Table - NACO

Foreword .............................................................................................................. 1

Acknowledgement ............................................................................................. 11

Abbreviations ..................................................................................................... 12

Glossary .............................................................................................................. 14

1. Introductionof“Plan,Do,CheckandAct” ......................................................... 16

2. PurposeofStandardOperatingProcedures ....................................................... 17

Section 1: Overview of Supply Chain Management

3. ObjectiveofSupplyChainManagement ............................................................ 20

4. IntroductiontoSupplyChainManagement ....................................................... 21

5. HIV/AIDSCommoditiesSupplyChain ................................................................. 24

6. LogisticsManagementInformationSystem ....................................................... 27

7. Quantification ..................................................................................................... 31

8. Procurement ....................................................................................................... 32

9. InventoryManagement ...................................................................................... 34

10. AssessingStockStatus ........................................................................................ 36

11. CalculatinganIndentQuantity ........................................................................... 38

12. WarehouseandStorage ..................................................................................... 42

13. QualityAssurance ............................................................................................... 48

Section 2: SOP for ARV Drugs and Other Commodities

14. ARVDrugsandOtherCommoditiesFlowProcess .............................................. 53

15. StandardOperatingProcedures ......................................................................... 54

16. StandardOperatingProceduresReferenceTables ............................................. 55

17. ForecastandProcureCommodities ................................................................... 58

18. MonitoringCommodityConditionsandLevels .................................................. 60

19. IndentCommodities ........................................................................................... 65

20. ReceiveandStoreCommodities ......................................................................... 68

21. IssueandDispenseCommodities ....................................................................... 72

22. DistributeCommodities(PackagingandTransportation) ................................... 75

Section 3: SOP for HIV Test Kits and Other Cold Chain Commodities

23. SOPforHIVTestKitsFlowProcess ..................................................................... 79

Tableof Contents

24. StandardOperatingProcedures ......................................................................... 80

25. StandardOperatingProceduresReferenceTables ............................................. 81

26. ForecastandProcureCommodities ................................................................... 84

27. MonitoringCommodityConditionsandLevels .................................................. 86

28. IndentCommodities ........................................................................................... 90

29. ReceiveandStoreCommodities ......................................................................... 93

30. IssueandDispenseCommodities ....................................................................... 97

31. DistributeCommodities(PackagingandTransportation) ................................. 100

AnnexuresI. ColdChainManagementforHIVTestKits ........................................................ 107

II. Indent Form ...................................................................................................... 115

Indent Form Job Aid ......................................................................................... 116

III. IssueandReceiveForm .................................................................................... 118

IssueandReceiveFormJobAid ....................................................................... 119

IV. BinCard ............................................................................................................ 120

BinCardJobAid ................................................................................................ 121

V. StockRegister ................................................................................................... 122

StockRegisterJobAid ....................................................................................... 123

VI. RTDForm .......................................................................................................... 124

RTDFormJobAid ............................................................................................. 125

VII. GoodsReceiptNote(GRN) ............................................................................... 126

GRNJobAid ...................................................................................................... 127

VIII. DDRForm ......................................................................................................... 128

DDRFormJobAid ............................................................................................. 130

IX. Monthly/QuarterlyStockReport(MSP/QSP) ................................................... 131

Monthly/QuarterlyStockReport(MSP/QSP)JobAid ....................................... 132

References ........................................................................................................ 133

Tableof Contents

SOP for Supply Chain Management under NACP 1

Indiaiscommittedto‘EndingtheAIDS’epidemicasapublichealththreatby2030inlinewithSustainableDevelopmentGoals(SDG).Aswemoveforward,wewillcontinuetoensurethatallpeoplelivingwithHIV, and those at risk, receive a comprehensive package of life-saving services for HIV prevention,testing,treatmentandcare.

AcrossNACO&SACS,SupplyChainManagement (SCM)ofHIV/AIDScommodities involvesaseriesofactivitiestoensureacontinuoussupplyofproductsfromthepointofmanufacturetothepointofcare.Thesupplychainfunctionprovidesprogrammemanagerswithdatatohelpdefinetheproductsrequired.Thedatahelps themoperateefficientlywithin thesystemandplan theavailabilityof theproductswith efficient deliveries in relation toquality, quantity andtime. In termsof supply chainmanagement, a greater integration within the health care system is proposed in the way ahead.Procurementand supply chainmanagement isoneof thecriticalenablers inNationalAIDSControlProgramme(NACP)alsoandcentraltoensuringcontinuous,uninterruptedsupplyofcommodities.Thelackofawell-functioningSCMisathreattotheimplementationofpreventionprogramme,deliveryofHIVtestingservices,andtreatment,careandsupportforHIV.

This document shall guide our joint efforts in the next coming years to fast-track organisation’scapacitytobettermanageHIV/AIDSsupplychaininIndia.TheimplementationoftheseSOPswillbeacomprehensiveelevationofprocurementandsupplychainfunctionandneedstobeusedasareferenceateveryleveltoaccelerateeffortstoendAIDSandhelpusrealiseourplannedoutcomes.TheNationalAIDSControlOrganizationremainscommittedtoassistallstakeholderswiththeimplementationofthisSOPtogarneroptimaloutcomesineachspecificsetting.

IhopetheSOPsforHIV/AIDSSupplyChainManagementwillbehelpfultoallthosewhoareinvolvedinthefieldofpolicy,administration,planning,management&researchofhealthservicesandensuretimelyserviceprovisiontoclients.

Datedthe30thSeptember,2020

Message


ItgivesmeimmensepleasuretopresenttheStandardOperatingProceduresforHIV/AIDSSupplyChainManagement.TheSOPrepresentthecollaborativeeffortofNationalAIDSControlOrganization(NACO)employeesespeciallyfromCSTandBSDivisionandStateAIDSControlSocieties(SACS)fromacrossthecountry,workinginpartnershipwithPlanIndiaontheSCMProject.

The objective of this Standard Operating Procedures is to improve the management of HIV/AIDScommoditiesatalllevelsofthesupplychain.Theinstructionsandjobaidsaredesignedtoguidetheworkofthosemanagingthesupplychain.TheSOPseekstobuildindividualandorganizationalcapacityandcapabilityofallinvolvedinsupplychainsystemmanagementacrossthecountry.

ThestepsoutlinedinStandardOperatingProceduresrepresentthecompletecommoditysupplychaincycle—fromindenttoissue.Totrackthemovementofcommoditiesandinformstandardinventorycontrol and levelmanagement, logisticsmanagement information system (LMIS) formsareutilized.These forms capture essential data for decision-making which is used to not only guide standardindenting, but also strategic forecasting and procurement. Further, each step builds on the bestpracticesforstoragetopreventdamage,wastage,ortheft.Finally,atthecoreofthisStandardOperatingProceduresistheobjectivetobuildingthecapacityofthoseinvolvedinsupplychainmanagement.ByprovidingSACSpersonnelwiththeknowledgeandskillsneededtounderstandwhyandcompetentlyapplythisSOP,wewillbeabletoensureaconstantandsufficientflowoflife-savingcommoditiestoour client.

NationalAIDSControlOrganization(NACO),MinistryofHealthFamilyWelfare(MoHFW),Govt.ofIndiahasfullycommitteditselftoprovideallsupporttoSACS instrengtheningtheHIV/AIDSsupplychainsystemacrossthecountry.TheinitiativeofthiseffortistoimprovetheavailabilityofcommoditiesateachlevelwithintheARTCandICTCssystemandmakesurethatthesupplyofcommoditiescontinuesuninterrupted.

IamsurethattheseSOPswillgoalongwayinimprovingSupplyChainManagementofcommunitiesintheCountry.

Message


Foreword

NationalAIDSControlOrganizationenvisionstopreventandcontrolHIVinfectionsinordertoeliminateAIDSby2030andalsowhereeverypersonlivingwithHIVhasaccesstoqualitycareandthesupportthroughcenterssetupinthecountrytodeliverservicesforthepurpose.

Toachieveuninterrupted supplies, servicesand commoditiesdeliveryat righttimeat rightplace isofutmost importance.TheStandardOperatingProcedures (SOPs) forSupplyChainManagementofHIV/AIDScommoditieshavebeendesignedconsideringthechangesinapproachandstrategyadoptedforsupplychainmanagementofARVdrugsoverlastfewyears.Thedevelopmentoftheoperationalprocedureshasbeendoneafterawideconsultativeprocessinvolvingexpertsandstakeholdersfrompartnerorganizations.

TheseSOPswillserveasaguidingtooltoallthefieldstaffandserviceproviderstomanagethesupplychainofHIV/AIDSdrugs/kitsandotherlogisticsinaneffectiveandefficientmanner.UsersoftheSOPsare encouraged to share the lessons learned during the application of the procedures for possibleincorporation into future revisions of the document. Finally, while the SOPs reflect usual practice,therewillbecircumstances fromtimetotimethatmayrequireanadaptiveresponsebasedontheprofessionaljudgementofthefieldstaffanddecisionmakers.

NACOwouldliketoacknowledgethetechnicalsupportprovidedbythePlanSCMProjectteamalongwithSub-RecipientpartnersandofficialsofCSTandotherDivisionsofNACOandI/cofARTCentresandSACSofficerswhoenrichedthecontentsoftheSOPsatthedesignworkshopwiththeirfield-basedinputs.

IhopethattheStandardOperatingProceduresfor‘SupplyChainManagementofARVsandHIVTestingKits’willprovetobeavaluabletoolinfacilitatingworkofallconcerned.


Foreword

IndiaisasignatorywithfullcommitmenttowardstheglobalvisiontoendAIDSasapublichealththreatby2030.ScalinguptoHIVcounsellingandtestingservices,whileensuringprivacyandconfidentiality,hasbeenasintegralcomponentofNACPandremainsthegatewaytoHIVprevention,treatment,careandothersupportservices.

AssessingthesupplychainofARVmedicinesandHIVtestkitsisindispensabletoimproveaccessandthus provide quality services. The Standard Operating Procedures to ensure effective supply chainmanagementofHIV/AIDScommoditiesprovidingspecificrecommendationandguidancewillensurequalityservicesbeingdeliveredtopublicandprivatesector,andtomovetheseservicestobeclosertothecommunitylivingwithHIV/AIDS.

Incomplete and erroneous data records, stock-outs, interrupted reports, inaccurate inventory andwastage ratesare indicators fordefective supply chainmanagementofHIV/AIDS commodities. It isimperative to improve thestorageanddistributioncapabilitiesofStates/UTs.ThenewSOPsaim toensureuniformstandardizedprocessimplementationinthecounsellingandtestingcentersacrossthecountry.

ItisnoteworthythatcomprehensiveSOPsforsupplychainmanagementofHIVtestingcommoditieshascomethroughwiththecoordinatedandconcertedeffortsofvariousindividuals,teams,organizationsand professional bodies to ensure last mile delivery of HIV testing kits under optimal cold chainconditions.

ItakethisopportunitytoacknowledgethecontributionmadebythetechnicalwritinggroupofPlanSCMProjectteam,BSDNACOteamandtheJointDirectors/DeputyDirectors/inchargeofICTCinSACSforprovidingtheirinvaluablesupportandinputsindevelopingtheseStandardOperatingProcedures(SOPs)envisionedtofurtherenhanceandimprovetheHIVCounselingandtestingservices.

SOP for Supply Chain Management under NACP8


Foreword

TheHIV/AIDSepidemicpreventionandcontrolhasbeenapriorityinIndiaandacrosstheworldoverthepastdecade.InIndia,especiallywehavesystematicallyimplementedprogressivestrategiestomeetvariouschallengesincontrollingtheepidemic.AsIndiamovestowardstheachievementofultimategoalof“EndingtheAIDS”,uninterruptedsupplyofall theNACPcommoditiesrelatedtoprevention,testingandtreatmenttotheenduserbecomesacommonobjectiveforallthedivisionsofNationalAIDSControlOrganization.

NACO,inafirstofitskindinitiativeinIndia’spublichealth,decidedtostreamlineNACPSupplyChainthrough GFATM Supply Chain Management Project. Under the SCM Project, Standard OperatingProcedure (SOPs) for Supply Chain Management of National AIDS Control Programme have beendeveloped.IampleasedtoconveythatthedevelopedSOPsareeasytoimplementatSACSandfacilitieslevelforallcommoditiesunderNACP.TheseSOPshaveoutlinedthedetailedinstructionsonhowtoperformtaskssothatSACSstaffcompletesthemcorrectlyandconsistently.IthasquickreferencestotheroleandresponsibilitiesofeachpersoninvolvedinSCMoperationsatSACSandfacilitylevelandwouldassisttheminmanagingtheirsuppliesandavoidstock-outsandoverstock.TheseSOPswillalsohelp tocustomizestrengtheningthee-LogisticsManagement InformationSystemcurrentlyused forNACPprogrammestostandardizetherecordingandreportingforinformeddecision.

TheimplementationoftheseSOPsatgroundlevelwouldchangethelandscapeofHIV/AIDSpreventionandcontrol in India. Itwouldensure that theprogrammeofficialsareable toconcentratemoreonprogramimplementationandutilizetheirexpertiseinprovidingoptimalmanagementforgreatimpactofindividualprogramsunderNACP.

I take this opportunity to congratulate Plan International (India Chapter) SCM project team fordevelopingauser friendly andhandymanualwhichwill behelpful tooneandall inmanaging thesupply chain ofNACP commodities and recommend careful reading and frequent reference to thismanualforoneandall.


ThisSOP,developedfortheHIV/AIDSSupplyChainManagement,isdedicatedtothepeopleofthecountrylivingwithHIV/AIDSandtothemanyindividualsfromcommunities,non-governmentalorganizations(NGOs),NationalAIDSControlOrganisation(NACO),andStateAIDSControlSocieties(SACS)andotherorganizationswho have consistently worked hard for access to antiretroviral drugs (ARV), HIV Testing Kits and othercommoditiesrequiredtoprovideHIV/AIDSservices.

SincerethanksgotoDr.NareshGoel-DDG(CST),Dr.A.K.Puri-DDG(BSD),Dr.ShobiniRajan-ADG(SIM),Ms.AlkaAhuja -DS (Procurement),Dr.ChinmoyeeDas -DeputyDirector (CST),Dr.S.P.Bhavsar - DeputyDirector,(BSD),Dr.BhawaniSingh-DeputyDirector(TI),Dr.ManinderKaur-NationalConsultant(CST),Dr.SudhaGoel-NationalConsultant(BSD),Mr.BijoAbraham-AssociateConsultant(CST),formerconsultantsDr.ManishBamrotiya-NationalConsultant(CST),Dr.SumanSingh-Consultant(CST),Dr.NehaGarg-AssociateConsultant(CST),Dr.VishalYadav-AssociateConsultant(BSD)andSACSofficialfromvariousstatesfortheirthoroughtechnicalsupport,reviewsandhelpfulsuggestions.Additionally,effortsofallRegionalSupplyChainManagersofSCMprojectandMr.VivekKumar,ProjectCoordinator(SCM)arewellappreciated.

SpecialthankstoMr.TauqueerAhmad,DeputyProjectDirector(SCM)forhisextensivetimetodeveloptheStandardOperatingProcedures(SOPs)ontheProject.WewouldalsoliketothankMs.TeenaKunwar,ProgramManager(SCM)andMs.RadhikaSingh,ProjectManager(SCM)fortheirinputsandreviewofSOP.

The development of these SOPs would not have been possible without the lessons drawn from variousresourceslikeWHOandUSAID|DELIVERPROJECT’sexperienceinmanagingHIV/AIDSsupplychains.

Acknowledgement


3PL 3rdPartyLogistics

AD AssistantDirector

AIDS AcquiredImmuneDeficiencySyndrome

AMC AverageMonthlyConsumption

APD AdditionalProjectDirector

ART AntiretroviralTherapy

ARTC AntiretroviralTherapyCentre

ARV Antiretroviral

BC BinCard

BSD BasicServicesDivision

CAC ConsigneeAcceptanceCertificate

CMSS CentralMedicalServicesSociety

CoA CertificateofAnalysis

CRC ConsigneeReceiptCertificate

CST Care,Support&Treatment

DD DeputyDirector

DDR DailyDispensingRegister

DAPCU DistrictAIDSPreventionandControlUnit

DDG DeputyDirectorGeneral

DPM DistrictProgramManager

DPO DistrictProgramOfficer

FEFO FirstExpiryFirstOut

FICTC FacilityIntegratedCounsellingandTestingCentre

eLMIS electronicsLogisticsManagementInformationSystem

EOP EmergencyOrderPoint

GFATM GlobalFundtoFightAIDS,TuberculosisandMalaria

GoI GovernmentofIndia

HMIS HealthManagementInformationSystem

HIV HumanImmunodeficiencyVirus

ICTC IntegratedCounsellingandTestingCentre

IEC InformationEducation&Communication

IMS InventoryManagementSystem

Abbreviations


IR IssuesandReceive

IT InformationTechnology

JD JointDirector

LAC LinkARTCenter

LMIS LogisticsManagementInformationSystem

LoA LetterofAcceptance

M&E Monitoring&Evaluation

MIS ManagementInformationSystem

MO MedicalOfficer

MoS MonthsofStock

MoHFW MinistryofHealthandFamilyWelfare

NACO NationalAIDSControlOrganisation

NACP NationalAIDSControlProgramme

NSP NationalStrategicPlan

OST OpioidSubstitutionTherapy

PD ProjectDirector

PDCA PlanDoCheckAct

PLHIV PeopleLivingwithHIV/AIDS

PM ProgramManager

PO PurchaseOrder

PR PrincipalRecipient

PQS Performance,QualityandSafety

QA QualityAssurance

RACI Responsible,Accountable,Consulted,Informed

RITES RailIndiaTechnicalandEconomicServices

RPR RapidPlasmaReagin

RTD Return,TransferandDiscard

RTI ReproductiveTractInfection

SACS StateAIDSControlSociety

SCM SupplyChainManagement

SCMP SupplyChainManagementProject

SDP ServiceDeliveryPoint

SoH StockOnHand

SOP StandardOperatingProcedure

SR SubRecipient

STI SexuallyTransmittedInfection

STN StockTransferNote

TRG TechnicalResourceGroup

WIC Walk-in-Cooler


• Average Monthly Consumption:Theaverageofthequantitiesdispensedtousersorpatientsinthemostrecentthreemonthsorsixmonths

• Clients, Patients and Beneficiaries:Thepeoplewhoreceiveorusesupplies.

• Commodity / Product / Supplies / Goods:Allitemsthatflowthroughthelogisticssystem.

• Continuous review system:Aninventorycontrolsystemwherestocklevelsarereviewedeachtimestockisissued.Ifthestocklevelisat,orhasfallenbelow,theminimumstocklevel,enoughstockisorderedtobringthelevelsuptothemaximumstocklevel.

