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NTA Level 5 • Semester 1 • PST05101 Procurement and Supply Agencies of Medicines and Medical Medicines and Medical Supplies Management • Source Session/Topic 13 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 13: Procurement and Supply Agencies of Medicines and Medical Supplies in Tanzania Total Session Time: 120 minutes Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • List major procurement agencies for medicines and medical supplies in Tanzania • Explain autonomous supply agencies for public and private procurement of medicines and medical supplies Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |05 minutes |Presentation |Introduction, Learning Tasks | |2 |10 minutes |Presentation |Major Procurement Agencies for Medicines| | | |Brainstorming |and Medical Supplies in Tanzania | |3 | |Presentation |Explanations of Autonomous Supply | | |85 minutes |Small Group |Agencies for Public and Private | | | |Discussion |Procurement of Medicines and Medical | | | | |Supplies | |4 |10 minutes |Presentation |Key Points | |5 |10 minutes |Presentation |Evaluation | SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing. STEP 2: Major Procurement Agencies for Medicines and Medical Supplies in Tanzania (10 minutes) |Activity: Brainstorming (5 minutes) | | | |Ask students to brainstorm on the following question: | | | |What is are major procurement agencies for medicines and medical | |supplies in Tanzania? | | | |ALLOW few students to respond | | | |WRITE their responses on the flip chart/ board | | | |CLARIFY and SUMMARISE by using the content below | The following are major procurement agencies for medicines and medical supplies in Tanzania; • Medical Stores Department (MSD): It is intended to serve public and faith based hospitals, health centres and dispensaries • Autonomous agencies eg Action Medeor and Mission for Essential Medical Supplies (MEMS) serves faith based hospitals, health centres and dispensaries • Private wholesale pharmacies, intentionally they serve the private retail pharmacies, ,ADDO shop, private hospitals, health centres and dispensaries STEP 3: Explanations of Autonomous Supply Agencies for Public and Private Procurement of Medicines and Medical Supplies (85 minutes) |Activity: Small Group Discussion ( 15 minutes) | | | |DIVIDE students into manageable groups | | | |ASK students to discuss in groups on the following question: | | | |What Explanations can you give on autonomous supply agencies for public| |and private procurement of medicines and medical supplies in Tanzania? | | | |ALLOW students to discuss for 15 minutes | | | |ALLOW each groups to present | | | |CLARIFY and SUMMARIZE by using the contents below | The following are autonomous supply agencies for public and private procurement of medicines and medical supplies: • Action Medeor • Mission for Essential Medical Supplies (MEMS) Action Medeor • Action Medeor International Healthcare Tanzania provides essential medicines and medical supplies of assured high quality and affordable prices to healthcare partners in Tanzania • action medeor Tanzania is a subsidiary of action medeor e.V. in Germany. This charitable, non-governmental organization was founded in 1964 to improve the access to medicines for people in need in developing countries. It draws on years of experience and competences in various skill-oriented trainings, workshops and individual consultancy, transferring knowledge and practical experience in Good Manufacturing Practices, Good Distribution Practices and Good Regulatory Practices • action medeor is also engaged in disaster relief programmes and diverse health care projects • They started operating in 2004 in Dar es Salaam. Today, the head office with warehouse of action medeor Tanzania is still located there. Additionally, there are two additional warehouses in Masasi and Makambako to serve the south and south-west of Tanzania • They offer service to the non-commercial health sector and public institutions, the health sector of faith-based groups as well as of national and international non-governmental and charitable organizations in Tanzania • They offer the following; o Supply of essential medicines and medical equipment of assured high quality at affordable prices o Provision of good services and reliable information on medicines and equipment for customers o Assistance with technical advisory services and training in medicine management and rational medicine use • Action medeor Tanzania has adopted high standards of quality assurance ensuring our goal of safe, effective and good quality products. High quality is achieved by doing the following; o All supplying manufacturers or distributors have to comply with and be certified in Good Manufacturing Practices (GMP) o Regular on-site audits of the manufacturer’s production control full compliance with GMP o A random testing of products by certified and independent laboratories o All products are procured with a maximum shelf life o Ensuring that each batch of each product is accompanied with the certificate of analysis of the medicine as well as of the active pharmaceutical ingredients (API) o Well trained pharmacists supported by modern stock management system ensure Good Warehouse Practice • Most of products are purchased locally or within the region in line with the policy of action medeor to support local manufacturers, however, without compromising on quality • Products not available locally or regionally are procured from international manufacturers • They negotiate with suppliers for the lowest possible price due to bulk sourcing, thus benefiting from quantity discounts Mission for Essential Medical Supplies (MEMS) • [pic]An ecumenical non profit registered company owned by TEC and CCT mandated to supply essential medicines and supplies to faith based facilities and others of the same kind at compepetitive price and with certain in quality • Mission for MEMS is to “effectively and efficiently acquire, store and distribute essential medicines and medical supplies to health facilities in

