsible for storage to locate all units of "Microgynon" and record how the task was carried out Totals Easily located units Located all units with difficulty or following prompting Could not locate all units Microgynon is not available Count Col % Count Col % Count Col % Count Col % Count Col % Amran 19 82.6% 1 4.3% 1 4.3% 2 8.7% 23 100% Marib 10 83.3% 2 16.7% 12 100% Shabwah 11 84.6% 1 7.7% 1 7.7% 13 100% Sa'adah 13 86.7% 2 13.3% 15 100% Al- Jawf 1 50.0% 1 50.0% 2 100% Total 54 83.1% 6 9.2% 3 4.6% 2 3.1% 65 100% Quality control Only 38.2% of facilities can provide evidence (records) of systematic quality checks of products (see Table 12). While Amran presents regular check ups, no evidence was found in Marib and Shabwah Governorate for such check ups. However the usefulness of such checkups is not certain since only one quarter of those facilities who do the quality checks send the results to the higher supply level. The value of quality checks is further limited by the fact that less than 4% of staff interviewed is able to quote signs of damage for the different contraceptive products (see Table 13). Almost all interviewees suggested specific actions to take if products were found damaged or expired. The suggested actions from their responses included “stop dispensing products to the clients”, “destroy the products and prepare a record documenting the loss” and “send the products back to the supplier (see Table 14). No unified protocol exists. Yemen Situation Analysis 19 Table 12: Quality control for the contraceptive products Governorate Record of examining medical items If yes, Is it documented in writing to the higher authorities? Yes No Yes No Count Col % Count Col % Count Col % Count Col % Amran 8 32.0% 17 68.0% 8 100% Marib 3 25.0% 9 75.0% 3 100% Shabwah 2 13.3% 13 86.7% 2 100% Sa'adah 14 93.3% 1 6.7% 1 7.1% 13 92.9% Al- Jawf 2 22.2% 7 77.8% 1 50.0% 1 50.0% Total 29 38.2% 47 61.8% 10 34.5% 19 65.5% Table 13: Knowledge of Signs of Damage for the Different Contraceptive Products Knowledge Level Frequency Percent Valid Percent Cumulative Percent Have enough knowledge 3 3.9 3.9 3.9 Don't have enough knowledge 35 46.1 46.1 50.0 Don't Know 38 50.0 50.0 100.0 Total 76 100.0 100.0 Table 14: Course of action the facility manger takes if there are any damaged contraceptives in the store Frequency Percent Cumulative Percent Record minutes documenting loss 14 18.4% 18.4% Send products back to district 6 7.9% 26.3% Send products back to GHO 17 22.4% 48.7% Destroy the products 5 6.6% 55.3% Inform supervisor 9 11.8% 67.1% No history of damaged or expired contraceptives 21 27.6% 94.7% Stop dispensing products to the clients 4 5.3% 100% Total 76 100% Yemen Situation Analysis 20 Existence of expired products Expired contraceptive products at the survey time were found only in 2 facilities at Shabwah governorate (GHO warehouse and one district warehouse) and one health center and one health unite at Sa'adah governorate. Table 15: Existence of expired products Governorate Are there any expired contraceptives in stock now? Yes No Amran 25 Marib 12 Shabwah 2 13 Sa'adah 2 13 Al- Jawf 9 Total 4 72 AVAILABILITY OF COMMODITIES Products available at the time of visit Oral Contraceptives (Microgynon) were available in one third of facilities at the time of visit. However, performance varied by governorate. Oral contraceptives were available in all visited facilities of Marib governorate and only 9.1% of facilities in Al-Jawf. Table 16: Oral Contraceptives available at time of visit Governorate Oral Contraceptives Available at time of visit Amran 80.0% Marib 100.0% Shabwah 71.4% Sa'adah 73.3% Al- Jawf 9.1% Intrauterine devices (IUDs) were available in all (5) GHO warehouses, 50% of district warehouses and 68% of district hospital warehouses. 30% of main health centers stocked IUDs. Vaginal foaming tablets (VFTs) were available in 4 GHO warehouses but were not available in the Amran GHO warehouse. VFTs were available at the time of visit in 28.6% of health centers and health units. Yemen Situation Analysis 21 Depo-Provera was available in all visited GHO warehouses and in 78.6% of the visited district warehouses and one third of district hospital warehouses. They were also available in 60% of visited health units. Implants were not available in 4 Governorates visited facilities because they don’t have the specialist staff to insert implants. Implants were available at Shabwah GHO warehouse, Male condoms were widely available. Figure 7: Percent of facilities with contraceptive available at time of visit 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 84% 76% 72% 63% 46% 42% 18% 4.7% Male Depo Micronor Microgynon Vaginal IUD Neogynon Implants condom provera tab. Yemen Situation Analysis 22 Table 17: Availability of contraceptive methods per facility type Facility type Total GHO Wareho use District Warehouse District hospital warehouse Main Health Center Peripher al Health Center Health Unit Availability of Microgynon available Count 4 11 13 9 1 9 47 Col % 80% 78.6% 68.4% 52.9% 20% 60% 62.7% not available Count 1 3 6 8 4 6 28 Col % 20% 21.4% 31.6% 47.1% 80% 40% 37.3% Availability of Micronor available Count 4 12 17 11 2 11 57 Col % 80% 85.7% 89.5% 64.7% 40% 73.3% 76% not available Count 1 2 2 6 3 4 18 Col % 20% 14.3% 10.5% 35.3% 60% 26.7% 24.0% Availability of Vaginal tab. available Count 4 4 9 5 0 9 31 Col % 80% 28.6% 56.3% 33.3% 0% 60% 46.3% not available Count 1 10 7 10 2 6 36 Col % 20% 71.4% 43.8% 66.7% 100% 40% 53.7% Availability of IUD available Count 5 6 11 4 0 1 27 Col % 100% 42.9% 68.8% 30.8% 0% 6.7% 41.5% not available Count 0 8 5 9 2 14 38 Col % 0% 57.1% 31.3% 69.2% 100% 93.3% 58.5% Availability of Depo provera available Count 5 11 11 11 2 9 49 Col % 100% 78.6% 64.7% 73.3% 100% 60% 72.1% not available Count 0 3 6 4 0 6 19 Col % 0% 21.4% 35.3% 26.7% 0% 40% 27.9% Availability of implants available Count 1 0 2 0 0 0 3 Col % 20% 0% 13.3% 0% 0% 0% 4.7% not available Count 4 14 13 13 2 15 61 Col % 80% 100% 86.7% 100.0% 100% 100% 95.3% Availability of Male condom available Count 5 12 14 15 1 12 59 Col % 100% 85.7% 82.4% 93.8% 33.3% 80.0% 84.3% not available Count 0 2 3 1 2 3 11 Col % 0% 14.3% 17.6% 6.3% 66.7% 20.0% 15.7% Availability of Neogynon available Count 1 4 6 0 1 12 Col % 20% 28.6% 37.5% 0% 0% 6.7% 18.2% not available Count 4 10 10 15 1 14 54 Col % 80% 71.4% 62.5% 100.0% 100% 93.3% 81.8% Yemen Situation Analysis 23 Stock outs Stock outs over the last six months were observed only in Amran Governorate, for Microgynon (mean 16 days) and Micronor (14 days) only, Depo provera (14 days) and for male condom (12 days). There was no data for stock out of Al-Jawf governorate Table 18: Mean days of stock out in last 6 months Governorate name Microgynon stock out Micronor stock out V tab stock out IUD stock out Depo Provera stock out Male condom stock out Amran Mean 16 14 .0 .0 14 12 N 25 24 2 8 24 24 Marib Mean .0 .0 .0 .0 .0 .0 N 12 12 7 9 10 9 Shabwah Mean .0 .0 .0 .0 .0 .0 N 9 10 3 2 1 3 Sa'adah Mean .0 .0 .0 .0 .0 .0 N 15 15 11 5 15 12 Al-Jawf No data No data No data No data No data No data Yemen Situation Analysis 24 REPORTING AND SUPERVISION Reporting frequency and content of contraceptive logistic reports Most visited facilities are reporting contraceptive logistics data (93.4%). 