• Consumption, Dispensed, Dispensed-To-User, Usage Data:Dataonthequantityofgoodsactuallygiventoorusedbyclients.

• Emergency Order Point:Thelevelofstockthattriggersanemergencyindent; itcanbereachedatanypoint.TheEOPmustbelowerthantheminimumlevel.

• Forced-Indenting System:Aninventorycontrolsystemwherefacilitiesalwaysrestockallcommoditiestothepre-setmaximumlevelattheendofeveryreviewperiodnomatterhowmuchorlittleisinstock.

• Inventory Control System:Astockcontrolsystemthatinformsthestorekeeperwhentoindentorissue;howmuch to indentor issue;andhowtomaintainanappropriate stock levelofallproducts toavoidshortagesandoversupply.

• Issues Data:Informationaboutthequantityofgoodsmovedfromonestoragefacilitytoanother(eitherbetweenlevelsorwithinafacility).

• Lead Time:Timebetweenwhenproductsareorderedandwhentheyarereceivedandavailableforuse.

• Max Level of Stock: The level of stock above which inventory levels should not rise, under normalconditions.Themaxstocklevelissetasanumberofmonthsofstock(forexample,themaxlevelmaybesetatfourmonthsofstock).

• Min Level of Stock:Thelowestlevelofstockthatafacilityshouldhaveinthestoreorwarehouse.Theminstocklevelissetasanumberofmonthsofstock(forexample,theminlevelmaybesetattwomonthsofstock).Ifstockreachestheminlevel,anindentshouldbeplacedtoreplenishinventory.

• Safety Stock/ Buffer Stock / Cushion Stock:Quantitiesheldtocoveruncertaintiesindemandandsupply.Clients demand has inherent variability and may be compounded by unanticipated demand. Supplyuncertaintymay include constraints or delays stemming from the supplier,manufacturer or source ofsupply,aswellastransportationleadtimevariability.

• Months of Stock:Thenumberofmonthsofstockindicateshowlongsupplieswilllast.

• Pipeline: Theentirechainofphysical storage facilitiesand transportation links throughwhich suppliesmovefromthemanufacturertotheuser,includingportfacilities,centralwarehouse,regionalwarehouses,districtwarehouses,allSDPs,andtransportvehicles.

• Pull System:Anindentingsystemwherethesupplychainworkerswhoreceivethesuppliescalculatethequantitiesofsuppliesrequired.

• Push System:Anindentingsystemwherethesupplychainworkerswhoissuethesuppliescalculatethequantitiesofsuppliesrequired.

• Informed Push System:Asystemwherethesupplychainworkerswhoissuethesuppliesbasedonrealtime information through eLMIS system calculating the quantities based on consumption and currentstockonhand.

Glossary


• Physical Inventory Count:Aprocesswhereactualstockonhandforeachcommodityiscomparedwiththeamountrecordedonthestockcard.

• Review Period:Timebetweenroutineassessmentswheresomeoneexaminesstocklevelstodetermineifanindentshouldbeplacedoranissueofresupplymade.

• Service Delivery Point:Anyfacilitywhereclientsreceivesupplies.

• Shelf Life:Lengthoftimeaproductmaybestoredwithoutaffectingtheusabilityandsafetyoftheitem.

• Stock on Hand:Quantitiesofusablestock.(Itemsthatareunusablearenotconsideredpartofstockonhand.Theyareconsideredlossestothesystem.)

• Supplies, Commodities, Goods, Products, and Stock:Allitemsthatflowthroughthesupplychain.

• Visual Inspection: Process of examining products and their packaging by eye to look for problems inproductquality.

• Cold chain: The system consisting of peoplemanaging a series of storage and transport steps,whichall require specialized equipment, procedures, and information, intended to keep products within anacceptablepredefinedtemperaturerangeuntiltheyareused,typically+2°Cto+8°C

• Cold chain capacity requirements:Thetemperature-controlledspaceneededatastoreorservice-deliverypointtostoreortransportproducts.

• Cold chain equipment: Equipment used to store and transport temperature-sensitive products at thepropertemperatureduringeachstageofthesupplychain.

• Coolant-pack:Apurposelydesignedleak-proofcontainer,typicallycomplyingwithperformance,qualityandsafety(PQS)specificationfilledwithtapwaterorwithanotherphase-changematerial.

• Domestic refrigerator or freezer: A refrigerator or freezer that is not WHO PQS-prequalified forpharmaceuticalstorage.

• Passive container:Acontainerthatmaintainsatemperature-controlledenvironmentinsideaninsulatedenclosure,generallywithoutthermostaticregulation,usingfrozen,conditioned,cool,orwarmcoolant-packs.

• Primary container:Vial,ampoule,prefilleddevice,plasticdispenser,ortubecontainingvaccineordiluent.

• Refrigerated vehicle: A road transport vehicle such as a van, truck or semi-trailer whose isolated,thermostaticallycontrolledcargocompartmentismaintainedatatemperaturedifferent

• Secondary packaging:Packagingthatholdstheprimarycontainer(s)(e.g.cartonscontainingoneormorevialsorprefilledsyringes).

• Shelf volume:Theaggregatedvolumeofalldesignatedequipmentbaskets, shelvesorpalletbays inamodelofcoldchainequipment.Thisvolumeincludesonlyareaswhereproductscanbestoredsafely.

• Storage temperature:Thetemperaturerangeforproductstorageasstatedbythemanufacturerontheprimarycontainerlabelandthepackageinsertandwithintheregulatoryfilingsfortheproduct.

• Temperature-controlled:Maintainedatatemperaturedifferentfromthatofthesurroundingenvironmentandwithinprecisepredefinedlimitsthrougheitheractiveorpassivemeans.

• Tertiary packaging:Thepackorcartonthatcontainsanumberofsecondarycartons;usuallyconstructedofcorrugatedfiberboard.

• Product storage volume:Themaximumvolumeofproductthatwillbestoredatastoreorservice-deliverypoint;includesthevolumepersupplyintervalaswellasthevolumeofthesafetystock.

• Product volume per supply interval:Thevolumeofproduct that isdeliveredat thebeginningofeachsupplyinterval,whichisbasedontheannualneedandthenumberofsupplyintervalsperyear.

• Walk-in cold room:Arefrigeratedenclosureaccessibleviaatleastonedoorandlargeenoughforapersontoenter.Itisdesignedtomaintainthepartsoftheroomdesignatedforstorageatatemperaturebetween+2°Cand+8°C.Usedforbulkstorageoflargevolumesusuallyatnationalandsubnationallevels.

• Water-pack: A coolant-pack, typically complyingwith PQS specificationPQS/E005/IP01, filledwith tapwater.


Allsupplychainsystemsshouldbemanagedthroughthelensofcontinuousimprovement.Theenvironmentinwhichsupplychainsystemsoperateisdynamic,asnewproductsareadded,healthpoliciesareamended,andthesystemsthemselvesmatureandevolve.Becauseofthischanginglandscape,itisimportantthatpharmacists,logisticiansandsupplychainmanagersrecognizethatsystemswillneedtoadapttonewenvironmentsandcircumstances.

After designing and implementation of a supply chain system for ARV drugs, HIV Testing Kits and othercommodities under NACP, supply chain managers will need to monitor lead times, stockout frequency,reporting levels, supervision,andother factors tounderstandhowwell thesystem is functioning. In somecases,improvementscanbemadeimmediately,suchasaddingtransportresources,providingadditionalon-the-jobtraining,orincreasingsupervision.Systemdesignerswillalwaysfindwaystoimprovethesystem.Somesolutionswillbeeasy,whilesomewillbemoreextensive,butthegoalistodiscoverwaystoultimatelyservetheclientbettertoensureproductavailabilitywheneverandwhereverclientsneedthem.Managersshoulduseallsourcesof information(reports,wordofmouth,andothers)tocontinually improvethesystemandintegratethechangesinthenextversionofthisSOP.

Securingadependable,regularsupplyofARVdrugsorHIVtestskitsoranyothercommoditiesunderNACPat service delivery points (facilities) are critical to the success of ART programmes and HIV Testing. AnyinterruptioninthesupplychainwillpreventdiagnosisofnewclientsorendangerthelivesofclientsalreadyonARV treatmentbecauseof the riskofdiscontinuationof treatmentordevelopmentofdrug resistance.Frequentinterruptionswillcompromisethesuccessoftheprogramme.

DOCHECKACT

PLAN

PlanyourSCM activitieslikedistributionofARVDrugsasper inventorylevel Example:DistributionPlanbasedonconsumptionandinventorylevel

Executionofdistributionplanincludingrouting

Example:PreparationofSTN/Issue

Vouchers,Picking,Packingandmodeof

transport

Adjustthedistribution,planconsideringtheleadtime,stockout,overstockingandserviceleveloftransportation Example:Optimizeroutingtominimizeleadtimeandconsideringthestockoutandoverstock

Checkthedistribution,completionwithfacilities

and according to estimateddeliverytime

Example:Confirmationofreceivingfromfacilities

andcheckingtheserviceleveloftransporter.

1 Introduction of “Plan, Do, Check and Act”


TheseStandard Operating Procedures (SOPs)areintendedtosimplifyandstandardizetheworkrequiredforthesupplychainmanagementofHIV/AIDSessentialmedicinesandcommoditiesincludingcoldchainitems.

TheseSOPsfocusonARVDrugs,HIVTestingKitsandothercommoditiesunderNACPbutarenotlimitedtothesecommodities.Thestepbystepprocesscapturedforcoldchain(HIVKits)andnon-coldchain(ARVDrugs)isapplicabletoallactivitiesinsupplychainforallcentrallyprocureditemsofNACO.Dependingonthetypeofcommodityi.e.coldchainornon-coldchaintheSCMpersonnelmayrefertorespectivesectionsforSCMoperationsofcommoditiesotherthanARVdrugsandHIVKits.

Purpose of Standard Operating Procedures2


ThisSOPforHIV/AIDSessentialmedicinesandcommoditieswillbeexpectedto:

• Enhancethequalityoftheservicesprovidedbythehealthfacilitiesetc.;

• Promoteuniformityintheservicesprovidedacrossthecountry;

• EliminateoperationalerrorsinHIV/AIDScaredeliveryservices;

• DeveloptheSCMstaffcapacityandenhancetheirskillsforbetterperformance.

ThedocumentservesasareferenceforhealthprovidersandmanagersdispensingandmanagingHIV/AIDScommoditiesatalllevelswithinthepublichealthcaresystem,guidingthecompletionofthefollowingtasks:

ThisSOPdocumentprovidesstep-by-stepinstructionsonhowtocarryouteachoftheseprocesses.Consistentresultswilloccuraslongaseveryonefollowsthesteps.Inthisway,theSACScanmaintainsufficientcommoditysupplybymanagingcommoditieseffectivelyandpreventingoverstockandstock-outs.

ForecastandProcureCommodities

MonitorCommodityConditionsandLevels

IndentCommodities

ReceiveandStoreCommodities

IssueCommodities

DistributeCommodities

1

2

3

4

5

6

Overview ofSupply Chain Management


Improvinghealthstatusrequirestheimplementationofcoordinatedandevidence-basedhealthcarepractices.Awell-functioningsupplychainisoneoftheseessentialpractices.Thegoalofrobustsupplychainsystemistoensurethateveryclienthascommoditysecuritywhichincreasethetrustinthesystem.Commoditysecurityexistswheneveryclientisabletoobtainandusequalityessentialhealthsupplieswheneverheorsheneedsthem.Arobustandefficientsupplychainiscriticaltoensuringcommoditysecurity.Supplychainsensurethatthe right commoditiesare selectedbasedonclientneeds; thatappropriatequantitiesof commoditiesareforecastedandprocured;andthattheseproducts,onceprocured,aredistributedtoservicedeliverypointsacrossthecountry.Theseactionsaresupportedthroughfinancing,policiesandcommitment.

Effective supply chainsnotonlyhelp ensure commodity security, they alsohelpdetermine the successorfailureofanypublichealthprogramme.Bothinbusinessandinthepublicsector,decision-makersincreasinglydirecttheirattentionto improvingsupplychains,becausesupplychain improvementsbring importantandquantifiablebenefits.Well-functioningsupplychainsbenefitpublichealthprogrammesby…

Ifaclientarrivesatafacilitytofindthattheneededcommoditiesare“stockedout”,sheorheislesslikelytomakeareturntripforthecommodity,whichmayresultinillnessorevendeath.Clientsalsobegintolosetrustinthehealthsystemwhenproductsareconsistentlystockedout;thisoftenresultsinthemgivinguptheuseofcommoditiesaltogether.Whenhealthfacilitieshaveareliablesupplyofcommodities,clientsaremorelikelytousethemasprescribed.Thus,supplychainactivitiesfacilitatecontinuousavailabilityofARVDrugs,HIVTestingKitsandothercommoditiesunderNACPsoeachclientcanaccessneededhealthcommodities.

Increasingprogramimpact

Enhancingqualityofcare

Improvingcosteffectivenessandefficiency

Objective of Supply Chain Management3


Definition of Supply Chain: A supply chain is the process ofmoving goods from the point of origin, ormanufacturer, to the point ofconsumption,oraservicedeliverypoint.Asmentioned,aproperlyfunctioningsupplychainisacriticalpartofensuringaccesstoARVDrugs,HIVTestingKitsandothercommoditiesunderNACP.ThegoalofHIV/AIDSsupplychainisnotlimitedtothe“deliveryrole”;supplychainensuresanenvironmentwherequalitycommodities,ARVDrugs,HIVTestingKitsandothercommoditiesunderNACPareeasilyaccessibletoeveryclientwhoneedsthem.

The Seven Rights of SCM:Foranysupplychaintoensurecommoditysecurityandserveclients,itmustachievetheSevenRights.Thismeansthatinahealthcommoditysupplychain...

• The right goods are the health commodities that are needed to serve the clients, in the appropriatepreparation,dosage,andpackaging.

Thesegoodsareavailable...

• Intherightquantitiestomeetthedemandwithoutoverstockingbutavoidingstockouts.

• Intherightconditionwherecommoditiesandtheirpackagingarenotdamaged,thereissufficientshelflifetoensuretheywillbeusedbeforeexpiryandmaintaining2-8oCtemperatureforstorageofHIVtestingkits.

Andthesegoodsaredelivered...

• Totherightplace–commoditiesaredeliveredtotheirintendeddestination.

• Attherighttime–commoditiesaredeliveredwhentheyareneededtomaintainappropriatestocklevels.

• Fortherightcost–notonlyarethemostcost-effectivecommoditiesdelivered,butalsothecostsassociatedwiththeirdeliveryarereasonableandcost-effective.

• Totherightclient

IfSACSsupplychainsprovidereliablesupplyofcommodities,morepeopleare likelytousetheseservices.Clientswillfeelmoreconfidentabouthealthserviceswhentheyhaveaconstantsupplyofcommodities—itmotivatesthemtoseekandusetheseservices.Finally,effectivesupplychainscontributeto improvedcosteffectivenessandcanstretchlimitedresources.Strengtheningandmaintainingasupplychainisaninvestmentthatpaysoffinthreewaysasit:

• Reduceslossofcommoditiesduetooverstock,waste,expiry,damage,pilferage,andinefficiency;

• Protectsothermajorhealthprogrammeinvestments;

• Maximizesthepotentialforprogrammeresourcerecovery.

Introduction to Supply Chain Management 4


The Supply Chain Cycle:Supplychainmanagement includesanumberofactivitiesthatsupporttheSevenRights.TheSupplyChainCycleillustratestheseactivitiesandtheirrelationship.

TheSupplyChainCycle is circularaseachactivity i.e. servingclients,product selection,quantificationandprocurement,andinventorymanagement,dependsonandisaffectedbytheotheractivities

EachcomponentoftheSupplyChainCycleisdefinedasfollows:

• Serving Customers/clients:whethertheyarecouples,motherorchildrenprescribed/dispenseARVDrugsoranyothercommoditiesunderNACP,understandingclientdemandsorneedsisessential.

• Product selection:commoditiesandotherhealthproducts(includingARVDrugs,HIVTestingKitsandothercommoditiesunderNACP)neededtoaddresshealthissuesmustbeselected.Theyareselectedbasedonstandardtreatmentguidelinesdeveloped by national formulary and therapeutics committees, pharmaceuticalboards,andothergovernment-appointedTechnicalResourceGroups(TRG).

• Quantification: once commodities are selected, the quantities needed in the short and long-termaredeterminedthroughquantification.Quantificationistheprocessofestimatingthequantityandcostoftheproductsrequiredtoensureanuninterruptedsupply,determiningwhentheproductsshouldbeprocuredanddistributedusingasupplyplan.

• Procurement: After a supply plan has been developed as part of the quantification process, productsmustbeprocured.Healthsystemsandprogrammesshouldbestrategicabouttheirprocurementactivities,whichshouldbecarefullyresearched,planned,andmonitored,allthewhileabidingbytheapplicablerulesandregulations.Thiswillenabletheprocurementtobecarriedoutinatimelymanner,accordingtoanopen,fair,andcompetitiveprocessandtoultimatelysupplyquality-assuredproductsforthebestvalue.

Figure 1:SupplyChainCycle(AdaptedfromUSAIDDELIVER2011)

If there are No commodities,

then there is No service!


• Inventory management:Inventoryplaysakeyroleinmeetingtheobjectivesofthesupplychain,anditistheresponsibilityofthesupplychainmanagertoensurethatinventorypoliciesareinplacetosupporttheorganization’smission,goals,andobjectivesrelatedtohealth.Thedecisiontoholdinventoryprovidesorganizationswith ameans to balance supply and demand. A cohesive inventory strategywill definepoliciesthatdeterminewhichproductstoholdininventory,howmuchinventorytohold,andwheretoholdthem,andensuresthatinventorymanagementdecisionsaredocumentedandappliedconsistentlyacrossthesystemorprogrammeorfacility.

• Warehousing, Storage and Distribution: After an item has been procured, its physical management,throughvariouslevelsofanin-countrysupplychain,mustbecarriedoutinastructuredwaytoensurethatitwillbeprotectedfromharmfulenvironmentalconditionsorhandlingandisavailable,accessible,andingoodconditionwhileposingnoriskofinjurytoworkers.Tomeettheserequirementsacombinationof interventions requiringbothphysical infrastructureand structuredproceduresmustbemaintained.Warehousingalsoensuresthatthestocksareproperlyreceived,put-away,andstockmaintainedandtheproductsarepickedanddispatchedtoservicedeliverypoints/facilities

• Quality monitoring: This function is applied throughout the entire supply chain cycle across variouscomponents.Thequalityof thecommodities themselvesand thequalityofeachsupplychainprocessmustbemonitoredforsuitability,effectiveness,andefficiency.

TheactivitiesinthecenterofthesupplychaincyclerepresentthemanagementsupportfunctionsthatinformandimpacttheotherelementsaroundtheSupplyChainCycle.

A Logistics Management Information System (LMIS) is shownat thecenterof thecycle,andweconsiderittobetheenginewhichdrivesthelogisticssystem.TheLMISisatoolforinformationandcommunicationnecessaryfordecisionswhichensureproductavailabilityandclientservice.

Finally,policyandadaptabilityarekeycomponentsofthesupplychaincycle.

• Policy: a supply chain operates within a policy environment. Different policies may affect the wholefunctioningofthelogisticssystem,orapartofthesystem.

• Adaptability:asupplychainmustbedesignedtobeflexibleandadapttoconstantlychangingcircumstancesandneeds,suchaschangesindemandforaproduct,orchangesinfundingpoliciesforlogisticsactivities.

Ultimately,theHIV/AIDSprogrammescannotfunctionwithoutacontinuousflowofARVDrugs,HIVTestingKitsandothercommoditiesunderNACP.Effectiveandefficientsupplychainmanagementcanhelptoincreasetheavailabilityofpriorityhealthcommoditiessothatpeoplehavereliableaccesstoqualityhealthcommoditieswhenevertheyneedthem,ensuringthatnoclient is turnedawaywithoutprovidingneededcommodities.TheSupplyChainCycleencompassesall theoperationalactionsnecessarytoensureuninterruptedflowofsupplies.


Commodities Operating StructureHIV/AIDS essential medicines and commodities supply chain comprises four/five levels. At National Levelthecommoditiesareprocuredthroughprocurementagents i.e.CMSS/RITESreceivingfundthroughannualbudgetandsupportedbyGFATM.Thedivisionsplace indentswiththeprocurementagentsCMSS/RITESasperforecastingestimationonestablishedschedulethroughvariouslotsasnotedinthediagrambelow.OncedeliveredtoCMSS/SACS,commoditiesflowdownfromthestatetoservicedeliverypoints,passingthroughtheStateStoreafterdeliveryfromsuppliers.ARTcenters,LACs,ICTCs,FICTCsserveasservicedeliverypoints.

Informationoncommodityissuesflowupfromeachleveltothelevelabove,asnotedinthediagrambelow.Ateachleveldataisaggregatedbeforemovingtotheabovelevel.Thisinformationisusedtodeterminethequantityofcommoditiestobeissued.Whencommoditiesaredelivered,thedeliveryreceiptisacknowledgedwithformalsignature.

Feedbackreportsaregeneratedcentrallyanddistributedtolowerlevelsforsupervisionandfeedbackaction.TheflowprocessforARVdrugsandHIVTestingKitsisasfollows:

HIV/AIDS Commodities Supply Chain

Figure 2:ARVDrugsandHIVTestingKits:

5


Roles and Responsibilities: “Responsible, Accountable, Consulted and Informed” (RACI) Ateach level in thesupply chain, keypersonnelensures theeffectivemanagementof commodities.Everypersoninanorganizationmustunderstandtheirroleandtowhomtheyreportto.Specifically,theyneedtoknow:

• Towhomtheyreport

• Theirresponsibilitiesandexpectations,and

• Thelevelofauthorityrequiredtomakedecisions.

RACIhasbeenintroducedinthisdocumenttoclarifyrolesandresponsibilitiesincrossfunctionalprocesses.ThestructureofRACI clearly identifies the individualsor functions thatparticipate in theprocess, thekeyactivities takingplace andprimaryoutcomes. RACI acronymderived from the four potential roles that anindividualorfunctionwillplayrelativetoaspecificactivity:

R= Responsible: An ‘R’designatestheperson(s)forfunction(s)responsibleforcompletingaparticularactivityorstepintheprocess.Forexample:StoreinchargeisresponsibleforreceivingandissuingARVdrugsinSACSstore.

A= Accountable: An ‘A’designatestheperson(s)andfunction(s)ultimatelyaccountableforensuringthattheactivityiscompleted.Forexample:JDCSTisaccountableforreceivingandissuingofARVdrugsinSACSstorebystoreincharge;

C= Consulted: A ‘C’ designates the person(s) and function(s) thatmust be consulted before a decision oractivityisfinalized.Forexample:Transporterisconsultedfortype,modeandcapacityofvehicleandroutings;

I= Informed: An ‘I’designatestheperson(s)andfunction(s)thatmustbeinformedoftheresultsonceastepiscompleted.Forexample:AllARTcentersareinformedregardingthedispatchofARVdrugs.

ThefollowingRACIhasbeendevelopedtounderstandtherolesandresponsibilitiesofpersonnelateachtier(figure 2)andfunctiontoensurethatthetasksareperformedstepbystep.ARACIcharthasbeendevelopedwithclearlyarticulatedrolesandresponsibilitiesofalltiersofHIV/AIDSsupplychain.Thecharthelpstoensurethatnopartoftheworkloadisoverlooked.

Activities/Responsibilities

Responsibillity Matrix for ARV Drugs

NACO Level SACS Level ART/LAC

DDG-NACO DD-NACODS, US

ProcurementUS-Procurement

PD/APD SACS

JD CST/DD/AD

Store In charge

Nodal Officer/Medical Officer

phamacist

Forecasting A R C C C C C C C

Procurement C C A R I I I I I

Indenting A R C C A A R A R

Receiving I I I I A A R A R

Inventory Management I I I I A A R A R

Issue I I I I A A R A R

Legend Responsible Accountable Consulted InformedR A C I


Figure 3:RACIMatrix

When team members understand and accept the roles, responsibilities and accountabilities that havebeendesignatedwithintheteam,communicationisclearandeffective.Teammemberscansharetherightinformationwith the right people in a timelymanner. It alsomeans that teammembers can rely on oneanothertogetandgivesupport.

Activities/Responsibilities

Responsibillity Matrix for HIV Testing Kits

NACO Level SACS Level ICTC/FICTC

DDG-NACO DD NACODS, US

ProcurementUS-Procurement

PD/APD SACS

JD BS/DD/AD

Store In charge

Lab Technician Counsellor

Forecasting A R C C C C C C C

Procurement C C A R I I I I I

Indenting A R C C A A R A R

Receiving I I I I A A R A R

Inventory Management I I I I A A R A R

Issue I I I I A A R A R

Legend Responsible Accountable Consulted InformedR A C I


OverviewInformationistheenginethatdrivesthesupplychainofNACOandSACS.Supplychainmanagers-DDG,PD,APD,JD,DD,store inchargeandpharmacists,collect informationtomakedecisions;betterthe informationavailable, better the decisions taken. A logisticsmanagement information system (LMIS) is the system ofrecords and reports that the supply chainworkersuse to collect, organize, andpresent supply chaindatagathered fromall levels of the system.Managers analyse gathered LMIS data tomakedecisions, improvefunctions,andcoordinatefuturesupplychainactionsinwaysthatwillultimatelyimproveclientservice.

Maintaining accurate data and records is crucial togood supply chainmanagement. At any level of thesystem,managersshouldbeabletoquicklyandeasilyreport the stock on hand for any item. In a smallwarehouse,thismaymeanwalkingtothestorageareaandreadingthenumbersfromaconvenientlylocatedstockcard.Inalargewarehouse,thismaymeanbeingabletofindthebincardquickly,ortolookupdatainrecords.Theentiretransactionshouldbeclear—whoplaced the indent and when, when the indent wasfilledandshipped,andwhentheindentwasreceived.

Logistics Management Information in NACO/SACSNACO/SACSLMISandeLMIScollectsthreeessentialdataitems.Thesedataitemsformthebasisofalldecisions.Theyare:

Data Type Definition Example

Consumption Datathatdescribesthequantitiesofproductsgiventoclients/patientfortheiruse.Consumption data can be collected from 2 sources:

1. Dispensed-to-userdatawhichisthequantityofcommoditiesadministeredtoaclient.

2. Whendispensed-to-userdataisnotavailable,issuesdatacanbeusedtodetermineconsumption.Issuesdatareferstoquantitiesofproductsthataresentfromupperlevelfacilitiestolowerlevelfacilities.

Note: “Dispensed-to-user” data is preferred over “issues” data. Dispense to user data represents actual commodities given to clients and represents real demand. Issues data is a proxy for “dispensed to user” data. However it does NOT represent actual client consumption, therefore it should be carefully labeled “issues” data if it is used as a proxy for “dispensed to user” data.

� Ifafacility“dispensestoclients”100 TLEthenthe“consumption”datais100.

� Ifafacility“issue”100 TLEtoanotherfacilitylikeARTCentersthenthe“issue”datais100 TLE

Logistics Management Information System6


Stock on Hand

Datathatdescribesthequantitiesofstockheldatafacility. � Ifawarehousehad1,000TLEinstorage,thenthestock on handis1,000units.

Losses and Adjustment

Datathatdescribesanyquantitiesofstockthatleavethepipelineforreasonsotherthanbeinggiventoclients:

1. Losses–thesearethequantityofstockremovedfromstockduetoexpiry,theft,damage,etc.

2. Adjustments–quantitiesofstockissuedtoorreceivedfromotherfacilitiesatthesamelevelofthepipeline.Also,adjustmentsmaybeoperationalcorrectionsmadetostock-keepingrecord.

NOTE: losses and adjustments MUST be accurately tracked. If they are reported as “consumption” then will falsely elevate consumption levels. This false level will result in excess ordering, future overages and potential expiries, and overall poor use of available budget and procurement processes.

� Ifawaterleakdamagesaboxoforalcommoditiesandtheyhavetobediscarded,thenthelossisoneboxoforalcommodities.

� Ifafacilityhas100extraTLEandtransfers/relocatestheextraTLEtoanotherfacility,thentheissuingfacilityhasanadjustmentof-100TLEandthereceivingfacilityhasanadjustmentof+100TLE.

Eachdatapointisessentialtocollectand,assuch,formsaredesignedtocapturethisinformation.

Essential data (consumption, stock on hand, and losses and adjustments) are captured in different typesofrecords.Fromasupplychainpointofview,onlythreethingscanhappentosuppliesinapipeline—theycanbestored,moved(intransit),orconsumed(used).Becausewewanttomonitorproductsatalltimesinthepipeline,weneedthreetypesofrecordstotracktheproductsandreportessentialdata items. Thesecategoriesare:

Record Type DefinitionEssential Data Captured and Reported

Example of Record

Stock-keeping � Tracksinformationaboutcommoditiesinstorage

� #stockonhandbyproduct � #oflossesbyproduct � #ofadjustmentsbyproduct

� Bincards � StockRegister � Inventorycontrolcard � Storeledger

Transaction � Tracksinformationaboutcommoditiesbeingmoved

� Donotneedtoincludeanyoftheessentialdataitemsalthoughsometimesitwillbecombinedwithatypeofreportandwillincludedatalikecurrentstockonhandorlossesandconsumptiondata

� IssueandReceive(IR)vouchers

� Packingslips � Waybills

Consumption � Tracksinformationaboutcommoditiesthatareconsumedorused

� Consumptiondata � DailyDispensingregisters

� Dispensinglogs � Tick/tallysheets � IMS


NACO/SACSutilizesspecificLMISformsthatfallwithinthesecategoriestocollectessentialsupplychaindata.Theseformsare:

STANDARD OPERATING PROCEDURE – LMIS Forms

NACO/SACS LMIS collects three essential data items. These data items form the basis of all decisions. They are:

Form DescriptionFacilities Which Use this Form

Indent • UsedtoplaceindentsforHIV/AIDSessentialmedicinesandcommodities

Allfacilities

Issue and Receive (IR) Form

• Usedtoissuecommoditiesandrecordreceipt.Ittracksthemovementofcommodities–fromrequesttoissueandtoreceipt.

Allfacilities

Stock Register • Recordsdetailedinformationabouteachitem.Itisupdatedonanon-goingbasis,recordingissues,transfers,etc.

Allfacilities

Bin Card • Recordsinformationaboutasingleproductbylotnumberorbatchnumber.

• Everyiteminthatlotwillhavethesameexpirydate.

OnlyStateStores

Daily Dispensing Register (DDR)

• Recordsthequantityofeachproductreceivedbyaclient(bynameorclientnumber)andbydate.

• AttheendoftheDDR,thetotalquantitydispensedorusediscalculatedforeachproducteachdayandthenusedforreportingpurposes.

Allservingfacilities(SDPs)

Return /Transfer /Discard (RTD) Form

• Recordsitemswhicharebeingreturnedforanyreason,oraredamaged,orarebeingtransferred/relocatedtoadifferentfacility.

Allfacilities

Monthly/Quarterly Stock Report

• Recordsalldetailedinformationknownaboutacommodityinagivenlocationforagivenreportingperiod

AtStateLevel

Eachformcaptureskeysupplychaindata,asnotedbelow.Thesedataitemsformthebasisofalldecisionsandareusedtomakesupplychaindecisions,asalsonotedbelow:

Transaction

Type Purpose DataCollected DecisionsMade

Indent Form and Issue and Receive Forms (IR)

Totrackmovementofcommoditiesbetweenfacilities

• quantityofproductbeingordered/shipped/received

• authorizationtoissue • proofofissue/receipt • datesofissue/receipt • indentleadtime • locationofcommodity

• Guidereceiptandissuequalityinspections

• Confirmcommoditylevelsatanypointintime

Stock-keeping

Bin Card

StockRegister

Return/ Transfer/Discard(RTD)Form

Totrackwherecommodityisatinagivenfacilityandatwhatlevels

• commodityonhand • losses/adjustments • quantityreceived • quantityissued

• Setcommoditylevelsthatwewouldliketokeepinthestoreand indent to meet demand


• Decidehowmuchtoindent • InformFEFOdistribution/

wheretoissuecommodity


Consumption

Daily Dispensing Register/ IMS

Togatherdataonhowmanycommoditiesarebeingdispensed

• commodityonhand • rateofconsumptiondata

• Setcommoditylevelsthatwewouldliketokeepinthestoreand to meet demand

• Decidehowmuchtoindent • Confirmcommoditylevelsat

anypointintime

Digital LMIS (eLMIS)PreparingsummaryandfeedbackreportsiseasierandlesstimeconsumingwhentheLMISisautomated.DigitalLMISapplicationscanautomaticallypopulatereportelements,especiallyiftheeLMISisalsousedforroutineinventorycontrol,andforopeningbalance,receipts,consumption,lossesoradjustmentsthatarerecordedwitheverytransaction.Withtheclickofabutton,theeLMIScangenerateasummaryreportandarequisitionorder(indent)with suggested replenishmentquantities. It also canquickly identifymathematicalerrors,highlightmisseddeadlines,listthepercentageofexpectedreportsreceived,andsearchfordataaverages,highs,andlow.

Figure 4:IMSDashboard

Types of LMIS ReportsAnLMISalsoincludesreportswhichareusedtocommunicatesupplychainmanagementinformation(includingthethreeessentialdata items) fromone levelofthesystemtoanother.Reportsmove informationupanddownthroughthelevelofsupplychainandprovidedecision-makersatvariouslevelstherightinformation,attherighttime,intherightplace,intherightquantity,oftherightquality,andtherightcost.

Data Use: for Forecasting and ProcurementTo provide quality HIV/AIDS essential medicines and commodities, it must be well-supplied in the rightquantitiesattherighttime intherightplace.Quantification isaprocessthatestimatesthequantities and costs and delivery sources and specificationsoftheseessentialcommodities.ItlinksinformationonservicesandcommoditiesfromthefacilitylevelwithprogrammepoliciesandplansatthenationallevelandmakessurethateachfacilityhastheHIV/AIDSessentialmedicinesandcommoditiesitneedstoservetheclients.

Datamustbecollectedfromindenttoquantifyhowmuchcommoditiesareneededandwhatitwillcosttogetthosecommodities.ThisdatacomesfromLMISreportswhichcollectdataateverylevelandeveryfacility.ThismeansthatEVERYsupplychainworkeratEVERYfacilityplaysanimportantroleinensuringcommoditiesareavailableallthetime.DatacollectedonLMISreportsandthensharedusingLMISrecordsisessentialtomakingdecisions;thebetterinformationwehave,thebetterdecisionswecanmake.


Overview Quantificationistheprocessofestimatingthequantitiesandcostsoftheproductsrequiredforaspecifichealthprogramme(orservice),anddeterminingwhentheproductsshouldbedeliveredtoensureanuninterruptedsupplyfortheprogramme.

Quantification is a critical supply chainmanagementactivity that links information on services andcommodities from the facility level with programmepoliciesandplansatthenationalleveltoestimatethequantitiesandcostsofthecommoditiesrequiredforaHIV/AIDShealthprogramme.

Quantificationisimportantforinformingsupplychaindecisionsonproductselection,financing,procurement,and delivery. The results of a quantification exercisehelpprogrammemanagers:

• Identifythefundingneedsandgapsforprocurementoftherequiredcommodities

• Leverage the sources, amounts, andtimingof funding commitments tomaximize theuseof availableresources

• Advocateforadditionalresources,whenneeded

• Developasupplyplantocoordinateprocurementsandshipmentdeliveryschedulestoensureacontinuoussupplyofcommoditiestoallfacilityacrossthecountry

Thequantificationprocessisnotaone-time,annualexercisebutaniterativeprocessof reviewingandupdating thequantificationdataandassumptions,andrecalculatingthetotalcommodityrequirementsandcoststoreflectactualservice delivery and consumption aswell as changes in programmepoliciesandplans.The resultsofaquantificationexercise shouldbe reviewedeverysixmonths,andmorefrequentlyforrapidlygrowingorchangingprogrammes.

The right peopleneed tobe involved in each stepof thequantificationprocess, fromdata collection andanalysistopresentingfinalresultstotheNACO/SACSandotherrelevantauthorities.Thefollowingpersonnelare usually involved in a quantification exercise: SCM managers, policymakers, programme managers,technicalexperts,procurementofficers,warehousemanagersandserviceproviders.Quantificationofhealthcommoditiesfollowsastep-by-stepapproachandisconsistoftwocomponents:

• Forecasting:thisprocessestimatesthequantityofeachcommoditythatwillbedispensedorusedduringadefinedtimeperiod(e.g.oneyear).ThisiscurrentlydonebyNACOatthenationallevelwhichisapprovedbyTRG.

• Supply planning:thisprocesscoordinatesprocurementsanddeliveryschedulesofshipmenttoensureacontinuoussupplyofcommodities.

Toproperlyforecasthowmuchofeachcommoditywillberequired,dataisneeded.

Quantification

Quantification is not a one-time annual

exercise but an iterative process which includes

reviews and updates required year-round.