NTA Level 5 • Semester 1 • PST05101 Managing Drug Donations Medicines and Medical Supplies Management • Source Session/Topic 12 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 12: Managing Drug Donations Total Session Time: 120 minutes Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Explain drug donation • List its associated benefits and problems • Explain the core principles in drug donation Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |05 minutes |Presentation |Introduction, Learning Tasks | |2 |30 minutes |Presentation |Explanations of Drug Donation | | | |Buzzing | | |3 |20 minutes |Presentation |Identify the Core Principles in | | | |Buzzing |Pharmaceutical Donations | |4 | |Presentation |Benefits and Problems of Drug Donations | | |40 minutes |Small Group | | | | |Discussion | | |5 |15 minutes |Presentation |Key Points | |6 |10 minutes |Presentation |Evaluation | SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing. STEP 2: Explanations of Drug Donations (30 minutes) |Activity: Buzzing (5minutes) | | | |ASK students to pair up and buzz on the following question for 3 | |minutes | | | |What do you understand by drug donation? | | | |ALLOW few pairs to respond on the question and let other pairs add on | |points not mentioned WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | Drug Donations • Drug donations are usually given in response to acute emergencies, but they can also be part of development aid • Most pharmaceutical donations are given with the best of intentions but can nevertheless create problems at the receiving end. Often, donated pharmaceuticals are not relevant to the needs of the recipient, or they arrive unsorted or close to expiry. They may be labeled with a brand name or in a language that is not understood. Many pharmaceutical donations counteract government policies or violate national regulations of the recipient country and can be expensive for the country to store or destroy • Guidelines for pharmaceutical donations are needed for a number of reasons. Donors and recipients do not communicate on equal terms, and recipients often need assistance in formulating their needs. Many donors do not understand the potential difficulties at the receiving end and need guidance. Medicines require special regulations because they are different from other donated items. Pharmaceutical donations that occur without input from the recipient countries should be discouraged STEP 3: Core Principles for a Useful Pharmaceutical Donation. (20 minutes) |Activity: Buzzing (5minutes) | | | |ASK students to pair up and buzz on the following question for 3 | |minutes | | | |What are the core principles for useful donation of pharmaceuticals? | | | |ALLOW few pairs to respond on the question and let other pairs add on | |points not mentioned WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | • The four core principles for a useful pharmaceutical donation are; o A donation benefits the recipient to the maximum extent possible o A donation should be given with full respect for the wishes and authority of the recipient o Items that are not acceptable in the donor country for quality- related reasons are also not acceptable as donations: there should be no double standards in quality o Effective communication between the donor and recipient is necessary before any donation • These principles have been translated into a set of guidelines for pharmaceutical donations. First, recipients should review and adopt these guidelines and present them officially to the donor community. Only then can they be implemented and enforced. Second, recipients should develop and publish administrative procedures for pharmaceutical donations. Third, recipients should indicate to the donors, as clearly as possible, how they want to be helped, specifying the medicines they need, the quantities, and the priorities. Donors should inform the recipients well in advance which pharmaceutical donations are coming, and when. STEP 4: Benefits And Problems of Drug Donations (60 minutes) |Activity: Small Group Discussion ( 15 minutes) | | | |DIVIDE students into manageable groups | | | |ASK students to discuss in groups on the following question: | | | |What are the benefits and problems of drug donations? | | | |ALLOW students to discuss for 15 minutes | | | |ALLOW each groups to present | | | |CLARIFY and SUMMARIZE by using the contents below | Benefits of Drug Donations • Medicine donations can save lives and ease suffering when well- coordinated and managed. • In cases where recipient countries are not able to ensure adequate medicines access, donations can bring major benefits to those in need • They help to eradicate the situation of out of stock medicines • Medicine donations can become strategic benefits to recipient countries. They are often used to support the rebuilding of health systems or to ensure access of population to health products they otherwise wouldn’t have • Good donation practices may provide savings in development support budgets, enabling these resources to be used for other purposes • To donors there is a benefit of tax deduction • Builds good relationship between countries Problems of Drug Donations These are based on the following categories; Pharmaceutical donations in emergency situations • Donated pharmaceuticals are often not relevant for the emergency situation, for the disease pattern, or for the level of care that is a they available • Health workers and patients are not always familiar with the donated pharmaceuticals • The pharmaceuticals are often

NTA Level 5 • Semester 1 • PST05101 Quality Assurance in Procurement of Medicines and Medical Medicines and Medical Supplies Management • Source Session/Topic 11 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 11: Quality Assurance in Procurement of Medicines and Medical Supplies Total Session Time: 120 minutes Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • List sources of medicines and medical supplies for procurement • Explain the quality assurance in procurement of medicines and medical supplies Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |05 minutes |Presentation |Introduction, Learning Tasks | |2 | |Presentation |Sources of Medicines and Medical | | |35 minutes |Buzzing |Supplies for Procurement | |3 | |Presentation |Quality Assurance in Procurement of | | |40 minutes |Small Group |Medicines and Medical Supplies | | | |Discussion | | |4 |20 minutes |Presentation |Critical Elements in Quality Assurance | | | |Buzzing |for Pharmaceutical Procurement | |5 |10 minutes |Presentation |Key Points | |6 |10 minutes |Presentation |Evaluation | SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing. STEP 2: Sources of Medicines And Medical Supplies For Procurement (35 minutes) |Activity: Buzzing (5minutes) | | | |ASK students to pair up and buzz on the following question for 3 | |minutes | | | |What are the Sources of medicines and medical supplies for procurement?