36.6% prepare quarterly reports (mostly the GHO warehouses), and 63.4% of facilities prepare monthly reports. In Marib and Al-Jawf governorates quarterly reporting is more typical. Reporting contraceptive logistics data does not seem to be linked to routine ordering particularly where reporting intervals are 3 months or longer. Table 19: Type of report on contraceptive logistics Period Frequency Percent Valid Percent Cumulative Percent Monthly 45 59.2% 63.4% 63.4% Quarterly 26 34.2% 36.6% 100% Total 71 93.4% 100% No report 5 6.6% Total 76 100% Table 20: Type of report by facility type Type of reports on contraceptives logistics Total Monthly Quarterly GHO Warehouse Count 5 5 Col % 100% 100% District Warehouse Count 9 5 14 Col % 64.3% 35.7% 100% District hospital warehouse Count 9 8 17 Col % 52.9% 47.1% 100% Main Health Center Count 11 5 16 Col % 68.8% 31.3% 100% Peripheral Health Center Count 5 5 Col % 100% 100% Health Unit Count 11 3 14 Col % 78.6% 21.4% 100% Total Count 45 26 71 Col % 63.4% 36.6% 100% 48.9% of the reports submitted contain information about the number of clients by method and the number of commodities distributed. The broad majority of interviewees had never heard the word CYP: only five persons knew this term and only one of them knew how to calculate this indicator. Yemen Situation Analysis 25 Figure 8: Contraceptive Logistic Data type 45%49% 6% # Clients served by method # Contraceptives distributed by method Report w ith both types of data Supervision Only 47.4% of all facilities visited have ever received a supervision visit with logistics management content. Responses varied considerably between Governorates: In Marib and Sa'adah around 80% of facilities have received supervision specific to contraceptive logistics, but facilities in Amran, and Shabwah reported little logistics management supervision. Only two governorates supervised their health units: Sa'adah and Al-Jawf. Supervision is very weak. Of the 36 facilities which received any supervision, 8 facilities received supervision through the central level from the RH office of the MOPHP. 15 facilities (all in Marib governorate) reported having received a visit from Regional level staff, either the GHO RH director or GHO TST member. Only seven facilities reported having received a visit from a DHO officer such as the DHO RH responsible or the DHO RH supply responsible. Figure 9: Percent of Supervision Visits by Level of Responsibility 14% 25% 42% 19% MOPHP level GHO level District level Visit from GHO&DHC Yemen Situation Analysis 26 Among the 36 facilities that had supervision during the last 6 months, 33 facilities received 4 or more visits, a finding that may also point to deficiencies in efficient planning and use of resources. The assessment results support the observation that there is little supervision planning and that supervision is conducted on an ad hoc basis or in conjunction with other unrelated tasks. Facilities and service providers receive little supervision, especially at health units, and do not benefit from the support of their superiors for contraceptive logistics. It is further worth noting that central level needs to increase the frequency of support visits to GHOs in order to maintain minimum levels of quality and to understand needs and issues at the governorate level. Table 21: Number and percents of supervision visits done last 6 months per facility type Responsible Facility type GHO RH director DHO RH responsible DHO RH supply responsible RH GHO TST RH Supply responsible of MOPHP GHO RH director & DHO RH responsible Total Count 2 2 Col % 100% 100% GHO Warehouse Row % 22.2% 5.6% Count 4 1 1 6 Col % 66.7% 16.7% 16.7% 100% District Warehouse Row % 57.1% 12.5% 11.1% 16.7% Count 3 1 2 2 3 11 Col % 27.3% 9.1% 18.2% 18.2% 27.3% 100% District hospital warehouse Row % 42.9% 20% 25.0% 22.2% 60% 30.6% Count 3 3 2 8 Col % 37.5% 37.5% 25% 100% Main Health Center Row % 60% 37.5% 22.2% 22.2% Count 1 1 2 Col % 50% 50% 100% Peripheral Health Center Row % 20% 11.1% 5.6% Count 2 2 1 2 7 Col % 28.6% 28.6% 14.3% 28.6% 100% Health Unit Row % 100% 25% 11.1% 40% 19.4% Total Count 7 5 2 8 9 5 36 Col % 19.4% 13.9% 5.6% 22.2% 25% 13.9% 100% Row % 100% 100% 100% 100% 100% 100% 100% Yemen Situation Analysis 27 Contraceptive Supply Manual The training Manual on Contraceptives Logistic System is available in 38.2% of visited facilities, the manual is available in four out of five GHO warehouses. The family planning logistics manual was unknown to about 50% of the persons in charge of contraceptive storage interviewed. The majority of the family planning service providers (about 60% in this study) have not yet been introduced to it. Figure 10: Visited Facilities with Available Copy of Contraceptive Logistics Manual 80% 21% 45% 47% 20% 27% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% GHO District District HC Other HC HU Warehouse Warehouse Hospital 4/5 3/14 9/20 1/5 4/15 4/15 Yemen Situation Analysis 28 CONCLUSION The present Data reveals the following: Human resources working in contraceptive logistics GHO warehouses are understaffed; most have only one staff member who is required to do all logistic tasks (ordering, receiving, storing, dispensing). Staff is largely stable in their workplace, which is seen to be a favorable condition for investing in training and indicates that staff should be knowledgeable about specifics of their working environment. In general, the staff is satisfied with their work, but only 50% of health personnel have received specific training related to the task. Training does not appear to have been effective in raising staff knowledge and skills regarding contraceptive logistics. Staff ability to calculate need, place orders, maintain stocks and ensure minimal storage requirements is weak. Supply chain management Staff has good experience and hade good knowledge about some practical aspects of delivering contraceptives to their facility. They can give a reasonable estimation for costs of transportation of contraceptives from the supply facility to their facilities and they are completely aware of the various circumstances that may affect the process of transporting the contraceptives. The proper supply chain model as defined in the logistic system manual is not implemented. The main weaknesses include too frequent and inaccurate orders. Staffers do not know how to calculate reorder quantity and