7


Overview Once commodities are quantified and approved for indenting, they must be procured. However, theprocurementisacriticalpartofthesupplychaincycle(seefigurebelow)becauseitensuresthat:

• Correctproductsareprocured

• Productsareofgoodquality

• Valueforcostismaximized

• Supply of products is reliable and meets thedemand

• Procurement process follows the rules andregulationsofthegovernment

Only effective and rigorous procurement policies,processes, and procedures can ensure a reliableflow of commodities into the supply chain, and caneffectively respond to any contextual or operationalchangesinthesupplychain.

Theprocurement function is affectedbypreceding elementsof the supply chain cycle and the regulatorycontext.Factorsincludethecharacteristicsoftheproducts,registration,qualityandimportationrequirements,procurementrulesandregulations,andquantificationrequirements.Thesedirectlyflowintotheprocurementactivities,andneedtobereflectedinthetenderdocuments.

Specific Procurement ChallengesGiven the scope, highprofile, and valueof thepurchases, thenatureof the commodities, thenumberofstakeholders and the strict nature of public procurement procedures, challenges often arise during theprocurementprocess.Whileawiderangeof issuescanaffectprocurement, themostcommonandcriticalprocurementchallengesrevolvearoundthefollowing:

Lengthy Procurement Process and Extensive Lead Time: Eachstepoftheprocessrequiresacertainamountoftimetocomplete.Whilesomestepscanbedone inparallelandwillvaryinthetimerequired,someareoftenfixedforasetperiod,andmayrequirevalidationorconcurrenceofoneorseveralstakeholder(s).

Product Quality Assurance:Counterfeit and substandardproducts are in themarketplace, creating significantproductquality risks forthesupplysystem.Toaddressthisrisk,publicsectorprocurementprocessesandnationalregulatoryagenciesmustimplementappropriatequalityassurancemeasurestoensurethatonlygoodqualityproductsenterthesupplysystem.Procurementaddressesthisresponsibilitythroughthetechnicalspecifications, issuedinthetenderdocument,whichidentifykeyproductqualityrequirements,suchasproductcertificationrequirements,pharmacopeiastandards(whenapplicable),labelingandpackagingrequirements,shelfliferequirements,etc.

Procurement8


Transparency, Equity, and Integrity throughout the Procurement Process:Theprocurementunitmustsupportanopenprocurementprocessbyconsistentlyapplyingrelevantprocurementregulations and procedures, and international best procurement practices that promote transparency andaccountability.

Projections and Estimates: Costprojectionsandleadtimeestimatesareoftendifficulttomake.Theprocurementunitshouldbeawareof themainmarket trends, although it cannot readily gather information specific to a tenderprior to thepublishingofthetenderdocumentandreceiptofthebids.

Developing the Procurement StrategyProcurementactivitiesshouldbeconductedinthecontextoftheoverallNACOhealthprogrammestrategy:

Procurement isonepieceof theSupplyChainCyclewithmany challengesand stakeholders. Tobest alignprocurement activities with the overall NACO health programme goals and supply chain strategy, theprocurementunitshouldbeawareofthefollowing:

• Programinformation:goals,targets,timelines,stakeholders

• ImportanceoftheprogrammeofNACOanditsclients

• HowprocurementactivitiesalignoperationallywithotherelementsoftheSupplyChainCycle

Note: For more information, please refer to Procurement Manual of NACO (http://naco.gov.in/sites/default/files/Procurement%20Manual%20for%20National%20AIDS%20Control%20Progrmme%20%28NACP-III%29.pdf)


Overview Once commodities are quantified and procured, they must be managed. Storekeepers and supply chainmanagersateach levelmonitorstock levels todeterminewhenandhowmuchofacommodity isneededwhere. Theworst thing that canhappen in ahealthfacilityistohaveastockout(i.e.yourunoutofstock).Thebestwaytoavoidastockoutinahealthfacilityistoestablishaninventorycontrolsystem.

Anautomobile fuelgauge isanexampleofa simpleinventory control system. It informs a driver of thestock level of fuel and indicates when more fuelshouldbe“refilled”.Asupplychaininventorycontrolsystemis likeafuelgaugealso inthat it informsthestorekeeper,whoislikeadriver:

• whentoindentorissue

• howmuchtoindentorissue

• howtomaintainanappropriatestocklevelofallproductstoavoidshortagesandoversupply.

Whiledriving,youmonitoryourfuelconsumptionfromtimetotimeanddecidewhentopurchasemorefuel.Byassessingthefuellevelofthetank,youcancalculatewhentorefuelandhowmuch,dependingonyourdestination(andperhapsyourbudget).Driversoftenusetheredwarningareaasanindicatorofwhentobuymore fuel. Inothercases,drivers replenishthetankonaspecificdayof theweek, regardlessof the level,addingenoughfueltoreachfull.Indecidingonanapproach,driversarechoosingaformofinventorycontrol.

ThesesameprinciplesapplytoHIV/AIDSessentialmedicinesandcommoditiessupplychains.

Max and Min LevelsInventorycontrolsystemscanbedesignedinavarietyofways.Publicsectorhealthcommoditysupplychainscommonlyuseamax-min inventorycontrolsystem.Much likethefuelgauge inanautomobile,amax-mininventorycontrolsystem isdesignedtoensurethat thequantities instock fallwithinanestablishedrangewherestocklevelsshouldalwaysremainbetweenaminimumandmaximumlevel.

• Maxlevelofstockisthelevelofstockabovewhichinventorylevelsshouldnotrise,undernormalconditions.Themaxstocklevelissetasanumberofmonthsofstock(forexample,themaxlevelmaybesetatfourmonthsofstock).Thisnumberrepresentsthenumberofmonthsofstockthatafacilityshouldhaveinthestoreinordertoserveclientsduringagivenperiod.

• Minlevelofstockisthelowestlevelofstockthatafacilityshouldhaveinthestoreorwarehouse.IdeallyafacilityneverreachesthisMinlevel,butifitdoesanordershouldbeplacedimmediately

• EmergencyOrderPoint(EOP)–thisisthelevelofstockthattriggersanimmediateemergencyorder.Itcanbereachedatanypointandmustbelowerthantheminlevelofstock.

Maxandminlevelsareexpressedintermsof“monthsofstock”. Whenyouassessstockstatus,timeisan

InventoryManagement 9


essentialfactor.Forexample,astocklevelof100TLEtabletsmaybesufficienttosupplyasmallhealthfacilityi.e.ARTCforonemonthorlonger;however,inalargehospitalorwarehouse,astocklevelof100tabletsmayonlybeenoughforaweekorevenafewdays,makingthesupplydrasticallyunderstocked.It is important,therefore,toknowhowlongsupplieswilllast.

Insupplychainmanagement,yourjobistoturndataandnumbersintoinformationthatcanbeusedtomakedecisions.Inthiscase,youneedtousedatatodetermineifyouhaveenoughstocktolastuntilthenextorderisreceivedandavailablefordispensingorissuing.

Asystemshouldhavemaxandminlevelshighenoughtoavoidstockouts,yetlowenoughtonotriskoversupplywhichwouldleadtoincreasedriskofexpiryordamage.Itispossible,andactuallylikely,thatthestockbalancewill,attimes,gobelowthemin;but,ideally,itshouldnevergobelowtheemergencypoint.Thusminlevelsaresethighenoughtoensurethatthefacilitynevercompletelyrunsoutofstock.Atthesametime,maxlevelsaresetlowenoughtoensurethatspaceinthestoreroomisadequateandthatthestockdoesnotexpirebeforeitcanbeused.

Ultimately,thegoalistoavoidstockoutsofessentialhealthproducts.Moreover,thesystemshouldensurethatemergencyindentsarerarelyplaced,becausesuchindentsaretime-consumingand,generally,expensivetofill.

Please find SACS maximum levels of stock and emergency order points by facility in the “Standard Operating Procedure” section of this Guide (Table 5 at Page No. 56-57 )

Forced Indenting SystemSACSutilisesatypeofmax-minindentingsystemcalled“forcedindenting”.Withaforced-indentingsystem,amaximumlevelofstockisset.Thislevelrepresentsthemonthsofstockthatafacilityshouldhaveinthestoreinordertoserveclientsduringagivenperiod.Attheendofapre-establishedreview,orindentingperiod(e.g.1timeamonth,quarterly,bi-annually)astockassessmenttakesplace.Supplylevelsarecomparedtothemaxlevelandthesupplychainmanagerdeterminesthedifferencebetweenwhatiscurrentlyinstockandwhatthemaxlevelis.Anindentisplacedforthedifference.Theemergencyorderpointistheabsoluteminimumlevelthatstockmayreach.Itisbasedontheamountofstockneededtomeetdemandduringthelongestleadtimeneededtoreceiveanemergencyorder.Anemergencyindentisplacedifthestocklevelforanyitemfallsbelowtheemergencyorderpointbeforetheendofthereviewperiod.

Please find SACS indenting schedule in the “Standard Operating Procedure” section of this Guide (Table 7 at Page No. 57)


Overview Oncethemaximumandminimumstocklevelsareestablished,inventoryismanagedtomakesurethatitstayswithinthoselevelsandthatthereisenoughstocktomeetclientneeds.Assessingstockstatusisasupplychainmanagementfunctionregularlycompletedtomonitorstocklevelsandmakedecisionsrelatedtoresupplyandmanageinventory.

Stockatalllevelswithinthesystemisassessedatregularintervals,orreviewperiods.Byreviewingstockstatussupplychainmanagerscandetermineifafacility is understocked, overstocked, or adequately stocked. It is the supplychainmanager’sjobtoturndataandnumbersgainedthroughassessingstockstatus into information that canbeused tomakedecisions. Sheor heusesthisdatatodetermineifthereisenoughstocktolastuntilthenextindentisreceivedandavailablefordispensingorissuing.

Whenassessingstockstatuswiththepurposeofcreatinganindent,allcommoditieswithintheSACSHIV/AIDSessentialmedicinesandcommoditysupplychainarere-stockedtothepre-establishedmaximumlevel–nomatterhowmuchorlittleisinstock.

Stock Assessment Stockstatusisusuallyexpressedinmonthsofstock.Whenreviewingstockstatus,supplychainmanagersneedtodeterminehowmanymonthsofstockarepresentinafacility.MonthsofstockonhandisthenumberofmonthsHIV/AIDSessentialmedicinesandcommoditieswill lastbasedonthepresentconsumptionrate.Byindicatingstockstatusinmonths,supplychainmanagersareabletodeterminehowlongsupplieswilllast.Forexample,threemonthsofstockmeansthatyourstockwilllastthreemonths,aslongasconsumptionremainsatthecurrentrate.

Toassessstockstatus,twodataelementsarerequired:

• Stockonhand–thequantitiesofusablestock.(Itemsthatareunusablearenotconsideredaspartofstockonhand.Theyareconsideredinlossestothesystem.)

• Averagemonthlyconsumption–thequantityofcommodityusedonaverageoveragivenperiodoftimethatisrepresentativeofnormalconsumptionrates.Itiscalculatedusingthemostrecentdispensed-to-userdata,usuallyoverthelastthreeorsixmonths.

Remember: assessing stock statuswill tell us howmanymonths of stock are on hand. To use these dataelementstodeterminemonthsofstockonhand,asimpleformulaisused:

AssessingStock Status

How much stock we used during a defined period

(e.g. for the last 3 months)How much stock we have ÷ = How long the Stock will last

10

The purpose of assessing stock status

is to determine how long supplies

will last.


Average Monthly Consumption (e.g. for the

last 3 months)Stock on Hand ÷ = Months of Stock

Anotherwayofdefiningthisformulaisthe:

Amount we have is the same as… Stock on Hand Amount we use is the same as… Average Monthly Consumption How long the stock we have on hand will last is the same as… Months of Stock

EXAMPLE:

SupposeyouwereaskedtoassessthestockstatusofasupplyofTLEinaARTCandyoufound100tablets.Withthisinformation,couldyoutelliftheclinichas.

Toomanytablets?

Ortoolittle?

Orjustenough?

No,youcouldnotbecauseyoudonotknowhowmanytabletsareusedmonthly.

Youdonotwant toknow,“Howmany tabletsdoes theclinichave?”but instead,“How longwill theclinic’ssupplyoftabletslast?”Ifyouknowthattheclinicdispensesabout25tabletseverymonthduringregularmonths,youcanusethefollowingsimpleformulatodeterminethattheTLEsupplywilllastaboutfourmonths—

Average Monthly Consumption (e.g. for

the last 3 months)

100 tabs ______________________________

25 tabs dispensed monthly= 4 Months of Stock

Stock on Hand ÷ = Months of Stock

Basedonyourassessment,youmayfindthatyouneedtoplaceanindentor,insomecases,evenanemergencyindent.However,iffromtheassessmentyouseethatyoudonotneedtoplaceanindentbecauseyouhavesufficientsupplytomeetdemand,youcanreturntoyourotherdutiesconfidentthatyoursupplieswilllastuntilyournextindent.Thisanalysisprocessisassessingstockstatus!

Please find SACS schedule for stock assessment in the “Standard Operating Procedure” section of this Guide (Table 6 at Page No. 57)


Overview Inordertodeterminehowmuchtoindent,supplychainmanagersneedtoassessstocklevelsandfigureouthowmuchofeachHIV/AIDSessentialmedicinesandcommodityisavailableatafacilityandhowlongthesestockswilllast.Oncetheydothis,theycancomparetheirstocklevelstotheestablishedmaximumlevelofstock(remember–maximumstocklevelsarethehighestlevelofstockthatafacilityshouldkeeponhandtopreventstockouts).Thedifferencebetweenwhatafacility’smaxlevelofstockisandwhattheyactuallyhaveistheindentamount.

Formula for Calculating Quantity to IndentForeveryfacilityandeverycommoditytypes,theformulaforcalculatingtheindent,orissuequantity,isthesame.

Calculating an Indent Quantity

Quantity ON order (IF the indent is confirmed

to supply the order)

Average Monthly Consumption

Max Quantity of Stock (Remember! This is Max Stock

Level * AMC)

Stock on Hand

Max Level of Stock as Expressed in Months

- -

X

=

=

How long the Stock will last

The Max Amount of a given commodity that a facility

should have in storage

TocalculatetheQuantitytoOrder,followthesesteps:

HIV/AIDSEssentialMedicinesandCommodityOrderProcess

Step

1. Verify “max stock level”.

Maxquantityisthemaximumamountofstockafacilityshouldhaveatanygiventime.ThisnumberissetbytheNACO/SACS:

— State = 18 months of stock

— ARTC = 6 months of stock

— LAC= 3 months of stock

2. Turn “max stock level” into an actual number of commodities:

You must convert max quantities into the actual quantities of product needed. A supply chain managercannot,forexample,sendanindenttothecentralwarehousefortwomonthsofstockofanitem.Thecentralwarehousewouldnotknowwhattwomonthsofstockmeans.Thesupplychainmanagermustconvertmonthsofstockintoanactualquantityofstockbyusingthisformula:

11


Quantity ON indent IF the indent is confirmed that it

WILL still come


Level * AMC)

Stock on Hand

- - = Quantity TO Indent

3. Determine “stock on hand”.

Stockonhandistheamountofstockafacilityhasinitsstorage,readyforissue.Itcanbefoundby:

— Checkingthestockcard

— Conductingaphysicalinventory

4. Verify “quantity ON order”.

Quantityon indent is thequantityof commodities that youhavepreviouslyorderedbuthavenot yetarrived.Yousubtractthisamountsothatyoudonotindenttoomuch:

— IfyoumadeanindentinapastmonthbutithasnotarrivedandyouKNOWitwillarrive,subtractthatamount.

— IfyoumadeanindentinapastmonthbutitwillNOTarrive,thendonotsubtractit.

5. Use the formula and determine your “quantity TO indent”.

Example 1:

CalculatinganIndentforARV DRUGS:

1. YouworkataStatewarehouse.ThemaxquantityofstockforZLN,setbytheNACO,is18monthsofZLN.

• Max stock level = 18monthsofZLN

2. Yourstateissuesanaverageof300ZLNeachmonth.Sousingtheformulainthisstep:

• 18 * 300 =5400ZLNismaxnumberofZLNthatyoushouldhave

3. Youlookonyourstockcardandyoucurrentlyhave500tabletsofZLNinyourstore.YoualsocountthenumberofZLNtabletsandverifythatyoureallydohave500ZLNtabletsinyourstore.

• Stock on Hand =500ZLN

4. Youlookatlastmonth’sIndentandissuesandreceivingFormandfindthatyouplacedanindentfor300ZLN.YouhavenotyetreceivedthatIndentFormsoyoucalltheissuertoverifyifthatindentof300ZLNisstillcoming.Theysay,“Yes,itisstillcoming.”

• Quantity on Order = 300

5. Based on the information we know:

• MaxQuantityofStock=5400

• StockonHand=500

• QuantityonOrder=300


6. Aspertheformulaabovethecalculationwillbeasfollows:

5400 – 500 – 300= 4600 You should place an indent for 4600 tablets of ZLN.

Example 2:

CalculatinganIndentforHIV Test Kits

Supposeyouareaservicedeliverypoint(facilities)andyouareaskedtoplacethismonth’sindentforHIVtestingKits.Whatdoyoudotocompletetheindent?

YouknowthatServiceDeliveryPoints(facility)haveanestablishedmaxlevelforHIVTestingKitsof:2monthsofstock.

Youcheckyourstockcardandconductaphysicalinventorytoseehowmuchstockyouhaverightnow.Youfindthatyouhave25HIVTestsinstorageandreadyforuse

Then,youlookinyourrecordsandfindthatthisfacility’saveragemonthlyconsumption(usingthelast3monthsdata)forHIVTestingKitsis:30testspermonth.

Finally,youlookinyourrecordsandfindthatyouhavean indentalreadyplacedfromlastmonthfor10HIVTestingKitswhichhasnotyetarrived.YoucalltheStatestore(WIC)andtheytellyouthattheycancelledthelastindentanditwillNOTbecoming.How much should you indent?

Answer:

Using this formula:

Basedonyourassessment,youmayfindthatyouneedtoplaceanindentor,insomecases,evenanemergencyindent.However, iffromtheassessmentyouseethatyoudonotneedtoplaceanindentbecauseyouhavesufficientsupplytomeetdemand,youcanreturntoyourotherdutiesconfidentthatyoursupplieswilllastuntilyournextindent.Thisanalysisprocessisassessingstockstatus!

Quantity ON indent IF the indent is confirmed that it

WILL still come

(2 months max stock level * 30

tests /month)25 tests on hand

0 (since the last indent is

not coming)

35 tests should be ordered


Level * AMC)

Stock on Hand

-

=--

- = Quantity TO Indent

Push Versus Pull IndentingPlacingindentsisaroutineactivityinsupplychainmanagement.Inmostsupplychains,anindentisplacedfornewsupplieseverymonth,oreveryquarter,fromaSDP(facility)toahigherlevel.Thetwomostcommonwaysforindentingaretoeither“pull”or“push”anindent:

• Withapull system, thequantity toberesupplied toa facility iscalculatedby thepersonat thatsamefacilitywhoisplacingtheindent.