| | | |ALLOW few pairs to respond on the question and let other pairs add on | |points not mentioned WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | The following are the Sources of medicines and medical supplies for procurement: They could be primary or secondary sources: • Primary sources o Manufacturers o Industries • Secondary sources o Distributors o Agencies o Others eg individuals or private pharmacy These are examples of common Sources of medicines and medical supplies for procurement; • Medical Stores Department (MSD) • Private pharmacies • Donors (Non Governmental Organization-NGOs) ie Bilateral Aid programs eg. DANIDA,USAID, JICA • United Nation Organizations (United Nations International Children’s Emergency Fund-UNICEF, UNDP) • World Health Organization (WHO) • At the global level, United Nations agencies such as UNICEF, United Nations Population Fund, and United Nations Development Programme have long functioned as pooled procurement systems serving their country programs • In recent years, a number of new global procurement mechanisms have emerged, such as the Stop TB Global Drug Facility, the U.S. President’s Plan for Emergency AIDS Relief (PEPFAR)–funded Supply Chain Management System (SCMS), and the Global Fund to Fight AIDS, Tuberculosis and Malaria’s voluntary pooled procurement system STEP 3: Quality Assurance in Procurement of Medicines and Medical Supplies (40 minutes) |Activity: Small Group Discussion ( 15 minutes) | | | |DIVIDE students into manageable groups | | | |ASK students to discuss in groups on the following question: | | | |What is quality assurance in procurement of medicines and medical | |supplies? | | | |ALLOW students to discuss for 15 minutes | | | |ALLOW each groups to present | | | |CLARIFY and SUMMARIZE by using the contents below | Quality assurance in procurement of medicines and medical supplies: • The purpose of quality assurance in pharmaceutical supply systems is to help ensure that each medicine procured and that reach a patient is safe, effective, and of acceptable quality. • A comprehensive quality assurance program includes both technical and managerial activities, spanning the entire supply process from pharmaceutical selection to patient use. • For the purposes of primary health care, the most important characteristics of a pharmaceutical product are identity, purity, strength, potency, uniformity of dosage form, bioavailability, and stability. • Pharmaceutical quality is affected by starting materials, manufacturing process, packaging, transportation and storage conditions, and other factors; these influences may be cumulative. • If a pharmaceutical product does not meet established quality standards, passes its expiration date, or has been degraded by storage conditions, the possible consequences are; o Lack of therapeutic effect, leading to prolonged illness or death o Toxic and adverse reactions o Waste of limited financial resources o Loss of credibility of the health care delivery system • A comprehensive quality assurance program must ensure the following; o Pharmaceuticals selected have been shown to be safe and efficacious for their intended use, are presented in an appropriate dosage form, and have the longest possible shelf life o Suppliers with acceptable quality standards are selected o Pharmaceuticals received from commercial suppliers and donors meet specified quality standards at the time of delivery o Packaging meets contract and usage requirements o Repackaging activities and dispensing practices maintain quality o Storage and transportation conditions do not compromise product quality o Product quality concerns reported by prescribers, dispensers, and consumers are properly cataloged and addressed o Product recall procedures are implemented to remove defective products STEP 4: Critical Elements in Quality Assurance for Pharmaceutical Procurement (20 minutes) |Activity: Small Group Discussion ( 15 minutes) | | | |DIVIDE students into manageable groups | | | |ASK students to discuss in groups on the following question: | | | |What are the critical elements for quality assurance for pharmaceutical| |procurement? | | | |ALLOW students to discuss for 15 minutes | | | |ALLOW each groups to present | | | |CLARIFY and SUMMARIZE by using the contents below | • Product selection: products with longer shelf life (for example, powders for reconstitution rather than oral suspensions), avoidance of products with bioavailability problems, when possible • Product certification: supplier prequalification, recent GMP inspection reports from national drug authorities, formal supplier-monitoring system,

NTA Level 5 • Semester 1 • PST05101 Procurement Methods Medicines and Medical Supplies Management • Source Session/Topic 10 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 10: Procurement Methods Total Session Time: 120 minutes Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • List methods for procurement of medicines and medical supplies • Identify criteria for selecting a procurement methods • Identify procurement models Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |05 minutes |Presentation |Introduction, Learning Tasks | |2 |40 minutes |Presentation |Methods for Procurement of Medicines and| | | |Buzzing |medical supplies | |3 | |Presentation |Criteria for Selecting a Procurement | | |35 minutes |Small Group |Methods | | | |Discussion | | |4 |15 minutes |Presentation |Identify Procurement Models | | | |Buzzing | | |5 |15 minutes |Presentation |Key Points | |6 |10 minutes |Presentation |Evaluation | SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing. STEP 2: Methods for Procurement of Medicines and Medical Supplies (55 minutes) |Activity: Buzzing (5 minutes) | | | |ASK students to pair up and buzz on the following question for 3 | |minutes | | | |What are the methods for procurement of medicines and medical supplies?