contraceptive order quantities tend to be personal estimations. Nearly all facilities including GHO warehouses are going personally to request and transport contraceptives. This consumes a lot of time and cost especially when we know that there is a limited number of staff (one or two per facility) working on FP logistics., That means that staff must be absent from work two to three days per month in order to request and transport contraceptives which is clearly unacceptable. Storage and Stock Management Knowledge of some basic issues of physical storage was satisfactory. However, knowledge about basic stock management (e.g. FEFO, labeling of cartons etc.) was highly deficient. Staff was equally found unable to do simple quality control procedures and generally systematic quality control is not practiced. Lack of a consistent use of standard receipt and order forms poses additional challenges for store management. Contraceptive Availability At GHO level the whole contraceptive mix necessary for the District health System was not 100% available. Not surprisingly, none of the visited facilities had the full contraceptive method mix at the time of the visit. Availability was worse at the peripheral health centers and Health Units. Implants are not widely available because they are not yet considered standard elements of the contraceptive mix and few providers are trained to insert and remove them. Contraceptive stock out durations (where they could be measured) ranged from 12 to 16 days. Amran seemed to deal with the most stock outs. Al Jawf had no data. Yemen Situation Analysis 29 Reporting Routine reporting was introduced many years ago, and the majority of interviewees regularly report. However, one serious constraint is that the format and content of the reports is not standardized. Due to this, the little data available is of little use for pipeline monitoring, forecasting and other logistics functions. Supervision Supervision is random and unplanned and the roles of MOPHP and district personnel as supervisors of facilities and service providers are ill-defined. Health units do not benefit from support of their superiors in terms of contraceptive logistics. It is further worth noting that central level needs to increase the frequency of support visits to GHOs in order to maintain minimum levels of quality and to understand needs and issues in a decentralized system that theoretically should be empowering Governorates and Districts. Supervision is highly deficient in several aspects: If supervision is conducted, it is usually undertaken by the GHO level to the facility, the DHOs do not assume this responsibility (for a variety of reasons) to provide guidance to service providers/managers/store keepers and they equally miss the opportunity to steer and correct problems within their Districts. Most of the facilities do no receive any supervision at all, while some facilities receive an excessive number of visits Governorate warehouses do not receive supervision from the central level. The national manual for contraceptive logistics is not generally available and even where it is available; it is not used as a reference document. Yemen Situation Analysis 30 RECOMMENDATION Based on assessment results, to facilitate adequate supply, the following series of measures are recommended: At central policy level (Ministry and Partners) The contraceptive logistics policy needs to be nationwide, clear, well disseminated and supported by the appropriate tools and mechanisms; essential steps are: • Survey results of all current studies should be brought together and summarized in view of − Differences between regions or specific settings − Shared policy recommendations • The manual for contraceptive logistics needs to b e updated, reprinted and distributed to all facilities in the country • Registers, forms and the system of reporting needs to be unified; sufficient quantities of printed tools need to be printed, distributed At central warehouse level Regulation, supply and distribution must be actively managed by the experts in charge of the central warehouse focusing on • Appropriate central storage • Appropriate forecasting, procurement (including safety stocks to meet the most probably increasing need) based on a suitably (simple!) computerized system • Regular supply to the Governorates including supervision of the GHO warehouses • All public contraceptives need to be clearly labeled “not for sale” and the public must be informed about the policy At Governorate Level Ensuring a hierarchical and regular supply system in the Governorates by • Sharing the results of the SA with the GHOs to raise awareness off the challenges and opportunities • Enabling governorates to deliver appropriate quantities of contraceptives to their districts in order to overcome the shortage of working staff repeated and stock-outs • Ensuring appropriate storage in districts in order to address deficiencies in storing and quality control • Developing realistic distribution plans from the districts to ALL functioning health services and providing the necessary funds for distribution and regular supervision on a quarterly basis in order to overcome the currently prevailing unsystematic supply and wasted staff time and resources • ensuring that staff at all levels have appropriate registers and forms, as well as the appropriate skills to apply them, and to make appropriate quarterly orders in order to overcome the lack of capacity and facilitate management of contraceptive logistics at all levels Yemen Situation Analysis 31 32 Yemen Situation Analysis REFERENCES Cincotta, Richard P. and Robert Engelman. 1997. Economics and Rapid Change: The Influence of Population Growth. Washington, DC: Population Assistance International. FHI, 2005. The Importance of Family Planning in Reducing Maternal Mortality. FHI 2005 League of Arab States, the Republic of Yemen, Ministry of health and Population and Central Statistical Organization; 2005, Yemen Family health Survey (YFHS), Principal Report MOPHP, Yemen, April 2000, Guide to the Logistic Procedures, Responsibilities and Functions of Supervisors and Store Keepers of Family Planning Methods and Reproductive Health Drugs. MOPHP, Population Sector, THE NATIONAL STRATEGY AND NATIONAL PLAN OF ACTION FOR THE POPULATION SECTOR 2006 – 2010, draft version November 2005, translated in to English by YG_RHP Setty-Venugopal, V., R. Jacoby, and C. Hart. 2002. Family Planning Logistics: Strengthening the Supply Chain. Population Reports 30(1): 1.23. Shane, Barbara. 