• Withapushsystem,thequantitytobere-suppliedisdeterminedbythepersonwhofillstheindentatahigherlevelthanthefacilityrequestingarefill.

Regardlessofwhichtypeofsystem(pushorpull),theformulafordetermininghowmuchtoindentisthesame.

Whendecidingwhethertohavealeveloffacilities“push”indentsor“pull”indents,notethatasystemcanhaveonelevel(e.g.Nationallevel)be“push”andanotherlevel(e.g.SACS)be“pull”.However,itisrecommendedthatfacilitiesatthesamelevelshouldnotbebothpushandpull.Allfacilitiesatalevelshouldusethesameindentingsystemandeitherallbepushorallbepull.

Please find SACS indenting schedule in the “Standard Operating Procedure” section of this Guide (Table 7 at Page No. 57)


Overview Warehouse is a facility for storage and safe keepingof HIV/AIDS essential medicines and commoditiesto avoid damage, expiry, and theft. Proper storageprocedures help to ensure that storage facilitiesprotects the shelf life of products, issue only high-qualityproducts,and that there is littleornowasteduetodamagedorexpiredproducts.Ifproperstorageproceduresare followed,clientscanbeassuredthattheyhavereceivedahigh-qualityproduct.

Because products are stored at every facility in thepipelinealmosteveryoneworkinginthesupplychainisresponsibleforproductstorage.

Designing the Storage FacilityCapacity/space:Storagefacilitiesmusthavethespaceforbothstorageandhandling.Ideally,spaceshouldbeevenlydividedbetweenthetwo.Newproductsandpackaginginnovations,aswellasanincreaseinproductsrelatedtothepreventionandtreatmentofdiseaseslikeHIV/AIDShaveincreasedthevolumeofproductsandmedicalconsumablesthatflowthroughwarehouses.Whendesigninganewfacility,donotunderestimatethestoragerequirements.

Warehouseand Storage

Figure 5:Warehouselayoutforreceivinganddispatch

12


Figure 6:VisualInspection

Plan the store with staging areas for preparing shipments (issuing) and unloading deliveries (receiving).Separatethereceivingandshippingareastoavoidconfusionandtoenhanceefficiencyandsecurity.(Thisismorepracticalforbiggersizewarehouse)

Ifafacilitywillberepackagingproducts,planaseparatecleanpreparationareatoconducttherepackaging.Trytolocatetheareaclosetotheissuingarea.

Warehouse and Storage ActivitiesRegardlessofstoragefacilitysize- fromasmallhealthcentertoaSACSwarehouse- themainoperationalactivitiesforstorageareverysimilar.Theseactivitiesare:

• Receiving and inspecting incoming commodities–commoditiesbeingunloadedarevisually inspectedforqualityandquantitiesorderedandareverifiedagainstthepackagingsliporshippinginvoicetoensureaccuracy.

• Putting away–oncecommoditiesareunloaded,theyare“putaway”.Thisincludesmovingproductsfromtheunloadingdock,or receivingarea,after theyare released for storage,andassigning themto theirdesignatedstoragearea(rack,shelf,floor,etc.).

• Picking and packaging–tofillshipping,or indent,requests(orpicking lists),productsmustbe located,pulledfrominventory,andpreparedforshipment.

• Transport–onceproductsarepreparedforshipment,recordingandreportingdocumentsarepreparedandthencargoisloadedfortransport.Toavoiddamageduringtransit,productsarearrangedandsecuredwithinthevehicleusingpre-setrequirementsandconditionsforadequateloadingandtransport.

Howcomplextheseactivitiesbecomewillvarybasedonthevolumeofproductstobemanagedandstoragefacilitysize.

Receiving and Arranging Commodities:When you receive HIV/AIDS commodities in warehouse and Walk in Cooler (WIC) -

� Ensurethereissufficientstoragespace;

� Prepareandcleantheareasusedforreceivingandstoringtheproducts;

� Inspectpackagesfordamagedorexpiredproducts.


Arranging CommoditiesArrange the storeroom, Walk in Cooler (WIC) and shelves as follows:

Ifusingpalletsandshelves,stackcartonsonpalletsandshelvesasshowninpicture:

� atleast10cm(4inches)offthefloor

� atleast30cm(1foot)awayfromthewallsandotherstacks

� nomorethan2.5m(8feet)high(generalrule).

� Arrangeshelvesandracksinlineswithapassagewaynotlessthan90cmwide.

� Avoidplacingshelvesonlyaroundtheedgeoftheroom,whichwastesalotofspace.

� Placetheshelves90cmfromthewallsofthestoreroomtoensuretheyareaccessiblefrombothsides.Ideally,useadjustableshelves

Figure 7:ExampleofPalletsforstacking

Figure 8:Exampleofshelves


Figure 9:Exampleformarkingtheboxesinwarehouse

For all storage: � Followthemanufacturerorshipper’sdirectionswhenstacking,andfollowlabels/markingforstorage

� Placeliquidproductsonthelowershelvesoronbottomofstacks.

� Storeproductsthatrequirecoldstorageinappropriatetemperaturecontrolledzones.

� Storehighsecurity/highvalueproductsinappropriatesecurityzones.

� Separatedamagedorexpiredproductsinquarantineareafromtheusablestockwithoutdelayanddisposeofusingestablisheddisposalprocedures.

� AlwaysstoreallcommoditiesinamannerthatfacilitatesFEFOprincipleforstockmanagement.

� Arrangecartonsso that thearrowspointupand identification labels,expirydates,andmanufacturingdatesarevisible.Ifthisisnotpossible,writetheproductnameandexpirydateclearlyonthevisibleside.

Stock Rotation and FEFO PrincipleFirstExpiry, FirstOut,oftenabbreviatedby theacronymFEFO.This term isused in logisticsand inventorymanagementtodescribeawayofdealingwithproductwithalimitedshelflifesuchaspharmaceuticaldrugsorproductswithaspecifiedexpirydate.TheproductwiththefirstexpirywillbethefirsttobedistributedorremovedfromstockThis isasimple,highlyeffectiveinventorymanagementmethodthatprioritizesthehandlingandmovingofdatesensitiveinventory.

UsuallyFirst-In,First-Out(FIFO),acommonpractice,workswellinmostcases,butmanagingbyexpirydate(FEFO)ensuresthattheearliestexpiryproductsleavethewarehouse/facilityfirst.It isadvisabletoconfirmthatFEFOisbeingfollowedeverytimephysicalinventoryassessmentisdone.TheFirstexpiry,firstoutlogicisatypeofstockrotationthatenablessupplychainoperationsmanagerstooptimizethedistributionprocessandminimizethewastegeneration.

WhenissuingHIV/AIDScommodities,itisimportanttofollowtheFEFOpolicy.


Figure 10:PhysicalCountandstockrotating

Following FEFO minimizes wastage from product expiry. � Alwaysissueproductsthatwillexpirefirst,ensuringtheyarenottooclosetoorpasttheirexpirationdate.

Theshelfliferemainingmustbesufficientfortheproducttobeusedbeforetheexpirydate.

� TofacilitateFEFO,placeproductsthatwillexpirefirst,infrontofproductswithalaterexpirydate.

� Writeexpirydatesonstockcards,sostockscanbesenttofacilitiesatleast3monthsbeforetheyexpire.

Remember, the order in which you received products is not necessarily the order in which they will expire. Products you received most recently may expire sooner than the products you received earlier. So, it is extremely important to always check the expiry dates and to make sure the dates are visible while the products are in storage.

Storage ConditionStorageconditionswillaffectthequalityoftheHIV/AIDSessentialmedicinesandcommoditiesbeingstored.Stores that are too hot, stacks of cartons that are too high, and other poor storage conditions can causedamagetoHIV/AIDSessentialmedicinesandcommoditiesorcauseareductioninshelflife.Awell-organizedstoreroomwillalsosimplifyafacility’swork;neededsuppliesarequicklyfoundwithoutwasteoftime.

Eachcommodityhasashelflifewhichisspecifiedbythemanufacturer.Whenthecommodityreachestheendofitsshelflife,ithasexpiredandshouldnotbedistributedtoclients.

Shelf life isthe lengthoftimeaproductmaybestoredwithoutaffectingtheusabilityandsafetyoftheitem.Tomaximizeshelflifeandensureproductsarereadilyavailablefordistribution,facilitiesshouldadheretoacceptedbestpoliciesandprocedureswhenstoringHIV/AIDSessentialmedicinesandcommodities.CompletestorageguidelinescanbefoundinGuidelinesforthe Storage of EssentialMedicines and Other Health Commodities. Further, each commodity has specific

Shelf life is the length of time a product may

be stored without affecting the usability and safety of the item.


guidelineswhichshouldbefollowedtomaintainitsintegrity.Thisinformationisusuallyprintedontheproductcartonandboxesbythemanufactureranditshouldbeexactlyadheredto.

In supply chains, warehousing/storage costs can sometimes account for the largest percentage of overalllogisticscosts.Itisvitalthatthisfunctionismanagedeffectivelyandefficiently.Theshelflifeoftheproductsisdependentongoodstoragepractices.Thefollowingaresomeofthekeyexampleofgoodstoragepractices.

Storage Guidelines: � Cleananddisinfectstoreroomregularly

� Storesuppliesinadry,well-litandwell-ventilatedstoreroom,outofdirectsunlight

� Securethestoreroomfromwaterpenetration

� Ensurethatfiresafetyequipmentisavailableandaccessible,andthatpersonnelaretrainedtouseit

� Storecommoditiesawayfromelectricmotorsandfluorescentlights

� Maintaincoldstorage,includingacoldchain,forproductsthatrequireit

� Keephighvalueproducts/commoditiesinalockedplace

� Storeflammableproductsseparatelyusingappropriatesafetyprecautions

� Stackcartonsatleast10cm(4in)offthefloor,30cm(1ft)awayfromthewallsandotherstacks,andnomorethan2.5m(8ft)high

� StoreARVDrugs,HIVTestingKitsandothercommoditiessuppliesseparately,awayfrominsecticides,oldfiles,chemicals,officesuppliesandothermaterials

� Arrange cartons so that arrows point up, and ensure that identification labels, expiry dates, andmanufacturingdatesarevisible

� StoresuppliesinamanneraccessiblebyFEFO,countingandgeneralmanagement

� Separateanddisposeoffdamagedorexpiredproductswithoutdelay.

Physical InventoryStock-on-handinformationisrecordedinstockkeepingrecords.Butinindenttoknowiftheinformationrecordedonthestockcardiscorrect,supplychainworkers should conduct a physical inventory count. Physical inventory is a managementprocessusedtocompareactualstockonhandforeachcommoditywith the amount recorded on the stock card. A physical inventory countenablessupplychainworkerstoconfirmhowmuchstockisavailableforuseandwhetherformsarebeingcompletedcorrectly.

Forqualityassurance,aphysicalinventorycountisalsoanopportunitytovisuallyinspectproductsforpotentialdamage.

Largewarehousesshouldconductaphysicalinventorycountatleastonceayear.Forsmallerwarehouses,aphysical inventorycanbeconductedmoreoften.Attheclinic level,forexample,youmaywanttoconductaphysicalinventorycountasoftenasonceamonthandatthesametimethatyoucompleteyourmonthlyreport.Ifyoufindthatthestockkeepingrecordsdonotmatchtheactualstock,conductaphysicalinventorycountmoreoftenandtakestepstoimproverecordkeeping.

Whenyou conduct aphysical inventory count, remember,whenboxesare sealedand the rulesofproperstoragearefollowed,onlyoneboxorcartonisopenedatatime.Aphysicalinventorycount,therefore,canbeaquick,routineexercise,especiallyifyoufollowgoodstoragepractices.

A physical inventory count is used to compare actual stock on hand for

each commodity with the amount recorded on

the stock card.

Please find SACS physical inventory schedule in the “Standard Operating Procedure” section of this Guide (Table 2 at Page No. 55)


Overview Qualityassuranceistheprocessofdeterminingifacommoditymeetsspecificationsandinternationalstandardsforquality.Although laboratory testing is oneway to assure thequalityofmedicines and relatedmedicalsupplies, routine visual inspection is usually morefeasible,andcosteffective,attheservicelevel.Routinevisualinspectionisawarehousemanagementprocesswhereproductsandtheirpackagingareexaminedbyeyetolookforproblemsinproductquality.

A commodity shouldnotbedistributed if itsqualityis not as per standards. Questionable commoditiesshould be sent to the nearest authorized testinglaboratoryforanalysisandalllikecommoditiesheldinquarantineuntiltheresultsofthetestingarereceived.

Visual InspectionIn a perfect pipeline, all productswould be stored under ideal temperatureand humidity conditions, and according to proper storage guidelines. I n therealworld,thequalityofstorageconditionsmayvarywidelyfromplacetoplace.Storekeeperscanbestverifyqualitybyvisuallychecking theconditionof all products in their facility on a regular schedule through routine visualinspection.

Avisualinspectionshouldbecompletedeachtimeproductsarehandled,including:

• Receivingproductsfromthemanufacturer(usuallyattheRegional/statelevel)

• Receivingsuppliesfromawarehouseorhealthfacility

• Conductingaphysicalinventorycount

• Dispensingproductstoaclient

• Issuingproductsfromoneleveltoanother

• Receivingcomplaintsfromlowerlevelsorclients

• Productsareabouttoexpire

• Productsshowsignsofdamage

• Productshavebeenkeptunderimproperstorageconditions.

Duringavisualinspection,checkforthefollowingkindsofdamage:

• Physicaldamage–checkfordamagetothephysical integrityofacommodity,usuallyduetocrushing,tearing, rubbing, or ripping, like signs include: tears, perforations,water or oil or brokenor crumbledtablets,brokenbottles.

• Chemicaldamage–checkfordamageordeteriorationofthechemicalintegrityofacommodity,usuallyduetoexposuretolight,heat,humidity,ormoisture.

QualityAssurance

Visual inspection is the process of examining

products and their packaging by eye to look for problems in

product quality.

13


• Manufacturingdefects–checkforincompletesupply,missingorillegibleidentificationinformation.

• Labelingdefects–makesurethatproductsare labeledwiththedateofmanufactureorexpiration, lotnumberandmanufacturer’sname.

Ifaproblemwithacommodityisdiscovered,asampleofallpackagesshouldbecheckedtoensurethattheydonothavethesameproblem.

Damaged commodities should be removed from inventory anddestroyedaccordingtoestablishedhealthcarewastemanagementpoliciesandprocedures;thebalanceofthecommoditycannormallybedistributedasusual if it’san issuewiththepackaging. If it isachemically-causeddamage,thenalllikecommoditiesfromthesamelotshouldalsobedestroyed.

HIV/AIDS essential medicines and commodities Signs of DamageEachHIV/AIDSessentialmedicineandcommoditycontainsuniquechemical properties and is packaged specifically to protect thequality. When inspecting these commodities, they will displaywarningsignswhichindicatedamageorlossofintegrity.Damagedproducts should be refused upon delivery and/or not issued ordispensedifalreadyinstock.

Please find physical inspection components in the “Standard Operating Procedure” section of this Guide (Table 3 at Page No. 56)

Foracomprehensivedescriptionofstorageprocedures,consult:

• Guidelines for the Storage ofEssentialMedicines andOtherHealthCommoditiesJohnSnow,Inc./DELIVER. 2003. https://www.humanitarianresponse.i n f o / s i t e s / w w w .h u m a n i t a r i a n r e s p o n s e .info/files/documents/files/guidstoresse_pock_0.pdf

• Guidelines for WarehousingHealth Commodities JohnSnow, Inc. / DELIVER.2003. https://publications.j s i . c o m / J S I I n t e r n e t / I n c /Common/_download_pub.cfm?id=16917&lid=3


Standard Operating Procedures for ARV Drugs and Other

Commodities


ARV Drugs and Other Commodities Flow Process 14


Commoditymanagementconsistsofsixfundamentalprocessesthattakeplaceineveryfacilityateachlevelwithinthesupplychain:

Standard Operating Procedures


EachSOPiscomprisedofthefollowingparts:

• Overview:Listsall reference informationneededtoknowwhentheSOPwasauthorizedandwhois inchargeofit;

• Purpose:OutlinesbrieflytheobjectiveofthisspecificSOP;

• Scope:DescribeswhichfacilitiesmustfollowthisSOP;

• Responsible Persons:ListsthepeoplewhoareresponsibleforimplementingtheSOP(Please refer Table 1.0 on Page No. 55);

• Forms / Records:ListstheLMISformswhicharerequiredtocompletethisSOP;

• Procedure:ListseachstepthatmustbecompletedtoensurethattheSOPisfullycompleted;

• Effectiveness Criteria / Criteria for Completion: this is a checklist that is used after a SOP has beencompletedtoensurethattheSOPwascompletedfullyandaccurately;

• References:Listsanyexistinglaws,policies,orregulationsthatimpacttheimplementationofthisSOP;

• Revision History: SOPsaredynamicandevolvingdocuments.As systemsevolve, theSOP shouldalso.Revisionsaremadeandtrackedusingthissection.

15

ForecastandProcurecommodities


IndentCommodities


IssueCommodities


1

23456


Thefollowingtablesnotekeypolicydecisionswhichareusedtoguideday-to-daysupplychainoperations.Eachisreferenced,whereapplicable,inindividualSOPswhichfollow.