| | | |ALLOW few pairs to respond on the question and let other pairs add on | |points not mentioned WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | The following are the methods for procurement of medicines and medical supplies; Open tender • Open tendering is a formal procedure by which quotes are invited from any supplier’s representative on a local or worldwide basis, subject to the terms and conditions specified in the tender invitation. For example, International competitive bidding, as specified in World Bank (2000; 2004b) guidelines, is a tender open to all interested international manufacturers from World Bank member countries. Restricted tender • In a restricted tender, interested suppliers must be approved in advance, often through a formal prequalification process that considers adherence to good manufacturing practices, past supply performance, financial viability, and related factors. The prequalification process is often open to any supplier that wishes to apply. E-procurement and reverse auction • E-procurement is Internet-based tendering. In the reverse auction approach (which is a variation of restricted tenders), qualified bidders submit an initial offer; the lowest offer received is posted publicly without naming the bidder after the first round; and then qualified bidders are invited to offer lower prices than that posted low price. The process continues round-by-round until no more prices are submitted; then the lowest posted bid wins the contract. This approach has rarely been used for pharmaceutical procurement (with most experience in Latin America); however, it may gain traction as global Internet capacity and use increase. Pharmaceutical quality assurance requirements and related factors may limit the use of this model, at least in its current form. Competitive negotiation • In competitive negotiation, the buyer approaches a limited number of selected suppliers (typically at least three) for price quotations. Buyers may also bargain with these suppliers to achieve specific price or service arrangements. This procurement method is used primarily in the private sector, because public-sector procurement organizations are generally forbidden from negotiating or bargaining with suppliers. For example, global organizations such as UNICEF, the Clinton Foundation, and SCMS have successfully negotiated reduced prices of antiretroviral (ARV) medicines with manufacturers. International or local shopping • As with competitive negotiation, in international or local shopping, the buyer obtains at least three quotes from suppliers; however, bargaining or negotiation of any kind are generally not permitted. Direct procurement • The simplest, but usually most expensive, method of procurement is direct purchase from a single supplier, either at the quoted list price or at a negotiated standard discount off the list price. For single-source medicines (generally those under patent with no licensing agreements that allow other firms to manufacture the medicine), the buyer basically has three choices—negotiated procurement, direct procurement, or selection of an alternative drug product. STEP 3: Criteria for Selecting Procurement Methods (35 minutes) |Activity: Small Group Discussion ( 15 minutes) | | | |DIVIDE students into manageable groups | | | |ASK students to discuss in groups on the following question: | | | |What are the criteria for selecting a procurement methods? | | | |ALLOW students to discuss for 15 minutes | | | |ALLOW each groups to present | | | |CLARIFY and SUMMARIZE by using the contents below | The following are criteria for selecting procurement methods: • Funding sources(government and donors) • Reorder frequency models • Annual review • Scheduled review • Perpetual review • Cost of prized tender • Assured quality, efficacy and safety of the items STEP 4: Identification of Procurement Models (15 minutes) |Activity: Small Group Discussion ( 15 minutes) | | | |DIVIDE students into manageable groups | | | |ASK students to discuss in groups on the following question: | | | |What are the criteria for selecting a procurement methods? | | | |ALLOW students to discuss for 15 minutes | | | |ALLOW each groups to present | | | |CLARIFY and SUMMARIZE by using the contents below | The Procurement model commonly practices or used:- • Scheduled purchasing • Perpetual purchasing o Example : Impress system ▪ : Two bin system • Annual purchasing : Purchase once a year • Modified optional Replenishment: it is a combination of the above STEP 4: Key Points (15 minutes) • There are numerous mechanisms by which governments, non-governmental organizations

NTA Level 5 • Semester 1 • PST05101 Procurement Cycle Medicines and Medical Supplies Management • Source Session/Topic 9 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 9: Procurement Cycle Total Session Time: 60 minutes Prerequisites • None Student Learning Tasks By the end of this session students are expected to be able to: • List steps in the procurement cycle Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |05 minutes |Presentation |Introduction, Learning Tasks | |2 |05 minutes |Presentation |Meaning of procurement cycle | |3 | |Presentation |Steps in the procurement cycle | | |40 minutes |Buzzing | | |4 |05 minutes |Presentation |Key Points | |5 |05 minutes |Presentation |Evaluation | SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing. STEP 2: Meaning of Procurement Cycle (5 minutes) The procurement cycle includes most of the decisions and actions that determine the specific medicine quantities obtained, prices paid, and quality of medicines received. Procurement is defined here as the process of purchasing supplies directly from national or multinational private or public suppliers; purchasing through global agencies and procurement mechanisms or regional procurement systems; or purchasing from international procurement agents. These sources may be used individually or in combination to meet the entire range of pharmaceutical needs. STEP 3: Steps in the Procurement Cycle (40 minutes) |Activity: Buzzing (5 minutes) | | | |ASK students to pair up and buzz on the following question for 3 | |minutes | | | |What are the steps in the procurement cycle? | | | |ALLOW few pairs to respond on the question and let other pairs add on | |points not mentioned WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | The following are steps in the procurement cycle: • Review medicine selected • Determine quantities needed • Reconcile needs and funds • Determine procurement method • Locate and specify suppliers • Specify contract terms • Monitor order status • Receive and check medicines • Make payments • Distribute medicines • Collect consumption information Fig 8.1 The Procurement Cycle [pic] Source: Management Sciences for Health STEP 4: Key Points (5 minutes) • The procurement cycle includes most of the decisions and actions that determine the specific medicine quantities obtained, prices paid, and quality of medicines received • The steps involved in procurement cycle includes; review medicine selected, determine quantities needed, reconcile needs and funds, determine procurement method, locate and specify suppliers, specify contract terms, monitor order status, receive and check medicines, make payments, distribute medicines and collect consumption information STEP 5: Evaluation (5 minutes) • What is the meaning of procurement cycle? • What are the steps in procurement cycle? References MSH and WHO (2012) Managing Access to Medicines and Health Technology, 3rd Edition. Kumarian Press World Health Organization (WHO), Regional Office for Africa Brazzaville 2004, Management of Drugs at Health Centre Level Training Manual. United Republic of Tanzania Ministry of Health and Social Welfare, Strategy for Development and Implementation of an Integrated Logistics System for Essential Health Commodities: Government Printers, Dar es Salaam ← Previous TopicNext Topic →View all Medicines and Medical Supplies Management topicsOpen Complete Full Notes PDF / OFFLINE NOTES Unataka kutumiwa notes hizi kupitia WhatsApp?Kwa notes zilizopangiliwa vizuri kwa kusoma offline au PDF, bonyeza kitufe hapa chini. Ujumbe wenye Level, Semester, Module na Topic utaandaliwa moja kwa moja.TUMIWA NOTES WHATSAPP WhatsApp: 255620339260