1997. Family Planning Saves Lives. Washington, DC: Population Reference Bureau. UNFPA, WHO. 2003. Essential drugs and other commodities for reproductive health services. World Bank. 1993. World Development Report 1993: Investing in Health. New York: Oxford University Press. Yemen Situation Analysis 33 34 Yemen Situation Analysis ANNEX 1: DETAILED RESULTS OF SKILLS AND PRACTICE OF STORAGE PER GOVERNORATE Yemen Situation Analysis 35 Al- Jawf Facility type GHO Warehouse District Warehouse District Hospital warehouse Main Health Center Peripheral Health Center Health Unit Daily register of the temperature Yes No 1 1 2 5 Is the store-in-charge familiar with the recommended storage conditions of the different contraceptives? Yes No 1 1 2 5 Is the store-in-charge aware of maximum temperatures encountered in the store? Yes No 1 1 2 5 Is the stock register kept inside or outside of the storage area? Inside Outside 1 No records 1 1 2 4 Is it clean and free of debris? Yes 1 1 3 No 1 2 Indicator of infestation by insects or rodents? Yes 1 1 3 No 1 2 Evidence of water leakage Yes 1 1 1 3 No 2 Is there any ventilation facility Yes 1 1 1 2 No 3 Is there an electricity supply to the store? Yes 1 1 1 5 No Are there tube lights or other lighting facilities? Yes 1 1 1 No 1 4 Is there more than one access door? Yes 3 No 1 1 1 2 Is the store locked when the facility is closed? Yes 1 1 1 4 No 1 How many persons are keeping the store key? One 1 1 1 5 > 1 Yemen Situation Analysis 36 Is there any means to fight fire? Yes No 1 1 1 5 Are there any cupboards or store shelves? Yes 1 1 3 No 1 2 Are the commodities in the store properly stacked ( off the ground by 10 cm Yes 1 1 1 No 1 Are the commodities in the store with space (30 cm) between the walls and the stacks? Yes 1 No 1 1 Are the commodities in the store with labeled and Yes 1 1 expiry dates visible and cartons upright? No 1 Are there any expired contraceptives in stock now? Give name(s) of product(s) and expiry date(s) Yes No 1 1 2 5 Yemen Situation Analysis 37 Amran Facility type GHO Warehouse District Warehouse District hospital warehouse Main Health Center Peripheral Health Center Health Unit Daily register of the temperature Yes No 1 8 3 7 1 5 Is the store-in-charge familiar with the recommended storage conditions of the different contraceptives? Yes 2 1 1 No 1 5 2 6 1 5 Is the store-in-charge aware of maximum temperatures encountered in the store? Yes No 1 7 3 7 1 5 Is the stock register kept inside or outside of the storage area? Inside 1 6 3 7 1 5 Outside 1 No records Is it clean and free of debris? Yes 1 5 2 5 1 5 No 2 1 2 Indicator of infestation by insects or rodents? Yes 1 1 1 3 No 6 2 7 1 2 Evidence of water leakage Yes 1 2 2 No 7 1 7 1 3 Is there any ventilation facility Yes 1 1 2 4 3 No 6 1 3 1 2 Is there an electricity supply to the store? Yes 1 5 2 5 1 1 No 1 1 2 4 Are there tube lights or other lighting facilities? Yes 1 2 2 4 1 No 5 1 3 5 Is there more than one access door? Yes 1 1 1 No 7 2 7 1 4 Is the store locked when the facility is closed? Yes 1 6 3 6 1 3 No 1 1 2 How many persons are keeping the store key? One 1 7 3 6 1 5 > 1 1 1 Yemen Situation Analysis 38 Is there any means to fight fire? Yes No 1 7 3 7 1 5 Are there any cupboards or store shelves? Yes 5 1 5 1 3 No 1 2 2 2 2 Are the commodities in the store properly stacked ( off the ground by 10 cm Yes 1 5 2 3 1 1 No 2 1 4 4 Are the commodities in the store with space (30 cm) between the walls and the stacks? Yes 5 2 2 1 1 No 1 2 1 5 4 Are the commodities in the store with labeled and Yes expiry dates visible and cartons upright? No 1 7 3 7 1 5 Are there any expired contraceptives in stock now? Give name(s) of product(s) and expiry date(s) Yes No 1 8 3 6 1 5 Yemen Situation Analysis 39 Marib Facility type GHO Warehouse District Warehouse District hospital warehouse Main Health Center Peripheral Health Center Health Unit Daily register of the Yes temperature No 1 4 5 1 1 Is the store-in-charge familiar with the recommended storage conditions of the different contraceptives? Yes 4 4 1 1 No 1 1 Is the store-in-charge aware of maximum temperatures encountered in the store? Yes 2 4 1 1 No 1 2 1 Is the stock register kept inside or outside of the storage area? Inside 1 2 3 1 Outside 1 1 No records 1 1 1 Is it clean and free of debris? Yes 1 4 5 1 1 No Indicator of infestation by insects or rodents? Yes No 1 4 5 1 1 Evidence of water leakage Yes 1 No 1 3 5 1 1 Is there any ventilation facility Yes 1 3 4 1 1 No 1 1 Is there an electricity supply to the store? Yes 1 3 4 1 No 1 1 1 Are there tube lights or other lighting facilities? Yes 1 2 3 1 No 2 2 1 Is there more than one access door? Yes 1 No 1 4 5 1 Is the store locked when the facility is closed? Yes 1 4 4 1 No 1 1 How many persons are keeping the store key? One 4 5 1 1 > 1 1 Yemen Situation Analysis 40 Is there any means to fight fire? Yes 1 1 No 1 3 4 1 1 Are there any cupboards or store shelves? Yes 1 3 5 1 No 1 1 Are the commodities in the store properly stacked ( off the ground by 10 cm Yes 1 2 3 1 No 2 2 1 Are the commodities in the store with space (30 cm) between the walls and the stacks? Yes 1 3 3 No 1 2 1 1 Are the commodities in the store with labeled and expiry dates visible and cartons upright? Yes 1 4 5 1 1 No Are there any expired contraceptives in stock now? Give name(s) of product(s) and expiry date(s) Yes No 1 4 5 1 1 Yemen Situation Analysis 41 Sa'adah Facility type GHO Warehouse District Warehouse District hospital warehouse Main Health Center Peripheral Health Center Health Unit Daily register of the temperature Yes 1 No 1 1 4 3 4 Is the store-in-charge familiar with the recommended storage conditions of the different contraceptives? Yes 1 3 1 3 No 1 2 2 1 Is the store-in-charge aware of maximum temperatures encountered in the store? Yes 1 No 1 5 3 4 Is the stock register kept inside or outside of the storage area? Inside 1 1 Outside 1 No records 1 3 3 4 Is it clean and free of debris? Yes 1 1 4 3 No 1 Indicator of infestation by insects or rodents? Yes 1 4 3 No 1 1 Evidence of water leakage Yes 1 1 4 3 1 No Is there any ventilation facility Yes 1 3 1 1 No 1 1 2 Is there an electricity supply to the store? Yes 1 1 4 3 1 No Are there tube lights or other lighting facilities? Yes 1 1 4 3 No 1 Is there more than one access door? Yes 1 1 No 1 4 3 Is the store locked when the facility is closed? Yes 1 1 4 3 1 No How many persons are keeping the store key? One 1 1 3 2 > 1 1 1 1 Yemen Situation Analysis 42 Is there any means to fight fire? Yes No 1 1 4 3 1 Are there any cupboards or store shelves? Yes 4 3 No 1 1 1 Are the commodities in the store properly stacked (off the ground by 10 cm) Yes 1 1 4 1 No 2 Are the commodities in the store with space (30 cm) between the walls and the stacks? Yes 1 1 2 1 No 2 2 Are the commodities in the store with labeled and expiry dates visible and cartons upright? Yes 1 2 No 1 2 3 Are there any expired contraceptives in stock now? Give name(s) of product(s) and expiry date(s) Yes 1 1 No 1 1 5 3 3 Yemen Situation Analysis 43 Shabwah Facility type GHO Warehouse District Warehouse District hospital warehouse Main Health