TABLES COMPONETNS

TABLE 1 ResponsiblePersons

TABLE 2 PhysicalInventorySchedule

TABLE 3 QualityAssurance

TABLE 4 RemovalandReturnofDamagedand/orExpiredCommoditiesand/orReturnofNear-ExpiredCommodities

TABLE 5 MaximumInventoryLevels(NottoBeExceeded)andEmergencyOrderPoint

TABLE 6 CommodityLevelAssessment

TABLE 7 IndentSchedule

TABLE 1.0 – Responsible Persons

The following people are responsible for this SOP:

Level Person Who Completes Task Person Who Reviews the TaskPerson Who Approves Task

SACS Store Pharmacist/StoreKeeper StoreIncharge/DeputyDirector JDCST

Regional Store Store-In-Charge/Pharmacist DistrictProgramOfficer(DPO) DistrictProgramOfficer(DPO)

ART Centers Pharmacist MedicalOfficer NodalOfficer

LAC StaffNurse MedicalOfficer MedicalOfficer

TABLE 2.0 – Physical Inventory Schedule

Each facility conducts a physical inventory as per the SACS determined schedule which is as follows:

Facility Level Physical Inventory Conducted: Report to:

SACS Store � Halfyearly � PD

Regional Store � Quarterly � StoreIn-Charge–SACS

ART Centers � Quarterly � JD–CST

LAC � Monthly � MedicalOfficer,ARTC

Standard Operating Procedures Reference Tables16


TABLE 3.0 – Quality Assurance Each facility should verify the following aspects of each commodity upon receipt. If anything does not pass inspection, then they should be returned:

Physical Inspection Component What is Checked:

1. Physical damage Verify the physical integrity of a commodity:

• Ensurenocrushing,tearing,rubbing,orripping

• Lookforsignslike:tears,perforations,wateroroilorbrokenorcrumbledtablets,brokenbottles

2. Chemical damage Verify the chemical integrity of a commodity:

• Ensurenochangeincolororconsistencyorsmell

3. Manufacturing defects

Verify labeling is as required in the purchase order:

• Ensurelabelingiscorrect,batchno.andexpirydatearestamped

TABLE 4.0 - Removal and Return of Damaged and/or Expired Commodities & Return/Re-distribution of Near-Expiry CommoditiesEssential medicines and commodities are monitored on a regular basis. When damaged, near expiry, or expired commodities are found, each level responds as established in the table below:

Level If damaged then…If near-expired or excess then…

If expired then…

SACS � DisposeasperGovt.norms

� Redistributeasperneedtofacilities

� DisposeasperGovt.norms

Regional Store � DisposeasperGovt.norms

� Redistributewithinfacilities;ifnotneeded,thenreturntoSACS


ART Centers � DisposeasperGovt.norms

� InformSACSandrelocatetoassignedfacilities

� DisposeasperGovt.normsandinformtoSACS

LAC Centers � DisposeasperGovt.norms

� ReturntoARTStoreforredistribution


TABLE 5.0 – Maximum – Minimum (Forced) Inventory Control SystemFacility inventory levels should never exceed SACS-established maximum levels. When indenting, ensure that a facility reach to max level of stock on hand….

Inventory Levels – ARV DrugsStep Formula State/CMSS Level ARTC LAC

1. Lead Time for Placing and Filling Orders

Set by NACO 9months 1month 1month

2. Review Period Between Routine Stock Assessments

Set by NACO 6months 3months 1month

3. Safety Stock/ Buffer Stock

Safety ≥ ½ Review 3monthsofstock 1.5monthsofstock(roundedupto2months)

0.5monthofstock(roundedupto1month)


4. Min Level of Stock

Min = Lead + Safety Stock

12monthsofstock 3monthsofstock 2monthofstock

5. Max Level of Stock

Max = Min + Review 18monthsofstock 6monthsofstock 3monthsofstock

6. Emergency Order Point

Emergency Order Point = Longest Lead Time for Emergency Shipment

3months 1months 1month

Note:All facilitiesplaceanemergencyorder if their stock levels reachquantities thatwillonly last for2weeks.

TABLE 6.0 – Commodity Level Assessment

Facilitiesassessstocklevelseverytimeanindentisplaced.Ifexcessstockortoolittlestockisidentified,theissuingfacilitiyisnotifiedasstatedinthefollowingtable.

Intheeventthatthestocklevelisfoundtobezero,orstockedoutforARVDrugs:

• StatesplaceemergencyorderstoCMSS/NACO.

• ART/LACplaceemergencyordertoSACS

• SACSissuesapurchaseorderstosuppliersbasedonapprovalsfromNACO.

Level If excess stock is found (above “max”)… If too little stock is found (below “Min.”)…

SACS � Redistributeasperneed � Placeemergencyorderfromprocurementagent/supplierunderintimationtoNACOaftertakingapprovalfromNACO

ART Centres � ReturntoSACSStoreforredistribution

� NotifySACSStore

LAC Centres � Redistributewithincatchmentarea;ifnotneeded,thenreturntoARTforredistribution

� NotifyART

TABLE 7.0 – Indent Schedule

SACSemploysapullsystembelowthestatestores. Eachservicelevel(e.g.ServiceDeliveryPoint,regionalstore,State)placesindentatspecifictimeperiods.Theseindentintervalsareasfollowsfor

Level Indent Frequency: Indent is Sent to:

NACO � Annually � ToProcurementAgents

SACS � Biannually � ToCMSS

ART � Quarterly � ToSACSStore

LAC � Monthly � ToART

Note: SACS submit purchase orders to local suppliers only when faced with an emergency stock out based on approvals from respective division of NACO. A percentage of their budget is allocated for these types of emergency orders.

Step Formula State/CMSS Level ARTC LAC


PURPOSE

Thepurposeofforecastingistoaccuratelyestimatethequantityoftheselectedproductsneededovertheannualplanperiodbytheentirestate.

SCOPE

ThescopeofthisprocessisfocusedonNACOwithinter-linkagestoSACS.ItisalsolimitedtoARVdrugsandothercommodities

LMIS RESOURCES

TheseLMISresourcesarerequiredtosuccessfullycompletethisSOP:

Record/FormName

• Forecasting Tool (Excel based)

• Forecasting Output (Excel sheet), Summary Report

• Indent Form

OtherForms/Recordsreferredtointhisprocedure

• PurchaseOrder/LoA

• RateContracts

PROCEDUREThisprocedurecomprisesoftwosteps:

1. Forecasting of ARV drugs and Other Commodities

2. Procurement of ARV Drugs and Other Commodities

Sub-stepsarenotedasfollows:

1. Forecasting of ARV Drugs and Other Commodities 1.1 NACO Level (CST and Procurement Division)

Steps Instruction /Activities LMIS Tools Used

1.1.1 Collectallinputdatarequiredfortheforecastingtool(excelbased) Forecasting Tool, Forecasting Output and Summary Report

1.1.2 Incorporateallchangessuchasthoserelatedtonewproducts,treatmentguidelinechanges,targetpopulationetc.

1.1.3 Collateandcleaninputsdataandgeneratetheforecastingoutputinthetool.

1.1.4 Analyzeandextractoutputdataofforecastingtoolasagroupandfine-tuneifrequired.

Forecast and Procure Commodities 17


1.1.5 Inviteforecastingcommitteemembers(TRG)topresentoutputdataandconductgroupdiscussiononmethod,assumptionsconsideredandrationaleused.

1.1.6 Aggregateallinputs/suggestionsfromexpertsandshareminutesofthemeetingwithdetailsofforecastingexerciseandconclusions

1.1.7 Shareovere-mailwithhigherofficialsthefinaloutputandsummaryoffeedbackandapproval

1.1.8 Kickstartprocurementplanningusingtheforecastingoutputastheinputforindenting.

1.1.9 ProcessanannualindentforapprovalandsubmittotheProcurementDivisionofNACO

Indent Form

2. Procurement of ARV Drugs and Other Commodities 2.1 NACO Level (Procurement Division, CST Division and SACS)


1.1.1 AssessmentoftheIndentsubmittedbyprogrammedivisionsconsideringthefollowing:(Refer to Page no. 57 Table 7)

Procurement Manual for

National AIDS Control Programme

2.1.1.1 Currentstockavailableatnationallevelandexpectedstockpositionattimeofsendingtheindent

2.1.1.2 Budgetavailabilityandsources

2.1.1.3 Checkprocurementcycleandmodeofprocurement.

2.1.1.4 Projectedtimescalefordistribution,listofconsignees,deliveryschedules,storagecapacityatalllevelsetc.

2.1.2 Submitfinalizeddemandtoempaneledprocurementagentalongwithkeydetailsliketechnicalspecifications,consigneelist,deliveryscheduleetc.

Indent Form

2.1.3 Followupandoversightofallsub-activitieswithprocurementagentlikeTendering(Preparation,Advert,Issue,BidOpening,Evaluation,AwardofContract),Pre-dispatchinspection&QA,notificationsofdeliverytoconsignee,receiptofconsignment,resolutionofanydisputeetc.

Bid documents, NOA, PO and Delivery

2.1.4 Processpaymenttoprocurementagentagainstthesubmitteddocuments

EFFECTIVENESS CRITERIA / CRITERIA FOR COMPLETION

FortheSOPtobecompletedaccuratelyandcompletely,thefollowingcriteriamustbemet:

� AnnualquantityisdeterminedforARVDrugsandOtherCommodities

� Thefinaldeterminedquantityisapprovedandvalidatedbyalldivisions

� ProcuredandsuppliedalldeterminedquantitytoSACSwarehouse

REFERENCES

A.NOTEALLAPPLICABLEReferencepolicies/laws/regulations

1. Procurement Manual for National AIDS Control Programme (NACP III)- Oct 2007


PURPOSE

Monitoringcommoditylevelsisthesupplychainprocessinwhichsupplychainmanagersensurethatinventorylevelsaresufficienttomeetthefacilityrequirements.Thismeansmaintaininganaccurateinventorycount.Properandaccurateinventorycountmanagementiscrucialtoindenting,dispensing,andaccounting.Withoutaccurate inventorycounts,noneofthesefunctionscanbeperformedproperlywhichcanresult indelayeddeliveries,stockouts,andproductwastage.

SCOPE

This SOP applies to all facilities which store and dispense commodities.

LMIS RESOURCES

These LMIS resources are required to successfully complete this SOP:

Record/Form Name

• Stock Register/ IMS

• Bin Card

• RTD Form

• Indent Form

• Issue and Receive Form

OtherForms/RecordsReferredtointhisProcedure

• Applicablestorageguidelinesaspermanufacturerrequirements

• Applicabledestructionguidelinesaspermanufacturerrequirements

Note: ONLY SACS Stores and Regional Stores use Bin Cards. A Bin Card is not required at other facilities because inventory levels are such that a Stock Register is sufficient for monitoring inventory.

PROCEDUREThisprocedureiscomprisedof2steps:

1. Assess commodity conditions.

2. Verify commodity levels.

Monitoring Commodity Conditions and Levels18



1. Assess Commodity Conditions1.1 SACS Store/Regional Store/ART/LAC


1.1.1 Monitorcommodityconditionsonschedule. (Refer to Page No. 43 Figure 6)

--

1.1.2 Evaluatecommodityconditions. (Refer to Page No. 43 Figure 6)

--

1.1.3 Stackallcartonsneatly.Makesurepartiallyfilledcartonsareclearlyvisible --

1.1.4 Ensureallproductsareorganizedaccordingto“FirstExpiry,FirstOut”(FEFO).(RefertostockrotationchapteronPageNo.45)

--

1.1.5 Checkthatexpirydatesareclearlymarked(e.g.,withlarge,darknumbers)oneachboxand/orcarton.

--

1.1.6 Visuallyinspectcommoditiestoensurethatthereisnodamageornearexpiry(lessthan90days)orexpired. Ifdamaged,nearexpiryorexpiredcommoditiesarefound:

1.1.6.1 Separatethemintoaquarantinearea. IMS/ Stock Register

Bin Card (for SACS/ Regional Stores only)

RTD Form

1.1.6.2 WriteDamaged,NearExpiry,orExpiredonthebox.

1.1.6.3 RecordthequantityofexpiredordamagedstockasalossontheappropriateStockRegister/BinCardandsubtractthequantityfromtheBalancecolumn.

1.1.6.3 Addressdamage,nearexpiry,orexpiryusingRTDForm (Refer to Page No. 56 Table 4)

1.1.6.4 Disposedamaged/expiredcommodities.

1.1.6.5 Redistributenearexpirycommoditiestofacilitieswhocanissue/dispensebeforeexpirydate.


2. Verify commodity levels2.1 SACS Store/Regional Store


2.1.1 Monitorcommoditylevelsonschedule. (Refer to Page No. 57 Table 6)

--

2.1.2 Countstock: --

2.1.2.1 Countunopened/completecartonsfirst.Multiplythenumberofcartonsbythenumberofunitsinthecarton.

--

2.1.2.2 Counttheboxesinsidetheopencartons.

2.1.2.3 Ifanopencartoncontainsunopenedboxes,counttheboxesandmultiplybythenumberofunitsinabox.Thiswillgiveyouthetotalnumberoftheunitsintheunopenedboxes.

2.1.2.4 Countallindividualunitsthatareinopenboxes.

2.1.3 Evaluatecommoditylevelsagainstmax-minlevelorEOP. (Refer to Page No. 56-57 Table 5)

Stock Register /IMS

Bin Card (for SACS and Regional Stores only)

Indent and IR Forms

2.1.3.1 Addupthetotalunitsandthisistheactualquantityofstockonhand.

2.1.3.2 SubtractthecalculatedStockBalanceasrecordedinStockRegister/BinCardfromtheActualQuantityonHand.

2.1.3.3 Ifyourresultiszero,yourStockRegister/BinCardmatchthenumberofunitsofthecommoditiesinthestore.

2.1.3.4 Ifyourresultisanegativequantityyouhavesufferedalossofthecommodity.Adjustthesameinstockregister/bincard

2.1.4 CreatealineitemonStockRegister/BinCardlabeled“PhysicalCount”andwritethequantitycounted.

Stock Register /IMS


2.1.5 Compareamountofcommoditytorecommended“max”quantity. Stock Register /IMS


IR Form,

RTD Form and Indent

2.1.5.1 Multiplyyouraveragemonthlyconsumptionbymaximummonthsofstock.Thisistherecommended“max”quantity.

2.1.5.2 Compareyourstockonhandtotherecommended“max”quantity. (Refer to Page No. 56-57 Table 5)

Ifmorethanmax,then…

2.1.5.3 WriteExcessonthecartonswhichareexcess.

2.1.5.4 Stackexcessinventoryseparatelyfromusablestocks.RedistributeusingRTDForm. (Refer to Page No. 56 Table 4)

2.1.5.5 Recordthequantityredistributedasanegative“adjustment”inStockRegister/BinCardasfollowswithadashthatlookslikethis:“-“.(Refer to Page No. 56-57 Table 5) Ifatorbelowminlevel,then…

2.1.5.6 PlaceemergencyindentusingIndentForm.


2.2 Dispensing facilities (ART, LAC)


2.2.1 Onceaweek,transferquantitiesissuedasrecordedinDailyDispensingRegisterintoStockRegister.

DDR/ IMS (Dispensing Module) Stock Register

2.2.2 Monitorcommoditylevelsonschedule. (Refer to Page No. 55 Table 2)

--

2.2.3 Countthestock --

2.2.2.1 Countunopened/completecartonsfirst.Multiplythenumberofcartonsbythenumberofunitsinthecarton.

2.2.2.2 Counttheboxesinsidetheopencartons.

2.2.2.3 Ifanopencartoncontainsunopenedboxes,counttheboxesandmultiplybythenumberofunitsinabox.Thiswillgiveyouthetotalnumberoftheunitsintheopenboxes.

2.2.2.4 Countallindividualunitsthatareinopenboxes. Stock Register and IMS2.2.3 EvaluatecommoditylevelsagainstmaxlevelorEOP.

(Refer to Page No. 56-57 Table 5)


2.2.3.2 SubtractthecalculatedStockBalanceasrecordedinStockRegisterfromtheActualQuantityonHand.

2.2.3.3 Ifyourresultiszero,yourStockRegistermatchthenumberofunitsofthecommoditiesinthestore.

2.2.3.4 Ifyourresultisanegativequantityyouhavesufferedalossofthecommoditythenadjustthesameinstockregister/IMS

2.2.3.5 Ifyourresultisapositivequantity,youhavemoreunitsofthecommodityinstockthanyouhadrecordedontheStockRegister.

2.2.4 CreatealineitemonStockRegisterlabeled“PhysicalCount”andwritethequantitycounted.

Stock Register and IMS

2.1.5 Compareamountofcommoditytorecommended“max”quantity. Stock Register /IMS Indent Form IR Form RTD Form


2.2.5.2 Compareyourstockonhandtotherecommended“max”quantity. (Refer to Page No. 56-57 Table 5) Ifmorethanmax,then…

2.2.5.3 WriteExcessonthecartonswhichareexcess.

2.2.5.4 Stackexcessinventoryseparatelyfromusablestocks.RedistributeusingRTDForm. (Refer to Page No. 56 Table 4)

2.2.5.5 Recordthequantityredistributedasanegative“adjustment”inStockRegisterasfollowswithadashthatlookslikethis:“-“. (Refer to Page No. 56-57 Table 5) Ifatorbelowminlevelthen…




For the SOP to be completed accurately and completely, the following criteria must be met:

For commodity monitoring:

� Commodityconditionsaremonitoredaspertheestablishedscheduleandallitemsarestoredaccordingtoproperstorageguidelines.

• QuantityofcommoditiesonhandhasbeencountedandrecordedontheStockRegisterandBinCard.

• Losses/AdjustmentshavebeencalculatedandrecordedontheStockRegisterandBinCard,ifapplicable,andproperlyaccounted.Formoreinformationrefer Page No. 56 Table 4

For removal of damaged / expired or excess commodities:

� Damaged,expiredorexcesscommoditiesareseparatedfromusablestock.

� Damaged or expired stock is disposed as per Govt. norms and if destroyed, as per manufacturerrecommendation(LACreturndamagedorexpiredstocktoARTCenterfacility).

� Excesscommoditiesarereturnedtoissuingfacilities.

� StockRegistersandBinCardshavebeenupdatedasperthemovementofdamaged,expiredorexcesscommodities.

� RTDFormhasbeencompletedtoaccompanymovingcommodities

For indenting emergency commodities:

� IndentFormhasbeencompletedtorequestanemergencyorder

REFERENCES

A. NOTE ALL APPLICABLE Reference policies / laws / regulations


IndentCommodities

PURPOSEIndentingistheprocesstorequestproductquantitytoreplenishthestocklevel.Allcommoditiesarere-stockedtothepre-setmaximumlevel–nomatterhowmuchorlittleisinstock.

SCOPEThisSOPappliestoallfacilitieswhichindentcommodities.

LMIS RESOURCESTheseLMISresourcesarerequiredtosuccessfullycompletethisSOP:

Record/Form Name

• StockRegister• BinCard• RTDForm• Indent Form• IR Form


• PurchaseOrder/LetterofAcceptance(LOA)

• RateContracts


1. Determining the quantity to indent.

2. Submitting the indent to issuing store/Procurement Agent.


1. Determine quantity to indent1.1 NACO Level


1.1.1 Processindentquantitiesfromforecastingtools (Refer to Page No. 57 Table 7)

Indent Form, Forecasting Tool

1.1.2 Preparetheindentformforsubmissionandapprovalwithnecessarydetails. Indent Form

1.2 SACS Store


1.2.1 AggregateindentedquantitiesfromRegionalStore/ARTCandDAPCU/ICTCs.(Refer to Page No. 57 Table 7)

Indent Form/ Forecasting Tool

19


1.3 Regional Store, ART and LAC


1.3.1 Preparetoindentcommodities. (Refer to Page No. 57 Table 7)

Stock Register / IMS

1.3.2 Daypriortoscheduledindent,conductphysicalinventorycounttoverifycommoditylevels.

--

1.3.3 Notediscrepancies,ifany,betweenStockRegister/IMS/BinCardandphysicalinventoryinStockRegister.

Stock Register/IMSBin Card (for SACS and Regional stores only)

1.3.4 Computeaveragemonthlyconsumptionusinglast3monthsofconsumptionunlessdirectedotherwise.


1.3.4.1 1. For products in full supply:- ReviewissuesdatainStockRegister/IMSforownfacilitytoget

consumptiondata.