NTA Level 5 • Semester 1 • PST05101 Introduction to Procurement of Medicines and Medical Supplies Medicines and Medical Supplies Management • Source Session/Topic 8 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 8: Introduction to Procurement of Medicines and Medical Supplies Total Session Time: 120 minutes Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: a) Define terms used in procurement of medicines and medical supplies b) List objectives of good procurement c) List operation principles for good procurement d) Mention good procurement practices for medicines and medical supplies Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |05 minutes |Presentation |Introduction, Learning Tasks | |2 |10 minutes |Presentation |Definitions of terms used in | | | | |procurement of medicines and medical | | | | |supplies | |3 |25 minutes |Presentation |Objectives of good procurement | | | |Brainstorming | | |4 |20 minutes |Presentation |Operation principles for good | | | |Buzzing |procurement | |5 |40 minutes |Presentation |Good procurement practices for medicines| | | |Small Group |and medical supplies | | | |Discussion | | |6 |10 minutes |Presentation |Key Points | |7 |10 minutes |Presentation |Evaluation | SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing. STEP 2: Definitions of Terms Used in Procurement of Medicines and Medical Supplies (10 minutes) Procurement: • Is the acquisition of medicines and medical supplies, from an external source • It requires that the goods, services or works are appropriate and they are procured at the best possible cost to meet the needs of the acquirer in terms of quality, quantity, time and location. Procurement Period (PP) Indicates the time between one order and the next regular order Lead Time (LT) The period from the preparation of order to the arrival of products to the storage facility Procurement planning • Procurement planning is the process of deciding what to buy, when and from what source. During the procurement planning process the procurement method is assigned and the expectations for fulfillment of procurement requirements determined Bulk purchasing Procurement of pharmaceuticals in large quantities in order to obtain lower unit prices Generally done in a bid system in which all medicines are identified by their generic (INN) name. Direct procurement • The simplest but usually most expensive method of procurement, in which an item is purchased from a single supplier at its quoted price. Supplier • Any individual or company that agrees to provide medications, regardless of whether that party is the manufacturer STEP 3: Objectives of Good Procurement (25 minutes) |Activity: Brainstorming (5 minutes) | | | |Ask students to brainstorm on the following question: | | | |What are the objectives of good procurement? | | | |ALLOW few students to respond | | | |WRITE their responses on the flip chart/ board | | | |CLARIFY and SUMMARISE by using the content below | The following are the objectives of good procurement: • To eek to manage the buyer-seller relationship in a transparent and ethical manner • To procure the right medicines in the right quantities • To obtain the lowest practical purchase price • To ensure that all pharmaceuticals procured meet recognized standards of quality • To arrange timely delivery to avoid shortages and stockouts • To ensure supplier reliability with respect to service and quality • To set the purchasing schedule, formulas for order quantities, and safety stock levels to achieve the lowest total cost of purchasing at each level of the system • To achieve these objectives in the most efficient manner possible STEP 4: Operation Principles for Good Procurement (20 minutes) |Activity: Buzzing (5 minutes) | | | |ASK students to pair up and buzz on the following question for 3 | |minutes | | | |What are the operation principles of good procurement? | | | |ALLOW few pairs to respond on the question and let other pairs add on | |points not mentioned WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | • Division of responsibilities among different offices, committees and individual in respect to appropriate expertise. • Transparency in procurement procedures by having formal written procedure throughout the procedure. • Planning and regular monitoring of procurement process. STEP 5: Good Procurement Practices for Medicines and Medical Supplies (40 minutes) |Activity: Small Group Discussion ( 15 minutes) | | | |DIVIDE students into manageable groups | | | |ASK students to discuss in groups on the following question: | | | |What are the good procurement practices for medicines and medical | |supplies? | | | |ALLOW students to discuss for 15 minutes | | | |ALLOW each groups to present | | | |CLARIFY and SUMMARIZE by using the contents below | The following are good procurement practices for medicines and medical supplies; • Ordering medicines by generic name as most of the time are cheaper • Limiting procurement to products on essential medicine list or formulary list (can’t purchase all drugs available in the market) • Making bulk purchases i.e. large procurement volume makes favorable prices and contract terms possible. • Carrying out formal supplier qualification and monitoring i.e. suppliers should be pre or post qualified through a process that considers product quality, service reliability (and delivery time) and financial viability. • Using a competitive bidding process i.e. inducing supplier competition is a key to detaining favorable pricing. • Committing to a sole source i.e. except when each health facility purchases drug independently, all public pharmaceutical procurement systems are group purchasing programs (eg. MSD Tanzania).