Center Peripheral Health Center Health Unit Daily register of the temperature Yes No 1 7 3 4 Is the store-in-charge familiar with the recommended storage conditions of the different contraceptives? Yes 1 1 No 6 3 4 Is the store-in-charge aware of maximum temperatures encountered in the store? Yes 1 1 No 6 3 4 Is the stock register kept inside or outside of the storage area? Inside 1 1 Outside No records 6 2 4 Is it clean and free of debris? Yes 1 6 2 4 No Indicator of infestation by insects or rodents? Yes 1 6 2 4 No 1 Evidence of water leakage Yes 1 6 2 4 No 1 Is there any ventilation facility Yes 1 6 2 4 No 1 Is there an electricity supply to the store? Yes 1 7 1 4 No 1 Are there tube lights or other lighting facilities? Yes No 1 7 2 4 Is there more than one access door? Yes 1 No 1 6 2 4 Is the store locked when the facility is closed? Yes 1 7 2 4 No How many persons are keeping the store key? One 6 1 4 > 1 1 1 1 Yemen Situation Analysis 44 Is there any means to fight fire? Yes No 1 7 2 4 Are there any cupboards or store shelves? Yes 1 6 2 4 No 1 Are the commodities in the store properly stacked (off the ground by 10 cm) Yes No 1 1 2 Are the commodities in the store with space (30 cm) between the walls and the stacks? Yes 1 No 1 1 2 Are the commodities in the store with labeled and Yes expiry dates visible and cartons upright? No 1 1 2 Are there any expired contraceptives in stock now? Give name(s) of product(s) and expiry date(s) Yes 1 1 No 6 3 4 Yemen Situation Analysis 45 46 Yemen Situation Analysis ANNEX 2: QUESTIONNAIRE/SURVEY TOOL: FAMILY PLANNING LOGISTICS SITUATIONAL ANALYSIS Yemen Situation Analysis 47 1اﻷﺳـﺮة ﺗﻨﻈﻴﻢ ﻟﻮﺳـﺎﺋﻞ اﻹﻣـﺪاد ﻧﻈﺎم ﺗﻘﻴﻴﻢ 1sisylanA lanoitautiS scitsigoL gninnalP ylimaF اﻟﻤﻘـﺪﻣــﺔ dnuorgkcaB ﺞﻣاﻟﺒﺮﻧﺎ إﻟﻰ ﻤﺤﺎﻓﻈﺎتﻟﺑﺎ ﺼﺤﺔﻟا ﺎﺗﺐﻜﻣ ﺗﻘﺪﻣﺖ ﺤﻠﻲﻣ دﻋﻢ ﺑﻄﻠﺐ ﻴﺔﻧﺠﺎﺑاﻹ ﺼﺤﺔﻠﻟ ﻧﻲﻤﺎاﻷﻟ اﻟﻴﻤﻨﻲ اﻷﺳﺮة ﻟﺘﻨﻈﻴﻢ اﻟﺤﺪﻳﺜﺔ ﻟﻠﻮﺳﺎﺋﻞ اﻹﻣﺪاد ﻧﻈﺎم ﻟﺘﻘﻴﻴﻢ ﺿﻊو اﻻﻋﺘﺒﺎر ﺑﻌﻴﻦ ﺿﻊﻟﻮا ﻣﻊ ﻬﺎﻣﺤﺎﻓﻈﺎﺗ ﻓﻲ اﻟﺘﺤﺘﻴﺔ اﻟﺒﻨﻴﺔ ﺗﺸﻤﻞ ﻟﻠﺘﺤﺴﻴﻦ ﻣﻼﺋﻤﺔ اﺳﺘﺮاﺗﻴﺠﻴﺔ .واﻟﺘﺪرﻳﺐ ﻣﺼﻐﺮة ﻓﺮق ﺑﻮاﺳﻄﺔ ﻔﺬﻨﻳ أن ﻳﺠﺐ ﻴﺎناﻻﺳﺘﺒ هﺬا ﻋﻠﻰ اﻟﻤﺪﻳﺮﻳﺎت أو اﻟﺼﺤﺔ ﻣﻜﺎﺗﺐ ﻣﻦ اﺧﺘﻴﺎرهﺎ ﻳﺘﻢ زنﺎﺨﻣو ﺑﺎﻟﻤﺤﺎﻓﻈﺔ اﻟﺼﺤﺔ ﻣﻜﺘﺐ ﻣﺨﺰن ﻣﺴﺘﻮى اﻟﻤﺨﺘﺎرة اﻟﺼﺤﻴﺔ اﻟﻤﺮاﻓﻖ وﻣﺨﺎزن اﻟﻤﺪﻳﺮﻳﺎت أن ﻣﻌﻨѧﺎﻩ ﺑﻤѧﺎ اﻟﻨﻮﻋﻴѧﺔ ﺑﺎﻋﺘﺒѧﺎر ﺗﺆﺧﺬ أن ﻳﺠﺐ اﻟﻌﻴﻨﺔ ﺑﻨ ѧﺪدﻳﺤѧ أن ѧﺐﻳﺠѧ اﻟѧѧﺼﺤﻴﺔ ѧﻖاﻟﻤﺮاﻓѧ ѧﺪدﻋѧ ﻗﻊﻮـﻟﻤا ﺑﻴـﺎﻧﺎت اﻷول اﻟﺠﺰء ـــــــــــــــــــــ اﻟﻤﺤـﺎﻓﻈﺔ etaronrevoG ـــــــــــــــــ ـــــــــــــــــــــ اﻟﻤﺪﻳﺮﻳـﺔ tcirtsiD ـــــــــــــــــــــ ﻳﻌﻤﻞ ﺑﺎﻟﻤﺪﻳﺮﻳﺔ اﻟﺼﺤﻴﺔ اﻹدارة ﻓﺮﻳﻖ ﻳﻌﻤﻞ ﻻ ﺮﻳﺔﺑﺎﻟﻤﺪﻳ اﻟﺼﺤﻴﺔ اﻹدارة ﻳﻖﻓﺮ ﺑﺎﻟﻤﺤﺎﻓﻈﺔ واﻟﺴﻜﺎن اﻟﺼﺤﺔ ﻣﻜﺘﺐ ﻣﺨﺰن (اﻟﻤﺨﺰن ﻣﺴﺌﻮﻟﺔ/ﻣﺴﺌﻮل) ﺑﺎﻟﻤﺪﻳﺮﻳﺔ اﻟﺼﺤﺔ ﻣﻜﺘﺐ ﻣﺨﺰن (اﻟﻤﺨﺰن ﻣﺴﺌﻮﻟﺔ/ﻣﺴﺌﻮل) اﻟﻤﺮآﺰ ﻓﻲ ﺤﻲﺻ اﻟﻤﺮآﺰ (ﻴﺔاﻹﻧﺠﺎﺑ اﻟﺼﺤﺔ ﻣﺴﺌﻮﻟﺔ/ﻣﺴﺌﻮل) ﺧﺮﺁ ﺤﻲﺻ ﻣﺮآﺰ (ﻴﺔاﻹﻧﺠﺎﺑ اﻟﺼﺤﺔ ﻣﺴﺌﻮﻟﺔ/ﻣﺴﺌﻮل) ة ﺻﺤﻴـﺔ وﺣـﺪ اﻟﺼﺤﻴﺔ ﻮﺣﺪةاﻟ ﻋﺎﻣﻠﺔ/ﻋﺎﻣﻞ) lacoL PHR-GY detseuqer setaronrevoG eht ezylana ot redro ni seidisbuS rieht ni scitsigol sevitpecartnoc gningised ot weiv a htiw etaronrevoG tnemevorpmi rof seigetarts etairporppa .gniniart dna erutcurtsarfni gnidulcni yb deilppa eb dluohs eriannoitseuq sihT etaronrevoG ta detceles smaet llams OHG eht ta level tcirtsiD ro/dna detceles dna ,stcirtsiD eht ,esuoheraW eb dluohs gnilpmaS .seitilicaF htlaeh . taht ,evitcepsrep evitatilauq a morf enod eb dluohs seitilicaf fo rebmun eht si eht fo ecneirepxe eht yb denimreted eht gniwohs fo weiv ni maeT-OHG naht rehtar ,smelborp fo epocs .seititnauq etulosba gninimreted ﻋﻠѧѧﻰ ѧﺎءѧ ﻣѧﻦ وذﻟѧﻚ ﺑﺎﻟﻤﺤﺎﻓѧـﻈﺔ اﻟﺼﺤﺔ ﻣﻜﺘﺐ ﻳﻖﻓﺮ ﺧﺒـﺮات آﻤﻴѧﺎت ﺗﺤﺪﻳѧﺪ وﻟѧﻴﺲ اﻟﻤѧﺸﻜﻠﺔ ﻧﻄѧﺎق إﻇﻬѧﺎر ﻣﻨﻄﻠﻖ .ﻣﻄﻠﻘﺔ : noitacifitnedI etiS :enO traP ] [ maeT tnemeganaM htlaeH tcirtsiD ] [ ] [ gninoitcnuf maeT tnemeganaM htlaeH tcirtsiD ] [ gninoitcnuf TON ] [ ] [ ] [ ] [ esuoheraW OHG ] [ )elbisnopseR esuoheraW( esuoheraW tcirtsiD ] [ )elbisnopseR esuoheraW( ertneC eht ta ertneC htlaeH ] [ )elbisnopseR HR( ] [ ertneC htlaeh rehtO ] [ )elbisnopseR HR( ( tinU htlaeH ] [ )rekroW UH( 1 : اﻟﻤﻮﻗﻊ آـﺎدر اﻟﺜﺎﻧﻲ اﻟﺠﺰء :gniffatS etiS :owT traP 2-1: : :woleb secaps eht ni etis siht ta gnikrow ffats tsiL .1.2 ﺸﻬﻮرواﻟ ﺑﺎﻟﺴﻨﻮات ﻣﺤﺪدة اﻟﻤﻮﻗﻊ هﺬا ﻓﻲ اﻟﺨﺪﻣﺔ ﻓﺘﺮة eltiT etis siht ta gnikrow shtnom dna sraeY اﻟﻮﻇﻴﻔﺔ اﻟﺘﺎﻟﻲ اﻟﺠﺪول ﻓﻲ اﻟﻤﻮﻗﻊ هﺬا ﻓﻲ اﻟﻌﺎﻣﻞ اﻟﻜﺎدر اذآﺮ 2-2: :اﻟﺘﺎﻟﻲ اﻟﺠﺪول ﻓﻲ اﻻﻣﺪاد ﻣﻬﺎم ﻋﻦ اﻟﻤﺴﺆول اﻟﻜﺎدر اذآﺮ 2 2.2. List of staff who are responsible for carrying out the logistic tasks listed below ﻞه ﻰﻘﻠﺗ يأ ﺐﻳرﺪﺗ ﻣﻂﺒﺗﺮ ﺔﻤﻬﻤﺑ داﺪﻣﻹا ةﺪﻨﺴﻤﻟا ﻪﻴﻟإ Has ever received any training related to the logistic task لﻮﺌﺴﻤﻟا ﻦﻣ ءﺎﻀﻋأ اﻟﻜردﺎ Responsible staff member ﺔﻤﻬﻣ ﻹاﺪﻣدا Logistic Task ﻻ no ﻢﻌﻧ, ﺮآذا ﻳرﺎﺘﻟاﺦ Yes, add date ﺐﻠﻃ ﻞﺋﺎﺳو ﻢﻴﻈﻨﺗ ةﺮﺳﻷا Ordering contraceptives مﻼﺘﺳا ﻞﺋﺎﺳو ﻢﻴﻈﻨﺗ ةﺮﺳﻷا Receiving contraceptives ﻦﻳﺰﺨﺗ وﺳﻞﺋﺎ ﻢﻴﻈﻨﺗ ةﺮﺳﻷا Storing contraceptives فﺮﺻ وﺳﻞﺋﺎ ﻢﻴﻈﻨﺗ ةﺮﺳﻷا ﺎﺑﺰﻠﻟﺋﻦ Dispensing contraceptives to clients فﺮﺻ وﺳﻞﺋﺎ ﻢﻴﻈﻨﺗ ةﺮﺳﻷا ﻤﻟﻮاﻊﻗ أﺧىﺮ Issuing contraceptives to other sites ﺴﺣبﺎ تﺎﺟﺎﻴﺘﺣﻻا ﻦﻣ ﻞﺋﺎﺳﻮﻟا Calculating needs داﺪﻋإ ﻊﻓرو ﺮﻳرﺎﻘﺗ داﺪﻣﻹا ﻞﺋﺎﺳﻮﺑ ﻢﻴﻈﻨﺗ ةﺮﺳﻷا Reporting on contraceptive logistics ﺐﻠﻃ ﻞﺋﺎﺳو ﻢﻴﻈﻨﺗ ةﺮﺳﻷا Ordering contraceptives 3 2-3: ﺿﻲرا أﻧﺖ هﻞ :اﻟﻤﺴﺌﻮل ﻟﻠﺸﺨﺺ اﻟﺴﺆال وﺟﻪ / ﻚاهﺘﻤﺎﻣﺎﺗ ﻣﺴﺘﻮى وﻋﻦ ﻋﻤﻠﻚ ﺔـﺌﺑﻴ ﻋﻦ راﺿﻴﺔ اﻟﺘﺎﻟﻲ اﻟﻔﺮاغ ﻓﻲ ﺑﺔﻹﺟﺎا ﺘﺐأآ ؟اﻟﻤﻬﻨﻴﺔ وﻣﻌﺎرﻓﻚ : gnikrow ruoy htiw deifsitas uoy erA :elbisnopser nosrep eht ksA .3.2 rewsna ruoy etirW ?tseretni lanoisseforp 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ﻮﺳﺎﺋﻞﻟا اﻟﻤﺮﻓﻖ ﻳﺘﻠﻘﻰ هﻞ : ) اﻟﺘﺎﻟﻲ ﻣﻦ اﻟﻤﻨﺎﺳﺒﺔ اﻹﺟﺎﺑﺔ اﺧﺘﺮ (: )etairporppa sa kcit esaelp( :sevitpecartnoc eviecer ytilicaf eht seoD .2.3 (أ ] [ ﻣﺨﺰﻧﻚ؟/ﻣﺮﻓﻘﻚ ﻗﺒﻞ ﻣﻦ ﻣﻘﺪم ﻃﻠﺐ ﻋﻠﻰ ﻨﺎءﺑ ـــــــــــــــــ وأﺧﺮ؟ ﻄﻠﺐﻟ ﺗﻘﺪﻳﻤﻚ ﺑﻴﻦ اﻟﻔﺎﺻﻠﺔ اﻟﻔﺘﺮة ﻣﺎ اﻷﺳﺮة؟ ﻟﺘﻨﻈﻴﻢ اﻟﺤﺪﻳﺜﺔ ﺳﺎﺋﻞاﻟﻮ ووﺻﻮل اﻟﻄﻠﺐ ﺗﻘﺪﻳﻢ ﺑﻴﻦ اﻟﺰﻣﻨﻴﺔ اﻟﻔﺘﺮة هﻲ ﻣﺎ ــــــــــــــــــ اﻷﺳﺎﺑﻴﻊ ﻋﺪد ﺬآﺮﺑ إﺟﺎﺑﺘﻚ ﺣﺪد ?esuoheraw/ytilicaf ruoy morf redro na fo tnemecalp eht no desab ] [ )a __________________________redro na ecalp uoy od netfo woH tnes si redro eht emit eht neewteb ekat ti seod gnol woH ni rewsna ruoy sserpxe ,evirra sevitpecartnoc eht nehw emit eht dna ___________________________skeew (ب ] [ اﻹﻣﺪاد؟ ﺟﻬـﺔ ﻋﻦ ﺻﺎدر ﻟﻘـﺮار ـﺎوﻓﻘ ــــــــــــــ اﻷﺳﺮة؟ ﻟﺘﻨﻈﻴﻢ اﻟﺤﺪﻳﺜﺔ ﺎﺋﻞﺳﻟﻮا اﺳﺘﻼم ﻳﺘﻢ آﻢ آﻞ ?tniop ylppus eht morf noisiced a ot gnidroccA ] [ )b ____________________?deviecer era sevitpecartnoc netfo woH :- اﻟﺘﺎﻟﻲ ﻣﻦ اﻟﻤﻨﺎﺳﺒﺔ اﻹﺟﺎﺑﺔ أﺧﺘﺮ اﻟﻤﺮﻓﻖ؟ ﻳﺘﻠﻘﺎﻩ ﺳﻮف اﻟﺬي اﻟﻤﺨﺰون ﺣﺠﻢ ﻳﻘﺮر اﻟﺬي ﻣﻦ .3.3 3-3: sa kcit esaelP( ?eviecer lliw ytilicaf eht kcots hcum woh sediced ohW اﻟﺘﺎﻟﻲ ﻣﻦ اﻟﻤﻨﺎﺳﺒﺔ )etairporppa ] [ اﻟﻤﺮﻓﻖ ﻓﻲ اﻟﻤﺨﺰن ﻣﺴﺌﻮل أو ﻴﺔﻧﺠﺎﺑاﻹ اﻟﺼﺤﺔ ﻓﺮﻳﻖ أو ﻓﻖ ﻠﻤﺮﻟ ﺼﺤﻴﺔاﻟ ﻨﺔاﻟﻠﺠ ﻓﻲ ﻋﻀﻮ . .esuoheraw FH fo elbisnopseR/TST HR/CFH eht fo rebmem A ] [ ] [ اﻟﻤﺪﻳﺮﻳـﺔ ﻓﻲ اﻟﺼﺤﻴﺔ اﻹدارة ﻳﻖﻓﺮ 5 )TMHD( maeT tnemeganaM htlaeH tcirtsiD ] [ )OHG( eciffO htlaeH etaronrevoG ] [ ﺎﻟﻤﺤـﺎﻓﻈﺔﺑ اﻟﺼﺤﺔ ﻣﻜﺘﺐ ] [ ] [ أﻋـﺮف ﻻ wonk t’noD ] [ 3-4: اﻷﺳﺮة؟ ﻈﻴﻢﻟﺘﻨ اﻟﺤﺪﻳﺜﺔ اﻟﻮﺳﺎﺋﻞ أﺻﻨﺎف ﻣﻦ ﺻﻨﻒ ﻟﻜﻞ ﺣﺘﻴﺎجاﻻ آﻤﻴﺔ (ﺣﺴﺎب) ﺗﻘﺪﻳﺮ ﻳﺘﻢ آﻴﻒ dedeen si taht tcudorp evitpecartnoc hcae fo seititnauq eht era od woH .4.3 ?detaluclac :ﻟﻲﻟﺘﺎا اﻟﻔـﺮاغ ﻓﻲ اﻹﺟﺎﺑـﺔ أآﺘﺐ woleb xob eht ni rewsna eht droceR ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ 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اﻟﺒﻴــﺎﻧﺎت ataD fo ecruoS اﻟﺒﻴـﺎﻧﺎت ﻣﺼﺪر 6 اﻟﺮاﺑﻊ اﻟﺠﺰء : اﻷﺳﺮة ﻟﺘﻨﻈﻴﻢ اﻟﺤﺪﻳﺜﺔ اﻟﻮﺳﺎﺋﻞ وﻧﻘﻞ اﻹﻣﺪاد ﻣﺼﺪر ﻣﻊ اﻟﺘﻮاﺻﻞ dna ecruos ylppus eht htiw gnitacinummoC :ruoF traP sevitpecartnoc fo tropsnarT 4-1: اﻹﻣﺪاد؟ اﺳﺘﻼم ﻳﺘﻢ ﺑﺎﻟﺘﺤﺪﻳﺪ ﻳﻦأ ﻣﻦ ?deviecer seilppus era yltcaxe erehw morF .1.4 , ] [ ــــــــــــــــــ ﺣﺪدﻩ __________________________yficeps , esuoh eraw lartneC ] [ etaronrevoG ] [ ] [ ] [ tcirtsiD ] [ , ] [ ــــــــــــــــــــــــــــــ أذآﺮهﺎ ________________________________________yficeps ,rehto ] [ 4-2: اﻹﻣﺪاد؟ ﻣﺼﺪر إﻟﻰ اﻷﺳﺮة ﻈﻴﻢﻟﺘﻨ اﻟﺤﺪﻳﺜﺔ اﻟﻮﺳﺎﺋﻞ ﻃﻠﺒﻴﺔ إرﺳﺎل ﻳﺘﻢ آﻴﻒ ?ecruos ylppus eht ot tnes sevitpecartnoc rof tseuqer eht si woH .2.4 ﺑﻨﻔﺴﻪ اﻟﻤﻮﻇﻒ ﻳﺬهﺐ ﺪـﺑﺎﻟﺒـﺮﻳ نﻮﺘﻠﻔـﺑﺎﻟ آﺲﻟﻔـﺎﺑﺎ ] [ ] [ ] [ ] [ nosrep ni seog ffatS ] [ liaM ] [ enohP ] [ xaF ] [ , ] [ ــــــــــــــــــــــــــــ أذآﺮهﺎ ______________________________________ ebircsed ,rehtO ] [ 4-3: اﻟﻤـﻮرد؟ ﻣﻦ اﻷﺳﺮة ﻟﺘﻨﻈﻴﻢ اﻟﺤﺪﻳﺜﺔ اﻟﻮﺳﺎﺋﻞ اﺳﺘﻼم ﻳﺘﻢ آﻴﻒ ?reilppus eht morf deviecer sevitpecartnoc era woH .3.4 meht teg ot seog enoemos ] [ ﻻﺳﺘﻼﻣﻬﺎ اﻟﻤﻮﻇﻔﻴﻦ أﺣﺪ ﻳﺬهﺐ اﻟﻤﻮرد ﻳﻮﺻﻠﻬـﺎ ] [ ] [ ﻣﺮآﺰي ﻣﺨﺰن ﻓﻈﺔاﻟﻤﺤﺎ اﻟﻤﺪﻳﺮﻳﺔ ﺮىﺧأ ﺮىﺧأ sreviled reilppus ] [ ,ﺧﺮأ ﺷﺨﺺ ﻳﻮﺻﻠﻬـﺎ __________________________________ebircsed ,sreviled esle ydobemos ] [ 7 ] [ ـــــــــــــــــــــــــــــ وﺿﺤﻪ 4-4: اﻟﻤﺮﻓﻖ آﺎن إذا ) اﻟﺨﺪﻣﺔ ﺗﻘﺪﻳﻢ ﻄﺔﻧﻘ أو اﻟﻤﺨﺰن ( ﻓﻤﺎ اﻷﺳﺮة ﻟﺘﻨﻈﻴﻢ اﻟﺤﺪﻳﺜﺔ اﻟﻮﺳﺎﺋﻞ أﺧﺬ ﻳﺘﻮﻟﻰ اﻟﻤﺴﺘﺨﺪﻣﺔ؟ اﻟﻤﻮاﺻﻼت وﺳﻴﻠﺔ ﻧﻮع eht skcip )tniop yreviled ecivres ro esuoheraw( ytilicaf eht fI .4.4 ?desu si tropsnart fo edom tahw ,sevitpecartnoc اﻟﻤﺮﻓﻖ ﺳﻴﺎرة ﺎصﻟﺒـا ﺎرةﻴﺳ اﺳﺘﺌﺠﺎر ] [ ] [ ] [ ytilicaF eht fo raC ] [ suB ] [ rac a tneR ] [ _______________________yficeps ,rehto ] [ ] [ ﺮىﺧأ , ـــــــــــــــــ أذآﺮهﺎ 4-5: ﻟﻠﻨﻘﻞ أﻓﻀﻞ ﺑﺪﻳﻞ أو وﺳﻴﻠﺔ ﺑﺸـﺄن ﻣﻘﺘﺮﺣﺎت أي ﻋﻦ اﺳﺄل , اﻟﺘﺎﻟﻲ اﻟﻔﺮاغ ﻓﻲ اﻟﻜﺘﺎﺑﺔ ﺮﺟﻰﻳ : ,noitatropsnart rof evitanretla na ro yaw retteb a fo snoitseggus rof ksA .5.4 woleb xob eht ni etirw esaelp 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ﺳﺠﻞ و "OFEF ﻤﺼﻄﻠﺢﺑ ﻧﻌـﻨﻲ ﻣﺎذا" ﻋﻦ اﻟﻤﺨﺰن ﻣﺴﺌﻮﻟﺔ/ﻣﺴﺌﻮل إﻟﻰ اﻟﺴﺆال وﺟﻪ ﻻ أم ﻴﺤﺔﺻﺤ إﺟﺎﺑﺘﻬﺎ/إﺟﺎﺑﺘﻪ آﺎﻧﺖ إذا ﻣﺎ si rewsna eht ton ro rehtehw woleb drocer dna noitseuQ ”OFEF“ eht ksA .1.5 tcerroc ـﺢﺻ ﺎءﺧـﻄ ] [ ] [ tcerroc ] [ tcerroc ton ] [ 5-2: ﺑﺘﺴﺠﻴﻞ ـﻢوﻗ "اﻟﻤﺎﻳﻜﺮوﺟﻨﻮن" ﺣﺪاتو آﻞ ﻣﻮﻗﻊ ﻳﺪﺗﺤﺪ اﻟﺘﺨﺰﻳﻦ ﻋﻦ اﻟﻤﺴﺆول اﻟﻤﻮﻇﻒ ﻣﻦ اﻃﻠﺐ اﻟﻤﻬﻤﺔ هﺬﻩ ﺑﻬﺎ ﺗﻤﺖ اﻟﺘﻲ اﻟﻜﻴﻔﻴﺔ . fo stinu lla etacol ot egarots rof elbisnopser rebmem ffats eht ksA .2.5 .tuo deirrac saw ksat eht woh drocer dna ”nonygorcim“ stinu detacol ylisaE ] [ ﺑﺴﻬﻮﻟﺔ اﻟﻮﺣﺪات ﺟﻤﻴﻊ ﻣﻮﻗﻊ ﻳﺪﺤﺪﺗ ﺗﻢ ﺑﺼﻌﻮﺑﺔ اﻟﻮﺣﺪات ﺟﻤﻴﻊ ﻣﻮﻗﻊ ﻳﺪﺤﺪﺗ ﺗﻢ ] [ ] [ gnitpmorp gniwollof ro ytluciffid htiw stinu lla detacoL ] [ ] [ ﺣﺪاتاﻟﻮ ﺟﻤﻴﻊ ﻣﻮﻗﻊ ﺗﺤﺪﻳﺪ ﻳﺘﻢ ﻟﻢ stinu lla etacol ton dluoc ] [ 5-3: اﻟﻤﺨﺰﻧﺔ "اﻟﻤﺎﻳﻜﺮوﺟﻨﻮن" وﺣﺪات ﻋﺪد ﻋﻦ ﺎدةاﻹﻓ اﻟﺘﺨﺰﻳﻦ ﻋﻦ اﻟﻤﺴﺆول اﻟﻤﻮﻇﻒ ﺑﺈﻣﻜﺎن هﻞ اﻟﺴﺠﻼت؟ إﻟﻰ ﺑﺎﻟﺮﺟﻮع fo stinu ynam woh etats egarots fo egrahc ni rebmem ffats eht naC .3.5 ?sdrocer gnitlusnoc yb kcots ni era ”nonygorcim“ ] [ دورات 01 ﻋﻦ ﻘﻞﺗ ﺧﻄﺎء ﺒﺔﺑﻨﺴ أو ﺑﺪﻗﺔ ,ﻧﻌﻢ selcyc 01 naht ssel rorre ro ,yltcerroc ,seY ] [ ] [ دورات 01 ﻋﻦ ﺗﺰﻳﺪ اﻟﺨﻄﺎء ﻧﺴﺒﺔ وﻟﻜﻦ ﺠﻼتﺴاﻟ إﻟﻰ اﺳﺘﻨﺪ selcyc 01 naht retaerg rorre tub ,sdrocer stlusnoC ] [ ] [ اﻟﻤﻬﻤﺔ ﺑﻬﺬﻩ اﻟﻘﻴﺎم ﻘﺎﻣﻄﻠ ﺑﺎﺳﺘﻄﺎﻋﺘﻪ ﻴﺲﻟ ,ﻻ lla ta ksat siht mrofrep tonnac ,oN ] [ 5-4: ﺎﻟﻲﺘاﻟ اﻟﺠﺪول ﻓﻲ ﻋﻠﻴﻬﺎ وﻋﻠﻖ اﻟﺘﺨﺰﻳﻦ ﻋﻦ اﻟﻤﺴﺆول ﻟﻠﻤﻮﻇﻒ اﻷﺳﺎﺳﻴﺔ اﻟﻤﻬﺎم ﺗﻔﺤﺺ : 01 5.4. Check some basic tasks of the staff member in charge for storage and comment in the table below: ﻞه ﻨهكﺎ ﻞﻴﺠﺴﺗ ﻲﻣﻮﻳ ﻟﺪﺔﺟر ةراﺮﺤﻟا )ﺬﺧﺆﺗ اﺮﻬﻇ وأ ﻟاﺔﻋﺎﺴ 2 ﺪﻌﺑ ﺮﻬﻈﻟا(؟ Is there a daily register of the temperature (taken at noon or 2 pm)? ﻞه لﻮﺌﺴﻤﻟا ﻦﻋ ﻳﺰﺨﺘﻟاﻦ ﻰﻠﻋ ﺔﻳارد ﺑطوﺮﺸ ﻦﻳﺰﺨﺗ ﻞﺋﺎﺳﻮﻟا ﻟاﺔﻔﻠﺘﺨﻤ ﻢﻴﻈﻨﺘﻟ ؟ةﺮﺳﻷا Is the store-in-charge familiar with the recommended storage conditions of the different contraceptives? ﻞه لﻮﺌﺴﻤﻟا ﻦﻋ ﻦﻳﺰﺨﺘﻟا ﻰﻠﻋ ﺔﻳارد ﺪﺤﻟﺎﺑ ﻰﻠﻋﻷا تﺎﺟرﺪﻟ ةراﺮﺤﻟا ﻲﺘﻟا ضﺮﻌﺘﻳ ﺎﻬﻟ اﻟ؟نﺰﺨﻤ Is the store-in-charge aware of maximum temperatures encountered in the store? ﻞه ﻢﺘﻳ ﺣﻻاظﺎﻔﺘ ﻞﺠﺴﺑ نوﺰﺨﻤﻟا ﻞﺧاد مأ ﺎﺧجر ﺔﻘﻄﻨﻣ ؟ﻦﻳﺰﺨﺘﻟا Is the stock register kept inside or outside of the storage area? 11 :5-5 5.5. Comment, in the table below on the storage conditions listed ﻖـﻠﻋ ﻰﻠﻋ طوﺮﺷ ﻦﻳﺰﺨﺘﻟا ةرﻮآﺬﻤﻟا ﻲﻓ لوﺪﺠﻟا ﻲﻟﺎﺘﻟا ﻞه ﻮه ﻧﻒﻴﻈ ﻲﻟﺎﺧو ﻦﻣ ﻤﻟاﺨﻠﻔ؟تﺎ Is it clean and free of debris? ﻞه ﻨهكﺎ ﺎﻣ ﺮﻴﺸﻳ ﻰﻟإ دﻮﺟو وﺰﻏ ﻦﻣ ﻞﺒﻗ اﻟتاﺮﺸﺤ وأ اﻮﻘﻟ؟ضرا Is there any indicator of infestation by insects or rodents? ﻞه ﻨهكﺎ ﺎﻣ ﺮﻴﺸﻳ ﻰﻟإ ﺴﺗبﺮ ﻩﺎﻴﻣ )ﻦﻣ ﻒﻘﺴﻟا وأ نارﺪﺠﻟا وأ ﺔﻴﺿرﻷا(؟ Is there any evidence of water leakage (ceiling, walls, floors)? ﻞه ﻨهكﺎ يأ ﻞﺋﺎﺳو ﺔﻳﻮﻬﺗ ﻞﺜﻣ حواﺮﻣ اﻂﻔﺸﻟ وأ اﺮﻣحو اﺴﻟﻒﻘ وأ ﺬﻓاﻮﻧ ﻦﻜﻤﻳ ﺘﻓﻬﺤ؟ﺎ ﻞه ﺬﻓاﻮﻨﻟا ةﺎﻄﻐﻣ ؟ﻚﺒﺸﺑ Is there any ventilation facility such as exhaust fans; ceiling fans; windows that can be opened? Are the windows screened? ﻞه ﻨهكﺎ داﺪﻣإ رﺎﻴﺘﻟﺎﺑ ﻲﺋﺎﺑﺮﻬﻜﻟا ؟نﺰﺨﻤﻠﻟ Is there an electricity supply to the store? ﻞه ﻨهكﺎ ﺢﻴﺑﺎﺼﻣ ﺔﻴﺑﻮﺒﻧأ وأ يأ وﺳﻞﺋﺎ ؟ةرﺎﻧإ Are there tube lights or other lighting facilities? ﻞه ﻨهكﺎ ﺮﺜآأ ﻦﻣ ﺑبﺎ دﺧ؟لﻮ Is there more than one access door? ﻞه ﻢﺘﻳ قﻼﻏإ نﺰﺨﻤﻟا ﺎﻣﺪﻨﻋ ﻢﺘﻳ ﻏإقﻼ ﻤﻟاﺮﻓ؟ﻖ Is the store locked when the facility is closed? ﻦﻣ ﻆﻔﺘﺤﻳ حﺎﺘﻔﻤﺑ اﻤﻟ؟نﺰﺨ و ﻦﻳأ ﻢﺘﻳ ﻆﻔﺣ اﻔﻤﻟﺘ؟حﺎ Who keeps the key to the store? Where is it kept? ﻞه ﻨهكﺎ يأ ﺔﻠﻴﺳو ﺔﺤﻓﺎﻜﻤﻟ اﺮﺤﻟﻖﻳ ةﺮهﺎﻇ نﺎﻴﻌﻠﻟ راﻮﺠﺑ وأ ﻞﺧاد اﻤﻟ؟نﺰﺨ Is there any means to fight fire visible near or in proximity to the store? ﻞه اﻮﻟﺳﻞﺋﺎ ﺔـﺳﺪﻜﻣ ﻞﻜﺸﺑ ﺢﻴﺤﺻ ﻲﻓ اﻤﻟ؟نﺰﺨ Are the commodities in the store properly stacked: 1-ﺔﻌﻔﺗﺮﻣ )10 ﻢﺳ( ﻦﻋ ﺢﻄﺳ ضرﻷا 1. off the ground (10 cm)? -2 ﻊﻣ ﺔﺣﺎﺴﻣ)30 ﻢﺳ( ﻦﻴﺑ نﺎﻄﻴﺤﻟا ﻟاوتﺎﻴﻤﻜ ؟ﺔﺳﺪﻜﻤﻟا 2. with space (30 cm) between the walls and the stacks? -3 ﻊﻣ ﻟاﻮﻖﺻ ﺦﻳراﻮﺗو ﻧاءﺎﻬﺘ ﻇةﺮهﺎ نﺎﻴﻌﻠﻟ و ﺟﺔﻬ ﺢﺘﻓ ﻦﻴﺗاﺮﻜﻟا ﻩﺎﺠﺗﺎﺑ ؟ﻰﻠﻋﻷا 3. with labels and expiration dates visible and cartons upright? 12 5-6: وﺗﺎرﻳﺦ اﻟﻤﻨﺘﺞ اﺳﻢ اذآﺮ اﻟﻤﺨﺰون؟ ﺿﻤﻦ اﻟﺼﻼﺣﻴﺔ ﺔﻴﻣﻨﺘﻬ أﺳﺮة ﺗﻨﻈﻴﻢ وﺳﺎﺋﻞ اﻵن ﺗﻮﺟﺪ هﻞ اﻟﺼﻼﺣﻴﺔ اﻧﺘﻬﺎء fo )s(eman eviG ?won kcots ni sevitpecartnoc deripxe yna ereht erA .6.5 )s(etad yripxe dna )s(tcudorp etad yripxE اﻟﺼﻼﺣﻴﺔ اﻟﻤﻨﺘﻬﻲ اﻟﻤﻨﺘﺞ اﺳـﻢ اﻻﻧﺘﻬﺎء ﺗـﺎرﻳﺦ tcudorp deripxe fo emaN 31 اﻟﺴﺎدس اﻟﺠﺰء : اﻟﻤﺨﺰون إدارة tnemeganaM kcotS :xiS traP 6-1: اﻷﺳﺮة ﺗﻨﻈﻴﻢ ﻟﻮﺳﺎﺋﻞ ﺑﺎﻟﻨﺴﺒﺔ اﻟﻤﻨﺘﺞ ﺗﻮﻓﺮ : ﻳﺪك ﺟﻬﺔ ﻓﻲ اﻟﺬي اﻟﻌﻤﻮد ﻓﻲ اﻟﻤﺬآﻮرة دﻟﻠﻤﻮا ﺑﺎﻟﻨﺴﺒﺔ إﺷﺎرة ﺘﺎﺑﺔﺑﻜ ﻗﻢ اﻟﻴﺴﺮى "+" إﺷﺎرة أو "-" ﺣﺪة ﻋﻠﻰ ﻬﺎﻣﻨ ﺻﻨﻒ آﻞ ﺗﻮﻓﺮ مﻋﺪ أو ﻓﺮﺗﻮ ﻟﺒﻴـﺎن dnah tfel eht ni detsil smeti eht roF :sevitpecartnoc rof ytilibaliava tcudorP .1.6 yllacisyhp si meti hcae ton ro rehtehw “-“ sunim ro ”+“ sulp gnitirw yb etacidni ,nmuloc tneserp :ﻣﺘﻮﻓــﺮ -=ﻻ ,+=ﻧﻌـﻢ :elbaliavA -=oN ;+=seY اﻟﻤﻨﺘـﺞ tcudorP ﻣﺎﻳﻜﺮوﺟﻨﻮن اصﻗﺮأ nonygorciM ﻣﺎﻳﻜﺮوﻧﻮن اصﻗﺮأ ronorciM اﻟﺮﻏﻮﻳﺔ ﻮﺿﻌﻴﺔﻤاﻟ اصﻗﺮاﻷ telbat gnimaoF lanigaV اﻟﻠﻮاﻟﺐ DUI ااﻟﺪﻳﺒﻮﺑﺮوﻓﻴﺮ ﺣﻘﻦ arevorP opeD اﻟﻐـﺮﺳﺎت stnalpmI اﻟﺬآـﺮي اﻟﻮاﻗـﻲ modnoc elaM اﻟﺪﻳﺒﻮﺑﺮوﻓﻴﺮا ﻟﺤﻘﻦ ﺳـﺮﻧﺠﺎت arevorP opeD fo noitcejni rof segniryS 41 6-2: اﻟﻤﺨﺰون ﺳﺠﻼت دﻗـﺔ : أدﻧﺎﻩ اﻟﻤﺬآﻮرة ﻟﻠﻤﻨﺘﺠﺎت ﺑﺎﻟﻨﺴﺒﺔ , ﻓﻲ ﻴﻨﺔﺒاﻟﻤ واﻟﻜﻤﻴﺎت اﻟﻔﻌﻠﻲ اﻟﻌﺪ ﺳﺠﻞ وﺟﺪ إن ﻬﻤﺎﺑﻴﻨ ﻟﻔﺎرقاو ﻼتاﻟﺴﺠ lacisyhp eht drocer ,woleb detsil stcudorp eht roF :ycarucca drocer kcotS .2.6 yna fi ,ecnereffid eht dna ,sdrocer eht yb nwohs