Stock Register/IMSDaily Dispensing Register/IMSIndent Form

1.3.4.2 2. For products that have been stocked out at any point in the last 3 months:-AggregateaveragemonthlyconsumptionfromIndentandIssues/ReceiveFormsforallrequestingfacilities:

• SACSaggregatesRegionalStoresandARTindentsandIssue/ReceiveForms

• RegionalStoreaggregatesART(ifregionalstoreavailable)

• ARTaggregatesLACIndentandIssue/ReceiveForms

1.3.4.3 3. For products that are stocked out at both indenting and requesting facilities:

- ReviewissuesdatainStockRegister/IMSforownfacilityforthemostrecentperiodduringwhichtheproductwasavailable.

1.3.5 CalculatehowmuchofeachcommodityisrequiredforlevelstobebroughtuptomaxlevelsusingtheIndentForm.

Stock Register / IMSIndent Form/ Daily Dispensing Register

1.3.6 Preparetheindentforsubmissionandsigntheformwithnecessarydetails. Indent Form


2. Submit indent to issuing store / Procurement Agent;2.1 NACO Level


2.1.1 RequestingDivisionsubmitsIndentFormtoProcurementDivisionofNACO(Refer to Page No. 57 Table 7)

Indent Form

2.1.2 ProcurementDivisionsubmitsapprovedindenttoProcurementAgentsofNACO

--

2.2 SACS Store, Regional Store, ART, LAC


2.2.1 SubmitIndentFormtoissuingfacilities (Refer to Page No. 57 Table 7) Indent Form



� Commoditylevelsareassessed.

� Orderquantitiesarecalculated.

� IndentFormiscompleted.

� IndentFormisapprovedandsubmitted.

REFERENCES

A.NOTEALLAPPLICABLEReferencepolicies/laws/regulation


Receive and Store Commodities

PURPOSEReceivingisthesupplychainprocessofacknowledging,inspecting,andloggingreceivedcommoditiesintoinventory.

Errorsinreceivinghavearippleeffect.Ifanindent/issues/packaginglistareimproperlyfilledorcommoditiesarecountedincorrectly,theninventorylevelswillbeinaccuratewhichcanresultinoverstockorstockouts.Similarly,ifcommoditiesareputawayincorrectly,thenthereisriskoflosingproductdutoexpiryorstaffwillwastetimelookingforproductatthetimeofissue.

SCOPEThisSOPappliestoallfacilitieswhichreceiveandstorecommodities.


Record/Form Name

• StockRegister/IMS

• BinCard

• Indent Form

• IssueandReceiveForm(IRForm)


• Invoice

• PackingList

• CertificateofAnalysis(CoA)

• ConsigneeReceiptCertificate(CRC)

• ConsigneeAcceptanceCertificate(CAC)

• GoodsReceiptNote(GRN)

Note: ONLY SACS Store and Regional Stores uses Bin Cards. A Bin Card is not required at other facilities because inventory levels are such that a Stock Register is sufficient for monitoring inventory.


1. Receive commodities which includes inspecting and recording receipts.2. Store (Put away) commodities.

20



1. Receive commodities which includes inspecting and recording receipt:1.1 SACS Store and Regional Store


1.1.1AsperthePurchaseOrder/NOA,warehousereceivesthegoodsalongwithconsignmentdocuments.

Email/IMS /NACO

1.1.2 Checkcompletenessoffollowingdocuments:

Purchase Order (in case of local procurement)InvoicePacking List Delivery Note

1.1.2.1 • Twocopiesoforiginalinvoicesignedbyauthorizedsignatory

• PackingList/Transportreceipt/DeliveryNote

1.1.2.2

Ifanydiscrepancyisfound,reportthesametoNACO/ProcurementAgent.IncaseofmismatchbetweenPO,shipmentdetails,andinvoice;donotacceptcommoditiesuntilwrittenconfirmationisprovidedtoresolvethediscrepancy.

1.1.3VerifyquantitiesissuedarethesameasrecordedonthePurchaseOrder/Invoice/packaginglist/COA

Purchase Order (In case of local procurement)InvoicePacking ListDelivery Note

1.1.3.1

IfquantitiesareNOTthesameasPurchaseOrder/invoice/packaginglist,donotacceptcommoditiesuntilwrittenconfirmationfromissuerisprovidedthatquantitydeliveredislessthannotedonthePurchaseOrder/invoice/packaginglist/deliverynote.

1.1.4Inspectcommoditiesforphysical,chemicalormanufacturingdefects. (Refer to Page No. 58 Table 3)

1.1.4.1Ifdamageisfound,rejectcommoditiesandreturntosupplierforreplacement

--

1.1.4.2Ifnodamageisfound,acceptorderandgenerateGoodsReceivedNote(GRN)andprovidealldocumentstoProcurementAgent/NACO

--

1.1.5Endorsethesupplier/CMSSdocumenti.e.IssueSlipcumAcknowledgmentReceipt/TransportReceipt/DeliveryNote Purchase Order

(in case of local purchase),Invoice, Issue Slip cum Acknowl-edgment Receipt, Transport Re-ceipt/Delivery Note

1.1.5.1Receiverfilescopiesofallsignedforms(asnotedincolumntotheright).

1.1.5.2 Supplier/ProcurementAgentreceivescopyofforms.

1.1.6Ifdocumentsarefoundinorderandquantitiesandqualityofcommoditiesarecorrect,acceptthegoodsinreceivingareaofwarehouse

--

1.1.7 CompleteallentryofreceivedcommoditiesinIMSIMS and Stock Register


1.2 ART and LAC


1.2.1Receivemail/IMSnotificationfromSACSStorethatcommoditiesarereadyfordispatch.(Refer to Page No. 57 Table 6)


1.2.2 Receivecommoditiesatissuingfacility. --

1.2.3 VerifyquantitiesissuedarethesameasrecordedontheIRForm: IR Form/IMS, STN 1.2.3.1

IfquantitiesareNOTthesameasIRForm,donotacceptcommoditiesuntilwrittenconfirmationfromissuerisprovidedthatquantitydeliveredislessthannotedontheIRForm/STN.

1.2.4Conductpreliminaryphysicalinspectionforqualityofshipment.(Remember–apackagecanbedamagedbutthecommoditycanstillbeusable.) (Refer to Page No. 56 Table 3)

1.2.4.1Ifqualityproblemordamageisfound,notifyissuer.Quarantinegoodstillissuesareresolved.

--

1.2.5

SignIR/STNFormtoconfirmreceipt:• Issuingfacilitysigns,stampsandkeeporiginal• Receivingfacilitysignsandstamps1copyandreturntotransporterof

shipment• Receivingfacilitykeeps1copyforfiles.

Indent Form/Issue and Receive Form /IMS/STN Form

1.2.6 Receivethecommoditiesinstockregister/IMSStock Register / IMS

2. Store (Put away) commodities:2.1 SACS Store and Regional Stores


2.1.1Putawaycommoditiesaccordingto“FEFO”(FirstExpiry,FirstOut)topreventexpiry;andplaceolderproductsabovethenewerones.

--

2.1.2 Storethegoodsonpalletsandshelves(Refer to Page No. 45 Figure 9) --

2.1.3 RecordreceiptinStockRegister/IMS,BinCard.Stock Register/ IMSBin Card


2.2 ART, LAC


2.2.1VerifyquantitiesissuedarethesameasrecordedontheIR/STNsForm: (Refer to Page No. 57 Table 7)

Indent Form , IR Form, STN

2.2.1.1 IfquantitiesarethesameasIRForm,acceptcommodities.

IR Form/ IMS STN2.2.1.2

IfquantitiesareNOTthesameasIRForm,donotacceptcommoditiesuntilwrittenconfirmationfromissuersaysthatquantitydeliveredislessthannotedontheIRForm.

2.2.2 Conductfinalphysicalinspectionforquality.(Refer to Page No. 56 Table 3)

2.2.2.1 Checkforphysical,chemical,ormanufacturingdefects. --

2.2.2.2Verifyexpirydate.Iftheexpirydateislessthan90daysaway,thenreturnthecommoditiestothesourceofsupplytopreventanydispensingofexpiredcommoditiesbymistake.

--

2.2.2.3 Verifybatchnumbers.

2.2.2.4Ifqualityproblemordamageisfound,notifySACSQuarantinegoodstillissuesareresolved.

--

2.2.3 RecordcommodityinformationontheStockRegister/IMS.Stock Register/IMS

2.2.4

Putawaycommodities:• Ifthelabelonlystatesthedateofproduction,calculatetheexpirydateand

addtheperiodofstorageontheshelf.• Writedownthedateofexpiryonthecardboardboxinlargeboldnumbers

orletters.

--

2.2.5Storecommoditiesaccordingto“FEFO”(“FirstExpiry,FirstOut”)topreventexpiry

--



� Commoditiesarereceived.

� Damagedorexpiredstockhasbeenseparatedfromusablestock.

� StockRegisters/IMSandBinCardshavebeenupdated.

� RTDFormhasbeencompleted(ifnecessary).

� Commoditiesareputaway.

REFERENCES



Issue and Dispense Commodities

PURPOSEIssuingisthesupplychainprocessofreceivingandfulfillingindents.Forservicedeliverypoints,dispensingisthesupplychainprocessofissuingcommoditiestoclients.

SCOPEThisSOPappliestoallfacilitieswhichissueanddispensecommodities.


Record/Form Name

• Indent Form

• Stock Register

• Bin Card

• IR Form

• IMS Dispensing

• Daily Dispense Register (DDR)


• N/A



1. Receive and review indent.2. Issue commodities according to the indent.

Forservicedeliverypoints:

3. Dispense to clients.


1. Receive and review indent:1.1 SACS Store, Regional Store and ART


1.1.1 ReceiveIndentFormfromreportingfacility.(Refer to Page No. 57 Table 7) Indent Form

1.1.2 ReviewIndentFormtoconfirmcalculations.Correctifneeded. • Ifcorrectionsaremade,notifyindentingfacility.

Indent Form

21


2. Issue commodities according to the indent between facilities:2.1 SACS Store, Regional Store and ART


2.1.1 Aggregateallindentsfromtherequestingfacilitiesfordistributionplanning Indent Form

2.1.2CheckstockavailabilityintheStockRegister/IMStofinalizethequantitytobeissued:

Indent FormStock Register/ IMS

2.1.3 2.1.2.1Ifproductisavailableinenoughquantity,fulfilltheIndentFormrequest.

2.1.2.2Ifproductisnotavailableinenoughquantity,rationtheindentedquantity.

2.1.2.3 Ifproductisnotavailable,findthesubstituteproduct,ifpossible.

2.1.2.4Ifsubstitutionisnotpossibleanddemandisurgent,informtoNACO/SACStosupportonrelocationfromotherstates/facilities

2.1.2.5Ifsubstitutionisnotpossibleanddemandisnoturgent,waittillproductbecomesavailablethroughProcurementAgent/SACS

2.1.3 DevelopthedistributionplanforapprovalDistribution Plan

Calloremailindentingfacilitiestoupdateonapproveddistributionplan

2.1.4 CompleteIR/STNFormasperapproveddistributionplan IR/STN Forms

2.1.5 SelecttheavailableproducttobeissuedbyFEFO(“FirstExpiryFirstOut”). IR/STN Forms

2.1.6 Prepareshipmentofcommodities,asperIR/STNForm IR/STN Forms

2.1.7 Notifyreceivingfacilitythatindentisreadytobeshipped. IR/STN Forms

2.1.8 RecordtheissuedquantityinStockRegister/IMS/BinCard.Stock Register / IMS

3. Dispensing:3.1 ART and LAC


3.1.1DispensethedrugstotheclientasprescribedinpatienttreatmentrecordbySMO/MO(WhiteCardandGreenBook)

Patient Treatment Record

CheckstockavailabilityintheStockRegister/IMStofinalizethequantitytobeissued:

IMS/ Stock Register

3.1.1.1 Ifdrugsisavailableinenoughquantity,fulfilltheprescription.

3.1.1.2IncaseofTLE/ZLNfollowMMDpolicyforthosewhoareeligibleforMMD


3.1.1.3Ifproductisnotavailableinenoughquantity,rationtheprescribedquantity.


3.1.1.5Ifsubstitutionisnotpossibleanddemandisurgent,initiatethelocalpurchaseorinformtoSACSforemergencyrelocation

3.1.1.6Ifsubstitutionisnotpossibleanddemandisnoturgent,waittillproductbecomesavailablethroughSACS/Regionalstore

3.1.2 SelectthedrugstobeissuedbyFEFO(FirstExpiryFirstOut).

3.1.3 Dispensethedrugstopatient

3.1.4Counselthepatientonpossibledrugtoxicitiesandreportthesame,ifsignificant

3.1.5 RecorddispensedcommoditiesinIMS/DailyDispensingRegister IMS / DDR

3.1.6

RecordtotalquantityissuedintheIMS/DrugDispensingRegisterinStockRegisterattheendofthedayFormoreinformationonIMSDispensingmodulepleasewatchvideoavailableon YouTube:https://www.youtube.com/watch?v=Y1aSHSLOdpk&feature=youtu.be)

IMS/DDR/ Stock Register

3.1.7PatientcollectsdrugsfromdispensingcounterandrealtimeentryofthedrugsdispensedtopatientisrecordedinIMS

IMS



EffectivenessCriteria/CriteriaforIssueCompletion:

� IndentFormiscompleteandaccurate.

� Indentquantitiesarevalidated.

� DistributionPlanisapproved.

� Issuequantityispicked.

� Issuesquantityisreadyforpackagingandshipping.

EffectivenessCriteria/CriteriaforDispensingCompletion:

� Clientiscounselled.

� Commodityisdispensed.

� DailyDispensingRegisterisupdated.

� StockRegister/IMSareupdated.

REFERENCES



Distribute Commodities (Packaging and Transportation)

PURPOSEDistributionisthesupplychainprocessafterissuingofcommoditiesagainsttheindents.Keystepsinthedistributionprocessinclude:1. Packagingofcommodities.2. Distributionofcommoditiesaccordingtotheindentandissue.

SCOPEThisSOPappliestoallfacilitieswhicharechargedwithdistributionofcommodities.


Record/Form Name

• Indent Form

• IR Form

• STN from IMSOtherForms/RecordsReferredtointhisProcedure

• Distribution Plan

• Route Plan

• Dockets


4. Packaging of commodities5. Distribution of commodities according to the indent and issue.


1. Packaging of commodities:1.1 SACS Store, Regional Store and ART


1.1.1 AggregateallissuequantityasperapproveddistributionplanforARVdrugs IR/STN Form

1.1.2 Prepareforpackaging24hoursinadvancefromthedateofloading • Arrangesufficientpackagingmaterial

• Packalllooseitemsincartonbox,Marktheboxeswithfacilityname;incaseoflooseitemmarkdrugnameandquantity

IR/STN Form

1.1.3 Arrangetheboxesinseparatelotsonstagingareaofthewarehouse/storeforloadinginthevehicle

IR /STN Form

22


2. Distribution of commodities according to the indent and Issue:2.1 SACS Store, Regional Store and ART


2.1.1 Selectanappropriate transportationmodelbasedon thevolumeof the totalboxestobedistributed:

• Dedicatedvehicle:ForARVdrugsandothercommodities

• Fulltruckload(FTL):Forhighvolumeshipment

• Couriermode:foremergencyrelocation

IR/STN Forms

Distribution and Route Plan (Not LMIS Part) 2.1.2 Developrouteplanbasedondistributionlistinconsultationwithtransporter

2.1.3 Sharerouteplanfordistributionwiththetransporter

2.1.4 HandoverIR/STNformintriplicate:I. TransporterissuesdocketagainstIR/STNII. TransporterprovidesonecopyofdockettotheconsignorFilethedocumentsatyourlocation

IR/STN Form , Docket

2.1.5 Handoverthestockstothetransporterontheagreeddateandtime Docket (Transport document)

2.1.6 Tracktheshipmentuntilsignedandstampedproofofdelivery(POD)isreceived PODs (Docket and IR/STN)

2.1.7 Allow facilities Store to verify correctness of issue and visually inspectcommodities.

Docket, IR/STNs

2.1.7.1 Ifanyerrorsarefound,immediatelyinformtoissuingfacilities

2.1.7.2 SignIR/STNFormtoconfirmreceivingofcommodities: • Keep1copyatreceivingfacilities

2.1.7.3 Returnsignedandstampedcopytotransporter

2.1.8 Record any variances during the transportation and claim to transport orinsurancecompanyasnecessary.

Stock Register/ IMS


ForthisSOPtobecompletedaccuratelyandcompletely,thefollowingcriteriamustbemet:

Effectiveness Criteria / Criteria for Distribution Completion:

� PackingofdrugsandKitscompletedasperinstruction

� Distributionplannedandproductsmovedtofacilities

� IR/STNFormsignedhandedovertotransporter

� Receivingfacilityuponreceiptofcommoditiestoacknowledgereceipton:

o IR/STNandtransportdocketso Onecopyremainswithreceivingfacilitieso Onecopysignedandstampedandreturnedtoissuerfortheirrecord

REFERENCES



Standard Operating Procedures for HIV Test Kits and Other

Cold Chain Commodities


SOP for HIV Test Kits Flow Process 23


Commoditymanagementconsistsofsixfundamentalprocessesthattakeplaceineveryfacilityateachlevelwithinthesupplychain:

Standard Operating Procedures24

ForecastandProcurecommodities


IndentCommodities


IssueCommodities


1

23456


EachSOPiscomprisedofthefollowingparts:

• Overview:Listsall reference informationneededtoknowwhentheSOPwasauthorizedandwhois inchargeofit;

• Purpose: OutlinesbrieflytheobjectiveofthisspecificSOP; • Scope: DescribeswhichfacilitiesmustfollowthisSOP; • Responsible Persons: ListsthepeoplewhoareresponsibleforimplementingtheSOP

(Please refer Table 1.0 on Page No. 81); • Forms / Records: ListstheLMISformswhicharerequiredtocompletetheseSOPs; • Procedure: ListseachstepthatmustbecompletedtoensurethattheSOPisfullycompleted; • Effectiveness Criteria / Criteria for Completion: this is a checklist that is used after a SOP has been

completedtoensurethattheSOPwascompletedfullyandaccurately; • References: Listsanyexistinglaws,policies,orregulationsthatimpacttheimplementationoftheseSOPs; • Revision History:SOPsaredynamicandevolvingdocuments. Assystemsevolve, theSOPshouldalso.