NTA Level 5 • Semester 1 • PST05101 Application of Quantification Methods Medicines and Medical Supplies Management • Source Session/Topic 7 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 7: Application of Quantification Methods Total Session Time: 120 minutes Prerequisites • Completion of session 6 Learning Tasks By the end of this session students are expected to be able to: • Explain applications of the quantification methods • Carryout the calculations in different quantification methods in full supply • Carryout the calculations in different quantification methods in Non-full supply Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |05 minutes |Presentation |Introduction, Learning Tasks | |2 |20 minutes |Presentation |Application of the Quantification | | | |Small Group |methods | | | |Discussion | | |3 |40 minutes |Presentation |Calculations in Different Quantification| | | | |Methods in Full Supply | |4 |35 minutes |Presentation |Calculations in Quantification Methods | | | | |in Non-Full Supply | |5 |10 minutes |Presentation |Key Points | |6 |10 minutes |Presentation |Evaluation | SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing. STEP 2: Applications of Quantification Methods (90 minutes) |Activity: Small Group Discussion ( 15 minutes) | | | |DIVIDE students into manageable groups | | | |ASK students to discuss in groups on the following question: | | | |What are the applications of quantification methods? | | | |ALLOW students to discuss for 15 minutes | | | |ALLOW each groups to present | | | |CLARIFY and SUMMARIZE by using the contents below | The following are the applications of quantification methods; • Calculating order quantities for procurement: Formal quantification may be necessary before each scheduled procurement. These estimates need to be accurate to avoid stock outs, emergency purchases, and overstocks and to maximize the effect of procurement funds. The consumption method is the first choice, cross-checked to assess the appropriateness of usage and demand patterns. When consumption data are unreliable or unavailable, such as in new programs, the morbidity method, the proxy consumption method, or both, may need to be applied for an initial quantification, switching to the consumption method when reliable data can be compiled or the program has stabilized. • Estimating budget requirements: In many countries, the annual pharmaceutical procurement budget is determined by adding a fixed percentage to the previous year’s request or allocation to allow room for contingencies, such as expected cuts by the ministry of finance, population growth, or expansion of services. Both budget requests and cuts are frequently prepared without reliable estimates of actual needs. This cycle can be broken with rational, well-documented quantification. Although consumption-based quantification is the best guide to probable expenditures, the morbidity-based method may be the most convincing documentation for a budget request. Proxy consumption is useful for checking and justifying either consumption or morbidity methods. When budget requirements do not need to be justified by specifying order quantities, the service-level method can be used as an alternative. • Estimating pharmaceutical requirements for emergency relief situations: In emergencies such as floods or earthquakes, the first step is to provide emergency kits quickly. As local health problems become clear, a morbidity-based method can be used to project requirements in the short and medium term, until the regular supply system can resume services. • Developing procurement quantities for new programs: When medicines are needed for launching a new full-service health system or vertical program (such as HIV/AIDS programs or DOTS), quantification serves two purposes: to establish funding requirements for procurement and to develop the initial procurement list. In most situations, the consumption-based method is not feasible, and some combination of morbidity-based and proxy consumption methods must be used for the initial quantification. • Developing procurement quantities for scaling-up programs: Scaling up is the term used to describe an incremental increase or growth in the number of patients being treated over a period of time. Patient-months can be used to estimate needs for scaling up, where one “patientmonth” is the quantity of a product needed to treat one patient for one month. The total number of patients treated over an incremental period of time in months is often used in this situation for estimating needs for chronic conditions. For example, programs may not be able to serve all the patients needing ART at the start of an HIV/AIDS program but are able to scale up slowly as they receive additional donor funds, human resources, and training and address other access barriers • Quantifying for assistance projects: A donor organization may undertake ad hoc quantification studies to plan procurement needs in the context of a development project. When local consumption data are not sufficiently reliable for quantification, the morbidity or proxy consumption method should be used, either singly or in combination. • Estimating pharmaceutical requirements for emergency relief situations: In emergencies such as floods or earthquakes, the first step is to provide emergency kits quickly. As local health problems become clear, a morbidity-based method can be used to project requirements in the short and medium term, until the regular supply system can resume services. • Comparing actual medicine consumption with theoretical need: In most functional supply systems, the regular procurement quantification is based on past consumption. However, periodic comparison of consumption with theoretical demand based on public health priorities is a useful practice. The morbidity-based method provides the most informative comparison, but simply comparing consumption data from different systems is worthwhile because significant differences in medicine use can help identify irrational prescribing patterns or persistent inventory problems. STEP 3: Calculation in Consumption Based Quantification Method in Full Supply (40 minutes) In calculating amount to order where there

NTA Level 5 • Semester 1 • PST05101 Quantification Methods Medicines and Medical Supplies Management • Source Session/Topic 6 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 6: Quantification Methods Total Session Time: 120 minutes Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • List the methods of quantification • Explain the methods of quantification Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |05 minutes |Presentation |Introduction, Learning Tasks | |2 |10 minutes |Presentation |Methods of Quantification | | | |Buzzing | | |3 |80 minutes |Presentation |Explanations on Methods of | | | |Small Group |Quantification | | | |Discussion | | |4 |15 minutes |Presentation |Key Points | |5 |10 minutes |Presentation |Evaluation | SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing. STEP 2: Methods of Quantification (10 minutes) |Activity: Buzzing (5minutes) | | | |ASK students to pair up and buzz on the following question for 3 | |minutes | | | |What are the methods of quantification? | | | |ALLOW few pairs to respond on the question and let other pairs add on | |points not mentioned WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | There are four (4) methods of quantification as listed below: • Consumption quantification method • Morbidity quantification method • Adjusted consumption quantification method • Service level projection of budget requirements method STEP 3: Explanations on Methods of Quantification (80 minutes) |Activity: Small Group Discussion ( 15 minutes) | | | |DIVIDE students into manageable groups | | | |ASK students to discuss in groups on the following question: | | | |What are the explanations