seititnauq eht ,tnuoc اﻟﻔـﺎرق ecnereffiD ﻟﺴﺠﻞا واﻗﻊ ﻣﻦ اﻟﺠﺮد tnuoC droceR اﻟﻔﻌﻠﻲ اﻟﺠـﺮد tnuoc lacisyhP اﻟﻤﻨﺘـﺞ tcudorP ﻣﺎﻳﻜﺮوﺟﻨﻮن اصﻗﺮأ nonygorciM ﻣﺎﻳﻜﺮوﻧﻮن اصﻗﺮأ ronorciM ﻮﺿﻌﻴﺔﻤاﻟ اصﻗﺮاﻷ اﻟﺮﻏﻮﻳﺔ gnimaoF lanigaV telbat اﻟﻠﻮاﻟﺐ DUI اﻟﺪﻳﺒﻮﺑﺮوﻓﻴﺮا ﺣﻘﻦ arevorP opeD اﻟﻐـﺮﺳﺎت stnalpmI اﻟﺬآـﺮي اﻟﻮاﻗـﻲ modnoc elaM 51 6-3: اﻷﺳﺮة ﻢﻈﻴﺗﻨ وﺳﺎﺋﻞ اﺳﺘﻬﻼك : اﻟﻤﺼﺮوﻓﺔ اﻟﻮﺣﺪات ﺎﻟﻲﻤﺟإ دون أدﻧـﺎﻩ اﻟﻤﺬآﻮرة ﻟﻠﻮﺳﺎﺋﻞ ﺑﺎﻟﻨﺴﺒﺔ :اﻟﻤﺎﺿﻴﺔ ﺷﻬﺮأ ﺛﺔاﻟﺜﻼ ﺧﻼل ﻟﻠﻤﺴﺘﻬﻠﻜﻴﻦ ni etirw ,woleb detsil sevitpecartnoc eht roF :noitpmusnoc evitpecartnoC .3.6 elohw eerht tsal eht gnirud sresu ot desnepsid stinu fo rebmun latot eht shtnom ﺎﻟﺚﺜاﻟ اﻟﺸﻬﺮ 3 htnoM ﺎﻧﻲﺜاﻟ اﻟﺸﻬﺮ 2 htnoM اﻷول اﻟﺸﻬﺮ 1 htnoM اﻟﻤﻨﺘـﺞ tcudorP ﻣﺎﻳﻜﺮوﺟﻨﻮن اصﻗﺮأ nonygorciM ﻣﺎﻳﻜﺮوﻧﻮن اصﻗﺮأ ronorciM ﻮﺿﻌﻴﺔﻤاﻟ اصﻗﺮاﻷ اﻟﺮﻏﻮﻳﺔ gnimaoF lanigaV telbat اﻟﻠﻮاﻟﺐ DUI اﻟﺪﻳﺒﻮﺑﺮوﻓﻴﺮا ﺣﻘﻦ arevorP opeD ﻐـﺮﺳﺎت اﻟ stnalpmI اﻟﺬآـﺮي اﻟﻮاﻗـﻲ modnoc elaM 61 6-4: اﻟﻤﺨﺰون اﻧـﻌﺪام أﻳـﺎم : ﻋﻠﻰ ﻣﻨﺘﺞ آﻞ ﻣﺨﺰون ﻓﻴﻬﺎ اﻧﻌﺪم اﻟﺘﻲ اﻷﻳﺎم دون أدﻧﺎﻩ ﻮرةآاﻟﻤﺬ اﻷﺳﺮة ﺗﻨﻈﻴﻢ ﻟﻮﺳﺎﺋﻞ ﺑﺎﻟﻨﺴﺒﺔ آﺎﻣﻠﺔ اﻟﻤﺎﺿﻴﺔ أﺷـﻬﺮ اﻟﺴﺘﺔ ﺧﻼل ﺣﺪة eht fo hcae rof drocer ,woleb detsil sevitpecartnoc eht roF :kcots fo tuo syaD .4.6 kcots fo tuo saw tcudorp hcae taht syad fo rebmun eht shtnom elohw xis tsal دسﻟﺴﺎا اﻟﺸﻬﺮ 6 htnoM ﻟﺨﺎﻣﺲا اﻟﺸﻬﺮ 5 htnoM اﻟﺮاﺑﻊ اﻟﺸﻬﺮ 4 htnoM اﻟﺜﺎﻟﺚ اﻟﺸﻬﺮ 3 htnoM اﻟﺜﺎﻧﻲ اﻟﺸﻬﺮ 2 htnoM اﻷول اﻟﺸﻬﺮ 1 htnoM اﻟﻤﻨﺘـﺞ tcudorP اصﻗﺮأ ﻣﺎﻳﻜﺮوﺟﻨﻮن nonygorciM اصﻗﺮأ ﻣﺎﻳﻜﺮوﻧﻮن ronorciM اصﻗﺮاﻷ اﻟﻤﻮﺿﻌﻴﺔ اﻟﺮﻏﻮﻳﺔ lanigaV gnimaoF telbat اﻟﻠﻮاﻟﺐ DUI ﺣﻘﻦ اﻟﺪﻳﺒﻮﺑﺮوﻓﻴﺮا opeD arevorP اﻟﻐـﺮﺳﺎت stnalpmI اﻟﻮاﻗـﻲ ﺮيـآﻟﺬا elaM modnoc 71 لﺄﺳا اﻒﻇﻮﻤﻟ لوﺆﺴﻤﻟا ﻦﻋ ﺐﻠﻃ ﻞﺋﺎﺳو ﻢﻴﻈﻨﺗ ةﺮﺳﻷا ﻦﻋ ﺎﻣ اذا نﺎآ ﻪﻳﺪﻟ ﺔﻳارد تﺎﺤﻠﻄﺼﻤﻟﺎﺑ :5-6 ﺔﻴﻟﺎﺘﻟا ﺐﺘآاو ﺎﺟإﻪﺗﺎﺑ ﻲﻓ دﻮﻤﻌﻟا ﻦﻤﻳﻷا مﺎﻣأ ﻞآ ﺢﻠﻄﺼﻣ ﺎﻬﻨﻣ 6.5. Ask the staff member in charge of ordering contraceptives if he is familiar with the following terms and write his answers in the right column behind each term حﺮـﺸﻟا رﻮآﺬﻤﻟا ﻦﻣ ﻞﺒﻗ ﻒﻇﻮﻤﻟا Explanation provided by staff member اﻟﻤﺼﻄﺢﻠ Term ﻂﺳﻮﺘﻣ كﻼﻬﺘﺳﻻا يﺮﻬﺸﻟا ﻦﻣ ﻞﺋﺎﺳو ﺗﻨﻈﻢﻴ ةﺮﺳﻷا Average Monthly Consumption (AMC) نوﺰـﺨﻣ نﺎـﻣﻷا Safety Stock ﺪـﺤﻟا ﻷاﻰﻠﻋ ﻟﻠﻤﺨـنوﺰ Minimum level of stock ﺪـﺤﻟا ﻰـﻧدﻷا نوﺰﺨﻤﻠﻟ Maximum level of stock ﺔـﻴﺒﻠﻄﻟا ﺔﻴﻓﺎﻌـﺳﻹا Emergency order 18 ﻂﺒﺿ ﺠﻟاـةدﻮ : ءﺰﺠﻟا ﻊﺑﺎﺴﻟا Part Seven: Quality Control ﻞه كﺎﻨه يأ تﺎﺒﺛإ ﺮﻴﺸﻳ ﻰѧﻟإ ﻪѧﻧا ﻢﺘѧﻳ ءاﺮѧﺟإ ﺺѧﺤﻓ ﻢﻈﻨѧﻣ ﺪѧآﺄﺘﻠﻟ ﻦѧﻣ ةدﻮѧﺟ ﻞﺋﺎѧﺳو ﻢﻴѧﻈﻨﺗ ةﺮѧﺳﻵا :1-7 ( 7.1. ﺔﻤﻠﺘﺴﻤﻟا ﻦﻣ ﺔﻄﻘﻧ ؟داﺪﻣﻹا )ﻼﺜﻣ: ﺮﻀﺤﻣ ﺺﺤﻓ ﺔﻘﺑﺎﻄﻣو فﺎﻨﺻأ ﺔﻴﺒﻃ Is there evidence of a systematic check on the quality of contraceptives received from the supply point? (e.g. minute of examining medical items) ﻌﻧﻢـ ﻻ [ ] [ ] [ ] Yes [ ] No ﻞه ﻢﺘﻳ ﻖﻴﺛﻮﺗ ﻚﻟذ ﺎﻴﺑﺎﺘآ ﻪﻌﻓرو تﺎﻬﺠﻠﻟ ؟ﺎﻴﻠﻌﻟا , ﻲﻓ ﺔﻟﺎﺣ ﺔﺑﺎﺟﻹا ﻢﻌﻨﺑ :2-7 7.2. If yes, Is it documented in writing to the higher authorities? ﻌﻧﻢـ ﻻ [ ] [ ] [ ] Yes [ ] No لﺄﺳا ﺮﻳﺪﻣ نﺰﺨﻤﻟا ﻦﻋ ﺎﻣ اذإ نﺎآ ﻪﻳﺪﻟ ﺔﻳارد ﻦﻋ ﻼﻌﻟاتﺎﻣ ﻲﺘﻟا ﺮﻴﺸﺗ ﻰﻟإ نا ﻞﺋﺎﺳو ﺗﻈﻨﻢﻴ ةﺮﺳﻷا ﺪﻗ ﺎﻬﺘﺑﺎﺟإ ﻲﻓ دﻮﻤﻌﻟا ﻦﻤﻳﻷا / ﺐﺘآاو ﺑﺎﺟإﻪﺘ , ﺖﺿﺮﻌﺗ رﺮﻀﻠﻟ وأ ﻢﻟ ﺪﻌﺗ ﺔﺤﻟﺎﺻ لﺎﻤﻌﺘﺳﻼﻟ 7.3. Ask the store manager if he is aware of signs that contraceptives may be damaged or unusable and write his/her answers in the right column تﺎﻣﻼﻋ ﺎﺻإﺔﺑ ﺞﺘﻨﻤﻟا وأ ﺪﻋم ﺣﻼﺻﺔﻴ ﻪﻣاﺪﺨﺘﺳا Signs that the product may be damaged or unusable عﻮـﻧ ﺘﻨﻤﻟاـﺞ Type of Product ــﻗﻷاﺮاص Pills ﺐﻟاﻮﻠﻟا IUDS ﻷاﺮﻗصا اﻟﺔﻳﻮﻏﺮ ﺔﻴﻠﺒﻬﻤﻟا Vaginal Foaming Tablets ﻲـﻗاﻮﻟا يﺮـآﺬﻟا Condoms ﻘـﺣﻦـ ﻢﻴﻈﻨﺗ ةﺮـﺳﻷا Inject able contraceptives 19 7-4: ﺻﺎﻟﺤﺔ ﻏﻴﺮ اﺳﺮة ﻴﻢﻨﻈﺗ ﺎﺋﻞﺳو ﻮدوﺟ ﻋﻨﺪ اﻟﻤﺮﻓﻖ ﻣﺪﻳﺮ ﻗﺒﻞ ﻣﻦ اﻟﻤﺘﺒﻊ اﻹﺟﺮاء ﻋﻦ اﺳﺄل اﻟﺘﺎﻟﻲ اﻟﻔﺮاغ ﻓﻲ ﺑﺔﻹﺟﺎا آﺘﺐا ,ﻟﻼﺳﺘﺨﺪام : yna era ereht fi sekat regnam ytilicaf eht noitca fo esruoc tahw ksA .4.7 .woleb xob eht ni rewsna eht etirW .erots eht ni sevitpecartnoc degamad ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ 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gniredro rof egrahc ni ffats eht seoD .1.8 ?sdeen evitpecartnoc gnitsacerof ecitcarp ـﻢﻧﻌ ﻻ ] [ ] [ seY ] [ oN ] [ ﻳﺴﺘﺨﺪﻣﻬﺎ ﺘﻲاﻟ اﻟﻄﺮﻳﻘﺔ ﻋﻦ اﺳﺄﻟﻬﺎ/اﺳﺄﻟﻪ ,ﺑﻨﻌﻢ اﻹﺟﺎﺑﺔ ﺣﺎﻟﺔ ﻓﻲ / ﻓﻲ ﻹﺟﺎﺑﺔا واآﺘﺐ ﻟﻠﺘﺨﻤﻴﻦ ﺗﺴﺘﺨﺪﻣﻬﺎ ﺘﺎﻟﻲاﻟ اﻟﻔﺮاغ : dna gnitsacerof od ot sesu ehs/eh ygolodohtem eht ebircsed ot reh/mih ksa ,sey fI :woleb xob eht ni rewsna eht etirw ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ 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reh/sih ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ 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dleif fi reganam ytilicaf eht ro gnitroper rof elbisnopser eht ksA .1.9 nialpmoc sevitpecartnoc fo sresu/stneipicer nehw )gnitirw ni ro yllabrev( troper ?meht tuoba ـﻢﻧﻌ ﻻ ] [ ] [ seY ] [ oN ] [ 9-2: ﻴﺔﻣﺼﺪاﻗ ﻣﻦ اﻟﺘﺤﻘﻖ ﺑﻬﺎ ﻳﺘﻢ اﻟﺘﻲ ﻴﺔﻴﻔﻜﻟا ﻋﻦ اﻟﻤﺮﻓﻖ ﻣﺪﻳﺮ أو اﻟﺘﻘﺎرﻳﺮ رﻓﻊ ﻋﻦ اﻟﻤﺴﺆول اﺳﺄل ﺘﺎﻟﻲاﻟ اﻟﻔﺮاغ ﻓﻲ اﻹﺟﺎﺑﺔ اآﺘﺐ اﻟﺘﻘﺎرﻳﺮ؟ هﺬﻩ : stroper eseht woh regnam ytilicaf eht ro gnitroper rof elbisnopser ksA .2.9 :woleb xob eht ni rewsna eht etirW ?detadilav ro detnemucod ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ 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ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ 32 9-4: اﻟﻮﺳﺎﺋﻞ أﻧﻮاع ﻣﻦ ﻧﻮع ﻷي اﻟﺠﺎﻧﺒﻴﺔ ﺑﺎﻷﻋﺮاض ﻳﺘﻌﻠﻖ ﻓﻴﻤﺎ ﻣﺤﻠﻮﻟﺔ ﻏﻴﺮ ﻣﺸﺎآﻞ أي ﺎكهﻨ هﻞ ﻷﺳﺮة؟ا ﻟﺘﻨﻈﻴﻢ اﻟﺤﺪﻳﺜﺔ yna fo stceffe edis eht gninrecnoc stneilc htiw seussi devlosernu ereht erA .4.9 ?sevitpecartnoc eht fo اﻟﺠﺎﻧﺒﻴﺔ ﺑﺎﻟﻤﻀﺎﻋﻔﺎت ﻠﻖﻳﺘﻌ ﻤﺎﻓﻴ ﺣﻠﻬﺎ ﻳﺘﻢ ﻟﻢ ﺘﻲاﻟ ﻧﺐاﻟﺠـﻮا اذآﺮ tcudorP stceffe edis gninrecnoc seussi devlosernu ebircseD اﻟﻤﻨﺘـﺞ 42 اﻹﺷـﺮاف :اﻟﻌﺎﺷﺮ اﻟﺠﺰء noisivrepuS :neT traP واﻟﺴﺠﻼت اﻟﻤﺨﺰن ﻋﻦ ﻣﻌﺪة ﻠﺔﺳﺌاﻷ ﻓﻴﻪ ﺗﻜﻮن ﺑﺄﺳﻠﻮب إﺷﺮاف ﺑﻌﻤﻞ ﺎموﻗ ﻣﺎ أﺣﺪ أﺗﻰ هﻞ ﻷﺳﺮة؟ا ﻟﺘﻨﻈﻴﻢ اﻟﺤﺪﻳﺜﺔ ﺑﺎﻟﻮﺳﺎﺋﻞ اﻟﻤﺘﻌﻠﻘﺔ واﻟﻤﻮاﺿﻴﻊ 01-1: ni syaw eht gninrecnoc noisivrepus edivorp dna emoc reve enoyna seoD .1.01 eussi ro ,rof sdrocer peek ,erots , deraperp era snoitisiuqer hcihw ?sevitpecartnoc ـﻢﻧﻌ ﻻ ] [ ] [ seY ] [ oN ] [ , ,sey fI .2.01 01-2: ﺑﻨﻌﻢ اﻹﺟﺎﺑﺔ ﺣﺎﻟﺔ ﻓﻲ ــــــــــــــــــــــــــــــــــــ أﺗـﻰ؟ اﻟﺬي ﻣﻦ __________________________________________?semoc ohW ـــــــــــــــــــــــــــــــ ﻣﺮات؟ آـــﻢ _____________________________________________netfo woH ـــــــــــــــــــــــــــ ﺎرة؟ـﻳز أﺧﺮ ﺎﻧﺖآ ﻣﺘﻰ __________________________________?tisiv tsal eht saw nehW 01-3: ﻷﺳﺮة؟ا ﺗﻨﻈﻴﻢ ﺑﻮﺳﺎﺋﻞ اﻹﻣﺪاد ﻋﻦ دﻟﻴﻞ ناﻟﻤﺨﺰ أو اﻟﻤﻜﺘﺐ ﻟﺪي ﻳﻮﺟﺪ هﻞ ?erots ro eciffo eht ni tneserp launaM ylppuS evitpecartnoC a ereht sI .3.01 seY ] [ oN ] [ launaM siht htiw railimaf gnirots rof egrahc ni nosrep eht sI .4.01 seY ] [ ـﻢﻧﻌ ﻻ ـﻢﻧﻌ ﻻ ] [ ] [ ] [ ] [ oN ] [ 52 اﻟﺒﺎﺣﺚ ﻗﺒﻞ ﻣﻦ اﻟﻌـﺎم اﻟﺘﻘﻴﻴﻢ ﺑﺔاﻹﺟﺎ اآﺘﺐ ﻚﺑﺘﻘﻴﻴﻤ ﻣﻮاﻓﺎﺗﻨﺎ ﻧﺮﺟﻮ 11-1: :ﻋﺸﺮ اﻟﺤﺎدي اﻟﺠﺰء rehcraeseR yb tnemssessA llarevO :nevelE traP ,ﺎﺑﻠﺘﻬﻢﻗ اﻟﺬﻳﻦ اﻟﻤﻮﻇﻔﻴﻦ ﻣﻌﺎرف وﻋﻦ اﻟﻤﺮاﻓﻖ ﻋﻦ اﻟﻌﺎم :ﺘﺎﻟﻲاﻟ اغﻔﺮﻟا ﻓﻲ egdelwonk eht dna ytilicaf eht fo tnemssessa llarevo ruoy edivorp esaelP .1.11 :woleb xob eht ni rewsna ruoy etirW .tem ffats eht fo ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ 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rof dednemmocer e tem ffats eht fo yna sI 2.11 ?scitsigol ﻣﺘﻘﺪم ﺗﺪرﻳﺐ إﻟﻰ ﺑﺤﺎﺟﺔ ﻟﻴﺲ ton gniniart rehtruF yrassecen ﺑﺘﺪرﻳﺒﻬﻢ اﻟﻤﻮﺻـﻰ rof dednemmoceR ggniniart (ﻮﻇﻴﻔﻲﻟا اﻟﻠﻘﺐ) اﻟﻤﻮﻇﻒ )eltiT( ffatS آﺘﺎﺑﺔ ﺟﻰﻳﺮ ﻧﻈﺮك؟ وﺟﻬﺔ ﻣﻦ اﻟﺠﺎﻧﺐ هﺬا ﻓﻲ اﺣﺘﻴﺎﺟﺎ اﻷآﺜﺮ اﻟﻮﻇﺎﺋﻒ هﻲ ﻣﺎ ,آﺬﻟﻚ آﺎن إذا 11-3: :ﺘﺎﻟﻲاﻟ اﻟﻔﺮاغ ﻓﻲ ﺑﺔاﻹﺟﺎ ruoy etirw esaelP ?noinipo ruoy ni dedeen tsom era snoitcnuf tahw ,os fI .3.11 .woleb xob eht ni rewsna ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ 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It is usually the monthly average of the quantity of that product that has been dispensed to users during the past 3 months. (The information on the quantities dispensed is taken from the daily activity register or summary reports of dispensed-to-user data.). AMC is calculated as follows: Average Monthly Consumption = Quantity dispensed in 3 months 3 Couple-Years of Protection (CYP) Couple-Years of Protection (CYP) is a tool for looking at data on the quantities of contraceptives that have been dispensed and estimating how many clients (or couples) those contraceptives served. CYP is sometimes used to evaluate a program or to set targets. It can also be used to analyze a clinic or program’s method mix. CYP translates products into people; if one couple would need 4 doses of injectable contraceptive in a year, then 8 doses of injectable dispensed are equivalent to two couples, or two CYPs. Safety stock The Safety Stock, which is expressed in months and should be equal to at least half the time between regular orders (called the Order Interval or Review Period) or regular deliveries. If there are usually great fluctuations in demand during the year or if deliveries are unreliable, then the safety stock should be set higher. Minimum level of stock/ Maximum level of Stock Maximum stock level and Minimum stock level refer to the highest and lowest levels that should be maintained for this product at this outlet, expressed as months of supply. They are calculated as follows: Minimum level (expressed in months)=safety stock (in months)+lead time (in months) Maximum level (expressed in months)=Minimum level of stock in months + order interval (in months) Maximum quantity of products/ Minimum quantity of products Maximum quantity and Minimum quantity are the highest and lowest quantities that should be on hand for this product at this outlet, at current rates of use. They are calculated as follows: Maximum quantity (numbers of commodities) =Maximum stock level x AMC Minimum quantity (numbers of commodities =Minimum stock level x AMC NB: Quantities should always be expresses as individual pieces, not as larger units such as boxes or cartons. Emergency order An order placed between regular orders if due to unexpected developments the stock on hand will not last until the next order. The remaining months of supply on hand can be calculated as follows Months of Supply on hand =Stock on hand / AMC Quality check for contraceptives (what to look at?) -Pills: (visibly damaged pills or packaging, pills missing, brown spots, pills crushing easily) Adapted from Pocket Guide to Managing Contraceptive Supplies, October 1998, Revised February 2000, CDC and the national logistics manual, intended as a quick reminder for assessment teams 27 1 Condoms (packages have yellowed, brittle or otherwise damaged, seal of package not intact) -IUDs (sterile packaging broken or perforated, any product contents missing- note: copper darkening or tarnishing is not a sign of damage of copper IUDs) -Injectables (solid material remains on the bottom of the vial after vigouros shaking, cap no longer on the glass vial) Contraceptive method: A category of contraceptive, such as oral contraceptives, intrauterine devices (IUDs), injectable contraceptives, and condoms. Contraceptive product: The method and brand name of a contraceptive. Different brands of the same contraceptive method are considered to be separate products. For example, Lo-Femenal® and Microgynon® are different brands of combined oral contraceptive pills, and are separate contraceptive products. Dispense (to user): To provide a contraceptive or other item to its ultimate user (the client). A service provider dispenses contraceptives to a family planning user at a clinic or other outlet. Dispensed-to-user data: The number of units of a product (usually a specific brand or contraceptive method) provided to clients of family planning services (contraceptive users) over a specified time period. Issue: To provide a contraceptive or other item to a storage or service delivery facility. A storage facility issues supplies either to an outlet or to another storage facility (but not to a user). Lead time: The interval between the time that supplies are ordered (or allocated) and when they are received and available for use. Outlet or service delivery point: A clinic or other site where contraceptives are dispensed to users. Review period or order interval: The routine interval between reviews of stock levels to determine whether an order should be placed, or between regularly scheduled orders of supplies. The Stock Card Each contraceptive product (each brand of each method) in the storage area should have a Stock Card. This card provides essential information on the quantities of stock on hand of that product, any losses or adjustments to the inventory, and lead-time. The purpose of the stock card is to provide an up-to-date record of all transactions (the quantities of that product that have been received and issued or otherwise disposed of) and the amount currently in stock. Stock out: When an outlet or storage facility has no stock on hand of a particular item. Stock on hand Quantity of products actually available for use in the facility/warehouse Ordering Quantity The ordering quantity is the amount of products that has to be ordered, it can be calculated as follows: Order Quantity=Maximum Quantity -Stock on Hand -Stock on Order 28 For more information, please visit www.deliver.jsi.com. DELIVER John Snow, Inc. 1616 North Ft. Myer Drive, 11th Floor Arlington, VA 22209 USA Phone: 703-528-7474 Fax: 703-528-7480 www.deliver.jsi.com BACKGROUND METHODOLOGY AND STUDY DESIGN COMPOSITION OF ASSESSMENT TEAMS SURVEY TARGET POPULATION AND ASSESSMENT SETTING SAMPLING METHODOLOGY CHALLENGES TO DATA COLLECTION SAMPLE CHARACTERISTICS DISTRIBUTION AND TYPE OF FACILITIES SURVEYED BY GOVERNORATE HUMAN RESOURCES WORKING IN CONTRACEPTIVE LOGISTICS Staff Turnover Job Satisfaction and Career Plans Training on Contraceptive Logistic Tasks Knowledge and Skills DISTRIBUTION CHAIN (CURRENT SITUATION) Contraceptive Order and Distribution Communication Method When Ordering Contraceptives Transportation of Commodities Transport, Distance, Road Conditions and Cost: Storage Stock records Quality control Existence of expired products AVAILABILITY OF COMMODITIES Products available at the time of visit Stock outs REPORTING AND SUPERVISION Reporting frequency and content of contraceptive logistic reports Supervision Contraceptive Supply 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