PSM of Kits Atieno Ojoo Unicef Supply Division

1. PSM of Kits Atieno Ojoo Unicef Supply Division

2. Purpose of kits • Simply product delivery logistics • Transport (Weight, height, length, palletization) • Storage and warehousing • Ease of use (Self instructive, no assembly of parts) • Assumption that kit contents are the right ones for the intervention • Population characteristics • Problem prevalence, likely morbidity • Level of skills of providers • Usually designed for acute phase • Protracted phase-Set packing specific to situations

3. Procurement & Supply chain management Product Selection Needs identified Rational Use Forecasting Govts CSOs Distribution Supplier Selection Procurement Receipt and Storage Product Procurement Quality Assurance

4. Supply System context • PROGRAMME: product selection, standard setting, quantification of needs. • FINANCING: clarify budgets and funds • LEGISLATIVE/REGULATORY: check status of product registration, marketing authorisation, national procurement laws • COMMERCIAL/TRADE: customs duty, patents, licenses

5. Supply System Organisation • TENDER MANAGEMENT: supplier prequalification, bid evaluation, adjudication, Contracting. • QUALITY ASSURANCE: pre and post quality control, supplier performance • LOGISTICS: port clearance/receipt from suppliers, transportation, Storage, distribution. • MANAGEMENT INFORMATION SYSTEMS: data and information control, feedback/action

6. Important considerations • What is required in acute phase of emergency? • Save lives, prevent harm, stabilize the situation, mitigate against risks that could lead to harm in the future, • What is required in the protracted/recovery phase • Assessment of future needs, modified version of routine care • Content of kits-evidence, consensus, reflects real need • Language, naming of kits (universal, no confusion, relate to contents as much as possible), ease of identification for tracking & tracing • Compromise: some items may have to be left out or made to be ordered after an assessment is done • Transport; weight, height, length, Palettization (number of kits that can fit on a standard palette) • Kits do not replace routine healthcare provision • Political and social sensitivity

7. Selection of contents • Global level leadership and commitment-WHO stamp important • Evidence-base;Standard Treatment protocols- WHO • Agreed assumptions based on experience • Injectable medicines require professional health worker use e.g.MgSO4 • Single item per intervention; this allows HCW to concentrate on making the right intervention decisions, rather than choosing between interventions. Oxytocin Vs Misoprostol • Usability: ease of use • Volume and weight of product • Protective devices for health workers • No duplication with existing kits • Lifecycle of product- scenarios where a product is likely to become obsolete, change in treatment protocols e.g. MgSO4 • Product stability; choose longer shelf life formulation, avoid cold storage products • Storage requirements for components • Patents, regulatory concerns

8. Kit design • Several complete basic units within a kit • Bundle products that need to be used together • Do not mix external use and internal use products • Separate consumables from equipment and reusables • Sub kits with different contents • Supplementary kits • Higher level of skills required • Higher level of health services • Shelf life of kit dependent on product with shortest shelf life.

9. Forecasting & procurement • Morbidity based • Population based-Use prevalence information • Information from previous crises • standard, universal protocols • Prequalification of suppliers & products • Procurement by generic name • Competitive procurement process (public procurement principles) • Responsibilities for Quality assurance • Customs clearance • Financing the kits

10. Kit assembly • One stop packing • Procurement of kit contents • All products in a kit available at one place • Challenge with products that have to be in multiple kits • Quality assurance • Procurement, packing and distribution lead times • Compliance with international guidelines for quality, packaging, labeling

11. Warehousing, transport • How much to stock & where to locate stocks • Work with other emergency logistics • Stocks with suppliers of kits? • Include in the package of supplies in the logistics cluster for immediate response • Pre-agreements with logistics agents, other international agencies • Shipping, flights, ground transportation • Stock rotation, managing expiries

12. cost • Procurement of kit items • Kit packing • Storage, inventory management • Distribution and logistics • Other transaction costs • Cost of wastage • Cost of destruction of unusable kits

13. Supply Chain IN-COUNTRY LOGISTICS Assessment Planning Procurement Shipping Warehousing and Inventory Management Good Clearance Inland Transport and Distribution Supply Tracking and Evaluation

14. Dispatch Request WayBill Receipt Authorising M&E: SUPPLIES ALSO MOVE ON PAPER H U M A N R E S O U R C E S Daily Warehouse Operations Receiving & checking supplies Storing supplies in locations Authorising delivery Shipping supplies (FIFO/FEFO) Receipt Acknowledgement Store Receipt Stock Card WayBill Documents Sample Sample Sample Sample Monitoring & Control Notifying losses damages when receiving Monitoring Inventory Control Performance Notifying losses damages during storage & transport Claim ref: Book G Physical Count (IMAT) Property Survey Board Loss/Adj.Report Disposal Report Processes Sample Sample Inventory Database The Inventory database is updated for each transaction and reports generated regularly and upon request

15. Function Scheme Crisis area Partners Country Normative Logistical Services Logistical Services Normative Suppliers Suppliers Technical support Technical support Procurement & Contracting Procurement & Contracting Quality Asurance Quality Assurance Warehouse Management and Support Services