on the methods of quantification? | | | |ALLOW students to discuss for 15 minutes | | | |ALLOW each groups to present | | | |CLARIFY and SUMMARIZE by using the contents below | The following are the explanations on quantification methods; The Consumption Method • This method uses records of past consumption of individual medicines (adjusted for stockouts and projected changes in medicine use) to project future need • In many instances, this is the most precise method for quantifying pharmaceutical usage, provided the source data are complete, accurate, and properly adjusted for stockout periods and anticipated changes in demand and use. • It does not normally address the appropriateness of past consumption patterns, which may or may not correspond with public health priorities and needs. Thus, irrational medicine use may be perpetuated by total reliance on the consumption method. If stock outs have been widespread for long periods, applying this method accurately may be impossible, which is why capturing actual demand is the most accurate approach. The Morbidity Method • This method estimates the need for specific medicines based on the expected number of attendances, the incidence of common diseases, and standard treatment patterns for the diseases considered. It may be used when a program is scaling up. • This is the most complex and time-consuming method. In many countries, assembling valid morbidity data on more than a defined set of diseases is very difficult; therefore, some needs will be overlooked in the quantification. Data on patient attendance are often incomplete and inaccurate, and predicting what percentage of prescribers will actually follow the standard treatment regimens used for quantification is difficult. • Despite these constraints, this method may remain the best alternative for planning for procurement or for estimating budget needs in a supply system or facility in which a limited range of health problems accounts for virtually all medicine consumption, such as a small primary care system; a special-purpose hospital; a new program with no previous consumption history, such as HIV/AIDS programs rolling out antiretroviral therapy (ART); or changes in standard treatment guidelines. The Adjusted-consumption /Proxy Consumption Method • This method uses data on disease incidence, medicine consumption, demand, or use, and/ or pharmaceutical expenditures from a “standard” supply system and extrapolates the consumption or use rates to the target supply system, based on population coverage or service level to be provided • It is the method generally used if neither the consumption-based nor the morbidity-based method is feasible. This method is most likely to yield accurate projections when used to extrapolate from one set of facilities to another set that serves the same type of population in the same type of geographic and climatic environment. • Still, this method may be the best alternative in the absence of suitable data required for the consumption- or morbidity-based method. • The proxy consumption method is also useful for cross-checking projections made with other methods. Service-Level Projection of Budget Requirements Method • This method uses the average medicine cost per attendance or bed-day in different types of health facilities in a standard system to project medicine costs in similar types of facilities in the target system This method does not estimate quantities of individual medicines. • It produces a rough estimate of financial needs for pharmaceutical procurement and not the quantity of products. The method relies on two assumptions: o that the “standard” system (used for comparison) and the target system are comparable in terms of patient attendance and bed-days per type of facility, and o that the patterns of medicine use are roughly the same in both systems. Despite its limitations, this method can be useful in predicting medicine costs in a new system or in a system in which no data are readily available STEP 4: Key Points (15 minutes) • There are 4 types of quantification; which are Consumption quantification method, Morbidity

NTA Level 5 • Semester 1 • PST05101 Introduction to Quantification and Forecasting Medicines and Medical Supplies Management • Source Session/Topic 5 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 5: Introduction to Quantification and Forecasting Total Session Time: 120 minutes Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Define terms quantification and forecasting as applied in medicines and medical supplies • List objectives of quantification • Describe issues to consider in quantification Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |05 minutes |Presentation |Introduction, Learning Tasks | |2 |10 minutes |Presentation |Definitions of Terms Quantification and| | | | |Forecasting | |3 |30 minutes |Presentation |Objectives of Quantification | | | |Buzzing | | |4 |60 minutes |Presentation |Issues to Consider in Quantification | | | |Small Group | | | | |Discussion | | |5 |05 minutes |Presentation |Key Points | |6 |10 minutes |Presentation |Evaluation | SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing. STEP 2: Definitions of Quantification and Forecasting (10 minutes) Quantification • Is a process that includes estimating the quantities and the cost of medicines and medical supplies as required to meet customer demand and to fill the pipeline with adequate stock levels. • The process takes into account service delivery capacity, supply pipeline requirements, and resources available for procurement. • Is the process used to determine how much of a products is required for the purpose of procurement and the budget costs ie. Medicine needs for the next procurement activity • Is a critical supply chain activity that links information on services and commodities from the facility Forecasting • It means estimating the quantity of products (e.g. medicines to be dispensed and medical supplies to be used) to meet customer demand for a future period of time. It is about projection of future needs, beyond the next purchasing order • Is the process of making predictions of the future based on past and present data and most commonly by analysis of trends. STEP 3: Objectives of Quantification (30 minutes) |Activity: Buzzing (5minutes) | | | |ASK students to pair up and buzz on the following question for 3 | |minutes | | | |What are the objectives of quantification? | | | |ALLOW few pairs to respond on the question and let other pairs add on | |points not mentioned | | | |WRITE their response on the flip chart/board | | | |CLARIFY and SUMMARIZE by using the content below | The following are the objectives of quantification: • Provide evidence for medicines and medical supplies budget • To be used as bench mark for monitoring and evaluation • To achieve consistent availability of medicines • To ensure adequate supplies for projected scale up • To ensure minimal wastage • To ensure minimal over stoking • To attain Cost effectiveness (value for money) • To conduct rational adjustment where funds are inadequate • To easy management medicines and medicals supplies • To address and meeting actual demand • To satisfied clients as their needs are addressed STEP 4: Issues to Consider in Quantification (60 minutes) |Activity: Small Group Discussion ( 15 minutes) | | | |DIVIDE students into manageable groups | | | |ASK students to discuss in groups on the following question: | | | |What are the issues to consider in quantification? | | | |ALLOW students to discuss for 15 minutes | | | |ALLOW each groups to present | | | |CLARIFY and SUMMARIZE by using the contents below | The following are issues to consider in quantification; • Population which the health institution serves • Disease patterns in that particular facility catchment • Varying Monthly drug consumption • Knowledge of quantity