The current environment for automation within the supply chain might be best described as haphazard. Locally developed and managed systems do exist in CMS, selected regional warehouses, and a few facilities, but these tools are not linked and were not designed as part of an integrated commodity management system. In recent years, the MOH has not
prioritized automation to support the supply chain, and the resulting efforts have been local and small in scale. Additionally, the MOH and GHS have not emphasized the collection of national-level health commodity information. Data visibility for policy and operational leaders regarding commodity information has also not been a priority.
As part of this strategic plan, the NHCSA has been mandated to design and implement an integrated LMIS to collect and use commodity-related data. The MOH has also expressed its desire to implement an integrated, modern technology-based information system for
managing supply chain data. These interrelated processes will require considerable time, attention, leadership, and, ultimately, resources, if they are to be accomplished.
Key interventions related to LMIS and information systems include:
Complete an information requirements and data flows analysis for each user group and across user groups and clearly define objectives as well as expectations regarding information-sharing policies, procedures, processes, and service and performance levels.
Complete the system design phase for the primary logistics functions, including LMIS, distribution (warehousing and transport), inventory management, pipeline monitoring, and resupply schedules, ensuring that roles and responsibilities and information requirements are clearly defined, and leading to the detailed design of an integrated LMIS.
Create and maintain an IT Committee/Subcommittee to oversee the
review/selection process for a technology-based, integrated information system for managing and accessing supply chain data. Their tasks will include:
Review the scope, project plans, requirements, designs, and capabilities of any/all current automation projects/automated systems (e.g. – mSupply software) in relation to supply chain information management to determine whether they are appropriate for future integrated system needs.
Identify an IT solution for implementing the integrated LMIS (by competitive bid or other method).
Purchase and install hardware to support the IT solution (within the SCMU warehouse network and for facilities).
Develop a training/implementation plan based on the availability of human and other resources for training and onsite supervision.
Create a unit within NHCSA to support the new system. 5.6 Policy, Legal, and Regulatory Environment
The MOH and its agencies seek to reduce the occurrence of poor-quality medicines and health commodities within the public sector. This is an important objective within the public sector and one of the primary mandates of the FDB. However, the current systems,
mechanisms, and inspection resources do not seem to be adequate to ensure that inferior medicines and medical devices and supplies do not enter the public sector system. The MOH, with the support of the FDB and the NHCSA, need to address the following:
Define roles and relationships between/among the new agency and other MOH agencies and regulatory authorities regarding quality assurance responsibilities for medicines and medical devices (e.g., FDB, Ghana Standards Authority, etc.).
Review existing indicators as well as data requirements to assist in quality assessment, inspections, testing, and tracking within the drug and health commodity quality assurance programme.
Implement updated/revised policies and procedures for quality assurance and conduct inspections, testing of products, etc.
Strengthen FDB and NHCSA and support them to enforce guidelines for
sanctioning procurers within the system and/or vendors selling to the system who are found to be out of compliance with MOH and FDB regulations (inspections), and for testing drugs and other commodities.
Support development of incentives and sanctions to improve manufacturers’, importers’, and distributors’ self-regulation of medicine and health commodity quality.
5.7 Quantification and Product Selection
Similar to information systems, the current situation for quantification is somewhat random; if oversight and action are provided to quantification, it is most often by one of the various programme departments of the GHS, with varying degrees of effectiveness and little coordination or information sharing. The reality for product selection is even more haphazard, particularly at the lowest level of the public sector, as 1,000+ facilities are procuring with little regard to the guidelines for selecting medicines and medical supplies. For the new NHCSA, full agreement on the list of products that it will manage will be critical to helping others understand its defined roles in commodity availability. Similarly, the MOH and the new agency need to ensure that, going forward, all levels (GHS, RMS, and facilities) have a clearly defined scope of commodities they can procure and use. Both product lists will be reviewed at least annually.
Regarding quantification, the new agency will lead the forecasting process for all of the products it is expected to manage. It will also be expected to develop and implement a consistent process for quantification of all other commodities, together with other members of the national quantification team.
Key interventions for upgrading and managing commodity quantification include: Obtain any existing quantification guidelines (MOH, GHS, consultants), and then
draft revised guidelines that describe how, when, how often, and by whom
quantifications and forecast reviews will be conducted. Current forecasting tools will be reviewed and revised if appropriate.
Training of SCMU and other staff on quantification process, tools, and methodologies will be organized and held regularly.
An annual quantification exercise will be conducted for all health commodities: NHCSA or others specifically designated will produce annual commodity forecasts and supply plans, review procurement plans regularly, and update and revise as needed.
These agencies will also conduct formal quarterly reviews/updates of forecasts and supply plans with other concerned parties (including the THs) to determine and update procurement responsibilities for all commodities.
Quantification results, regardless of the source, will be shared with all relevant stakeholders for advocacy and resource mobilization.