of each dosage form that is regularly consumed • Delivery lead time may not be constant • Time lag between placing orders and receiving the orders • Changing Request indicator (re-order level) • Quantity of drug product that serves as a signal for re-ordering .After knowing the issues to consider in quantification, here are Steps to follow in quantification; • Prepare Action plan for quantification • Decide use centralized or decentralized approach • Decide use of manual or computerized system • Estimate time required • Develop the medicines and medical supplies list • Fill the supply system • Consider impact of lead time • Adjust for losses and wastes, thefts, growth • Estimate cost that is budget • Adjusting and reconciling funds and quantities required STEP 5: Key Points (5 minutes) • Quantification is the process used to determine how much of a products is required for the purpose of procurement and the budget costs ie. Medicine needs for the next procurement activity • Forecasting is the process of making predictions of the future based on past and present data and most commonly by analysis of trends • There are several objectives of quantification which include to achieve consistent availability of medicines and medical supplies, adequate supplies for projected scale up, minimal wastage, minimal over stoking and having satisfied clients just to mention a few. • There are important issues to consider in quantification (is forecasting) such as Population which the health institution will serve, Disease pattern, Seasonal variation in disease pattern, Varying Monthly drug consumption, Knowledge of quantity of each dosage form that is regularly consumed, Delivery lead time and Time lag between placing orders and receiving the orders, STEP 6: Evaluation (10 minutes) • What is the meaning of quantification? • What is the meaning of forecasting as applied in medicines and medical supplies ? •

NTA Level 5 • Semester 1 • PST05101 Criteria and Challenges Facing Selection Medicines and Medical Supplies Management • Source Session/Topic 4 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 4: Criteria and Challenges Facing Selection Total Session Time: 120 minutes Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Mention criteria for selection of medicines and medical supplies • List problems facing selection of medicines and medical supplies Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board and chalk/whiteboard markers SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |05 minutes |Presentation |Introduction, Learning Tasks | |2 |60 minutes |Presentation | Criteria for Selection of Medicines and| | | |Group discussion|Medical Supplies | |3 |40 minutes |Presentation |Problems Facing Selection of Medicines | | | |Brainstorm |and Medical Supplies | |5 |10 minutes |Presentation |Key Points | |6 |05 minutes |Presentation |Evaluation | SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing. STEP 2: Criteria for Selection of Medicines and Medical Supplies (60 minutes) |Activity: Small Group Discussion ( 15 minutes) | | | |DIVIDE students into manageable groups | | | |ASK students to discuss in groups on the following question: | | | |What are the criteria for selection of medicines and medical supplies? | | | |ALLOW students to discuss for 15 minutes | | | |ALLOW each groups to present | | | |CLARIFY and SUMMARIZE by using the contents below | The following are criteria for selection of medicines and medical supplies; for the facility • Relevance to the pattern of prevalent diseases in that area • Medicine that satisfy the healthcare needs of the majority of the population • Proven efficacy and safety from clinical studies data • Assured quality and bioavailability (desirable pharmacokinetic properties) • The knowledge and skills of the healthcare worker to administer. • Stable during storage and transport; When two or more similar medicines are available selection will base on the one which is:- • More stable • Cost effective; Total cost of treatment and not unit cost; Example, a vial can be cheaper but may need refrigeration, syringes, and expert healthcare worker to administer. • Appropriate for level of healthcare use; Example primary healthcare select simple and easy to use medicines and medical supplies • Avoid confusion of names and dispensing; avoid including same medicines with different strength, different medicines with similar name. • Possibilities for local manufacturer • Availability as single compounds • The drugs should be identified by the International Non-proprietary Name (INN), sometimes referred to as the generic name STEP 3: Problems Facing Selection of Medicines and Medical Supplies (40 minutes) |Activity: Brainstorming (5 minutes) | | | |Ask students to brainstorm on the following question: | | | |What are the Problems facing selection of medicines and medical | |supplies? | | | |ALLOW few students to respond | | | |WRITE their responses on the flip chart/ board | | | |CLARIFY and SUMMARISE by using the content below | The following are the problems facing selection of medicines and medical supplies: • Failure to respect National Protocol; this may bring about selection of medicines and medical supplies which are not essential for the community and nation at large; but also may lead to selection of supplies which are not important for a particular level of the facility i.e referral hospital/ regional hospitals, district hospitals, health centres and dispensaries • Multitude of products used; this is crowding of supplies in a facility which are used for similar purpose • Transition to new products; this is about innovation of new medicines and medical supplies. They could be of the same effectiveness or better than the older ones; however they could not be cost effective or of uncertain safety. Economical interests of the key people involved may hinder proper selection procedures • Lack of well trained personnel; key healthcare workers or people involved in selection should get trainings and updates in order for them to do informed decisions on selection STEP 5: Key Points (10 minutes) • Selection of medicines and medical supplies is based on several criteria. These include relevance to the pattern of prevalent diseases, medicine that satisfy the healthcare needs of the majority of the population, proven efficacy and safety from clinical studies data, assured quality and bioavailability (desirable pharmacokinetic properties), stable during storage and transport. When two or more similar medicines are available selection should base on the one which is more stable. Medicines selected should be cost effective; this implies the total cost of treatment and not unit cost • There are several problems facing selection of medicines and medical supplies such as failure to respect national protocol, multitude of products used and transition to new products • In a nutshell, selection of medicines and medical supplies is a process that requires to involve well-trained key personnel with the aim of satisfying health needs of the majority of the population STEP 6: Evaluation (5 minutes) • What are the criteria for selection of medicines and medical supplies? • What are the problems facing selection of medicines and medical supplies? References MSH and WHO (2012) Managing Access to Medicines and Health Technology, 3rd Edition. Kumarian Press World Health Organization (WHO), Regional Office for Africa Brazzaville 2004, Management of Drugs at Health Centre Level Training Manual. United Republic of Tanzania Ministry of Health and Social Welfare, Strategy for Development and Implementation of an Integrated Logistics System for Essential Health Commodities: Government Printers, Dar es Salaam ← Previous TopicNext Topic →View all Medicines and Medical Supplies Management topicsOpen Complete Full Notes PDF / OFFLINE NOTES Unataka kutumiwa notes hizi kupitia