Revisionsaremadeandtrackedusingthissection.


Standard Operating Procedures Reference Tables

Thefollowingtablesnotekeypolicydecisionswhichareusedtoguideday-to-daysupplychainoperations.Eachisreferenced,whereapplicable,inindividualSOPwhichfollow.

Tables Components

TABLE 1 Responsible Persons

TABLE 2 Physical Inventory Schedule

TABLE 3 Quality Assurance

TABLE 4 Removal and Return of Damaged and/or Expired Commodities and/or Return of Near-Expired Commodities

TABLE 5 Maximum Inventory Levels ( Not to Be Exceeded) and Emergency Order Point

TABLE 6 Commodity Level Assessment

TABLE 7 Indent Schedule

TABLE 1.0 – Responsible PersonsThefollowingpeopleareresponsibleforthisSOP:

Level Person Who Completes Task

Person Who Reviews the Task

Person Who Approves Task

SACSWIC Pharmacist/StoreKeeper StoreIncharge/DeputyDirector

JDBSD

DAPCUWIC DistrictSupervisor(DS) DistrictProgramOfficer(DPO)

DistrictProgramOfficer(DPO)

SA-ICTCs LabTechnician/Counsellor

MedicalOfficer MedicalOfficer

FICTCs LabTechnician/Counsellor

MedicalOfficer MedicalOfficer

TABLE 2.0 – Physical Inventory Schedule

EachfacilityconductsaphysicalinventoryaspertheSACSdeterminedschedulewhichisasfollows:

Facility Level Physical Inventory Conducted: Report to:

SACS WIC Halfyearly PD

DAPCU WIC Quarterly StoreIn-Charge–SACS

SA-ICTCs Quarterly JD-BSD

FICTCs Monthly MedicalOfficer,SA-ICTC

25


TABLE 3.0 – Quality Assurance

Each facility should verify the following aspects of each commodity upon receipt. If anything does not pass inspection, then they should be returned:

Physical Inspection Component What is Checked:

1. Physical damage Verify the physical integrity of a commodity: • Ensurenocrushing,tearing,rubbing,orripping

• Look for signs like: tears, perforations, water or oil or broken orcrumbledtestsorbrokenbottles

• Verifythattemperaturewasmaintainedduringthetransportation

• ChecktheHEATmarkerindicatoronthekits

2. Chemical damage Verify the chemical integrity of a commodity: • Ensurenochangeincolororconsistencyorsmell

3. Manufacturing defects Verify labeling is as required in the purchase order: • Ensurelabelingiscorrect,batchno.andexpirydatearestamped

TABLE 4.0 – HIV TESTING KITS – Removal and Return of Damaged and/or Expired Commodities and Re-distribution of Near-Expiry Commodities

Essential medicines and commodities are monitored on a regular basis. When damaged, near expiry, or expired commodities are found, each level responds as established in the table below:

Level If damaged then… If near-expired or excess then… If expired then…

SACS - WIC � DisposeasperGovt.norms

� Redistributeasperneedtofacilities


DAPCU - WIC � DisposeasperGovt.norms

� Redistributewithinfacilities;ifnotneeded,thenreturntoSACS


SA-ICTCs � ReturntoSACSWIC

� ReturntoSACSWICforredistribution

� ReturntoSACS/WICs

FICTCs � ReturntoICTC � ReturntoICTCsforredistribution � ReturntoSA-ICTCs

TABLE 5.0 – Maximum – Minimum (Forced) Inventory Control SystemFacilityinventorylevelsshouldneverexceedSACS-establishedmaximumlevels.Whenindenting,ensurethatafacilityreachtomaxlevelofstock on hand….

Inventory Levels – HIV Test Kits

Step Formula State Level DAPCU SA-ICTC FICTC

1. Lead Time for Placing and Filling Orders

SetbyNACO 9months 1month 0.5month 0.5month

2. Review Period Between Routine Stock Assessments

SetbyNACO 3months 1month 1month 1month

3. Safety Stock/ Buffer Stock

Safety≥½Review 1.5monthsofstock(roundedupto2months)




4. Min Level of Stock Min = Lead + Safety 11 months of stock

2 months of stock

1 month of stock

1 month of stock


5. Max Level of Stock Max=Min+Review 14monthsofstock

3monthsofstock

2monthsofstock

2monthsofstock

6. Emergency Order Point

EmergencyOrderPoint=LongestLeadTimeforEmergencyShipment

3month 1month 1month 1month

Note: All facilities place an emergency order if their stock levels reach quantities that will only last for 2 weeks.

TABLE 6.0 – Commodity Level AssessmentFacilities assess stock levels every time an indent has to be placed. If excess stock or too little stock isidentified,theissuingfacilityisnotifiedasstatedinthefollowingtable.

Intheeventthatthestocklevelisfoundtobezero,orstockedoutforHIVTestingkits:

• StatesplaceemergencyorderstosuppliersaftertakingapprovalfromNACO

• DAPCUsplaceemergencyorderstoSACS

• ICTCsplaceemergencyordertoDAPCU/SACS

• SACSissuesapurchaseordertosuppliersbasedonapprovalsfromNACO.

Level If excess stock is found (above “Max.”)…

If too little stock is found (below “Min.”)…

SACS � Redistributeasperneed � PlaceemergencyorderfromCMSS/NACO/Suppliers

DAPCU � ReturntoSACSStoreforredistribution � NotifySACSStore

SA-ICTC � Redistributewithincatchmentarea;ifnotneeded,thenreturntoDAPCU/SACSforredistribution

� NotifyDAPCU/SACS(innon-DAPCUdistricts)

FICTC � Redistributewithincatchmentarea;ifnotneeded,thenreturntoSA-ICTCforredistribution

� NotifySA-ICTC

TABLE 7.0 – Indent ScheduleSACSemploysapullsystembelowthestatestores.Eachservicelevel(e.g.ServiceDeliveryPoint,DAPCU,State)placesindentatspecifictimeperiods.Theseindentintervalsareasfollows:

Level Indent Frequency: Indent is Sent to:

NACO � Annually � ToProcurementAgents

SACS � Annually � ToNACO

DAPCU � Quarterly � ToSACSStore

SA-ICTC � Quarterly � ToDAPCU/SACS(innon-DAPCUdistricts)

FICTC � Monthly � ToSA-ICTC

Note: SACS submit purchase orders to local suppliers only when faced with an emergency stock out based on approvals from respective division of NACO. A percentage of their budget is allocated for these types of emergency orders.

Step Formula State Level DAPCU SA-ICTC FICTC


Forecast and Procure Commodities

PURPOSEThepurposeofforecastingistoaccuratelyestimatethequantityoftheselectedproductsneededovertheannualplanperiodbytheentirestate.

SCOPEThescopeofthisprocessisfocusedonNACOwithinter-linkagestoSACS.ItisalsolimitedtoHIVKits


Record/Form Name

• Forecasting Tool (Excel based)

• Forecasting Output (Excel sheet), Summary Report

• Indent Form

OtherForms/Recordsreferredtointhisprocedure

• Purchase Order/ LoA

• Rate Contracts


1. Forecasting of HIV Testing Kits;2. Procurement of HIV Testing Kits


1. Forecasting of HIV Test Kits1.1 NACO Level (BSD and Procurement Division)


1.1.1 Collectallinputdatarequiredfortheforecastingtool(excelbased)

Forecasting Tool, Forecasting Output and Summary Report

1.1.2 Incorporateallchangessuchasthoserelatedtonewproducts,testingguidelinechanges,targetpopulationetc.

1.1.3 Collateandcleaninputdataandgeneratetheforecastingoutputinthetool.

1.1.4 Analyzeandextractoutputdataofforecastingtoolasagroupandfine-tuneifrequired.

1.1.5 Inviteforecastingcommitteemembers(TRG)topresentoutputdataandconductgroupdiscussiononmethod,assumptionsconsideredandrationaleused.

26


1.1.6 Aggregateallinputs/suggestionsfromexpertsandshareminutesofthemeetingwithdetailsofforecastingexerciseandconclusions

1.1.7 Shareovere-mailwithhigherofficialsthefinaloutputandsummaryoffeedbackandapproval

1.1.8 Kickstartprocurementplanningusingtheforecastingoutputastheinputforindenting.

1.1.9 ProcessanannualindentforapprovalandsubmittotheProcurementDivisionofNACO

Indent Form

2. Procurement of HIV Testing Kits2.1 NACO Level (Procurement Division, BS Division and SACS)


2.1.1 AssessmentoftheIndentsubmittedbyprogrammedivisionsconsideringthefollowing:(Refer to Page No. 83 Table 7)

Procurement Manual for

National AIDS Control Programme

2.1.1.1 Currentstockavailableatnationallevelandexpectedstockpositionattimeofsendingtheindent

2.1.1.2 Budgetavailabilityandsources

2.1.1.3 Checkprocurementcycleandmodeofprocurement.

2.1.1.4 Projectedtimescalefordistribution,listofconsignees,deliveryschedules,storagecapacityatalllevelsetc.

2.1.2 Submitfinalizeddemandtoempaneledprocurementagentalongwithkeydetailsliketechnicalspecifications,consigneelist,deliveryscheduleetc.

Indent Form

2.1.3 Followupandoversightofallsub-activitieswithprocurementagentlikeTendering(Preparation,Advert,Issue,BidOpening,Evaluation,AwardofContract),Pre-dispatchinspection&QA,notificationsofdeliverytoconsignee,receiptofconsignment,resolutionofanydisputeetc.

Bid documents, NOA, PO and Delivery

2.1.4 Processpaymenttoprocurementagentagainstthesubmitteddocuments

EFFECTIVENESS CRITERIA / CRITERIA FOR COMPLETIONFortheSOPtobecompletedaccuratelyandcompletely,thefollowingcriteriamustbemet:

� AnnualquantityisdeterminedforHIVTestingKits

� Thefinaldeterminedquantityisapprovedandvalidatedbyalldivisions

� ProcuredandsuppliedalldeterminedquantitytoSACS-WIC

REFERENCES


1. Procurement Manual for National AIDS Control Programme (NACP III)- Oct 2007


Monitoring Commodity Conditions and Levels

PURPOSEMonitoring commodity levels is the supply chain process in which supply chain managers ensure thatinventorylevelsaresufficienttomeetthefacilityrequirements.Thismeansmaintaininganaccurateinventorycount.Properandaccurateinventorycountmanagementiscrucialtoindenting,dispensing,andaccounting.Withoutaccurateinventorycounts,noneofthesefunctionscanbeperformedproperlywhichcanresultindelayeddeliveries,stockouts,andproductwastage.

SCOPEThis SOP applies to all facilities which store and dispense commodities.

LMIS RESOURCESThese LMIS resources are required to successfully complete this SOP:

Record/Form Name

• Stock Register/ IMS

• Bin Card

• RTD Form

• Indent Form

• Issue and Receive FormOther Forms/Records Referred to in this Procedure

• Applicable storage guidelines as per manufacturer requirements • Applicable destruction guidelines as per manufacturer requirements

Note: ONLY SACS Stores and Regional Stores use Bin Cards. A Bin Card is not required at other facilities because inventory levels are such that a Stock Register is sufficient for monitoring inventory.

PROCEDUREThis procedure is comprised of 2 steps:

1. Assess commodity conditions.

2. Verify commodity levels.

Sub-steps are noted as follows:

1. Assess Commodity Conditions1.1 SACS Store/ DAPCU/ICTC/FICTC


1.1.1 Monitorcommodityconditionsonschedule.(Refer to Page No. 43 Figure 6) --

1.1.2 Evaluatecommodityconditions.(Refer to Page No. 43 Figure 6) --

1.1.3 Stackallkitsneatly. --

27


1.1.4 Ensureallproductsareorganizedaccordingto“FirstExpiry,FirstOut”(FEFO).(Refer to stock rotation chapter on Page No. 45)

--

1.1.5 Checkthatexpirydatesareclearlymarked(e.g.,withlarge,darknumbers)oneachkit.

--

1.1.6 Visuallyinspectcommoditiestoensurethatthereisnodamageornearexpiry(lessthan90days)orexpired.

IMS/ Stock RegisterBin Card (for SACS/ Regional Stores only)RTD Form

1.1.6.1 Separatethemintoaquarantinearea.

1.1.6.2 WriteDamaged,NearExpiry,orExpiredonthebox.

1.1.6.3 RecordthequantityofexpiredordamagedstockasalossontheappropriateStockRegister/BinCardandsubtractthequantityfromtheBalancecolumn.

1.1.6.3 Addressdamage,nearexpiry,orexpiryusingRTDForm (Refer to Page No. 82 Table 4)

1.1.6.4 Disposedamaged/expiredcommodities.

1.1.6.5 Redistributenearexpirycommoditiestofacilitieswhocanissue/dispensebeforeexpirydate.

2. Verify commodity levels2.1 SACS and DAPCU WIC


2.1.1 Monitorcommoditylevelsonschedule(Refer to Page No. 81 Table 2) --

Countstock: --

2.1.2 2.1.2.1 Countunopenedkitsfirst.Multiplythenumberofkitsbythenumberoftestsinthekit.

--

2.1.2.2 Kitsshouldbeissuedasawholebox.

2.1.3

Evaluatecommoditylevelsagainstmax-minlevelorEOP. (Refer to Page No. 82-83 Table 5)

Stock Register /IMS Bin Card (for SACS and DAPCU WIC only)Indent and IR Forms


2.1.3.2 SubtractthecalculatedStockBalanceasrecordedinStockRegister/BinCardfromtheActualQuantityonHand.

2.1.3.3 Ifyourresultiszero,yourStockRegister/BinCardmatchthenumberofunitsofthecommoditiesinthestore.

2.1.3.4 Ifyourresultisanegativequantityyouhavesufferedalossofthecommodity.Adjustthesameinstockregister/BinCard

2.1.4 CreatealineitemonStockRegister/BinCardlabeled“PhysicalCount”andwritethequantitycounted.

Stock Register /IMS Bin Card (for SACS and DAPCU WIC only)

2.1.5

Compareamountofcommoditytorecommended“max”quantity. Stock Register /IMSBin Card (for SACS and DAPCU WIC only)IR Form, RTD Form, Indent


2.1.5.2 Compareyourstockonhandtotherecommended“max”quantity.(Refer to Page No. 82-83 Table 5)Ifmorethanmax,then…

2.1.5.3 WriteExcessonthekitswhichareexcess.

2.1.5.4 Stackexcessinventoryseparatelyfromusablestocks.RedistributeusingRTDForm.(Refer to Page No. 83 Table 6)


2.1.5.5 Recordthequantityredistributedasanegative“adjustment”inStockRegister/BinCardasfollowswithadashthatlookslikethis:“-“.(Refer to Page No. 82-83 Table 5) Ifatorbelowminlevel,then…


2.2 Testing facilities (ICTC and FICTC)


2.2.1 Onceaweek,transferquantitiesissuedasrecordedinLaboratoryRegisterintoStockRegister.

Laboratory Register/ IMS (Dispensing Module), Stock Register

2.2.2 Monitorcommoditylevelsonschedule.(Refer to Page No. 81 Table 2) --

Countthestock --

2.2.2.1 Countunopened/completekitsfirst.Multiplythenumberofkitsbythenumberoftestinthekit.

--2.2.2.2 Countthetestsinsidetheopenkits.

2.2.2.3 Thiswillgiveyouthetotalnumberofthetestsinthefacility.

EvaluatecommoditylevelsagainstmaxlevelorEOP. (Refer to Page No. 82-83 Table 5)


2.2.3.1 Addupthetotaltestsandthisistheactualquantityofstockonhand.

2.2.3.2 SubtractthecalculatedStockBalanceasrecordedinStockRegisterfromtheActualQuantityonHand.

2.2.3.3 Ifyourresultiszero,yourStockRegistermatchthenumberofunitsofthecommoditiesinstorage.

2.2.3.4 Ifyourresultisanegativequantityyouhavesufferedalossofthecommoditythenadjustthesameinstockregister/IMS

2.2.3.5 Ifyourresultisapositivequantity,youhavemoreunitsofthecommodityinstockthanyouhadrecordedontheStockRegister.

2.2.4 CreatealineitemonStockRegisterlabeled“PhysicalCount”andwritethequantitycounted.


2.2.5

Compareamountofcommoditytorecommended“max”quantity.

Stock Register /IMSIndent FormIR FormRTD Form


2.2.5.2 Compareyourstockonhandtotherecommended“max”quantity.(Refer to Page No. 82-83 Table 5) Ifmorethanmax,then…

2.2.5.3 WriteExcessonthekitswhichareexcess.

2.2.5.4 Stackexcessinventoryseparatelyfromusablestocks.RedistributeusingRTDForm.(Refer to Page No. 83 Table 6)

2.2.5.5 Recordthequantityredistributedasanegative“adjustment”inStockRegisterasfollowswithadashthatlookslikethis:“-“. (Refer to Page No. 82-83 Table 5)Ifatorbelowminlevelthen…




For the SOP to be completed accurately and completely, the following criteria must be met:

For commodity monitoring:

� Commodityconditionsaremonitoredaspertheestablishedscheduleandallitemsarestoredaccordingtoproperstorageguidelines.

� QuantityofcommoditiesonhandhasbeencountedandrecordedontheStockRegister.

� Losses/AdjustmentshavebeencalculatedandrecordedontheStockRegister,ifapplicable,andproperlyaccounted.FormoreinformationRefer Page No. 82 Table 4

For removal of damaged / expired or excess commodities:

� Damaged,expiredorexcesscommoditiesareseparatedfromusablestock.

� Damagedorexpiredstockisdisposedaspernormsspecifiedbystategovernmentandifdestroyed,aspermanufacturerrequirements(FICTCreturndamagedorexpiredstocktoICTCfacility).

� Excesscommoditiesarereturnedtoissuingfacilities.

� StockRegistershasbeenupdatedasperthemovementofdamaged,expiredorexcesscommodities.

� RTDFormhasbeencompletedtoaccompanymovingcommodities

For indenting emergency commodities:

� IndentFormhasbeencompletedtorequestanemergencyorder

REFERENCES

A. NOTE ALL APPLICABLE Reference policies / laws / regulations


IndentCommodities

PURPOSEIndentingistheprocesstorequestproductquantitytoreplenishthestocklevel.Allcommoditiesarere-stockedtothepre-setmaximumlevel–nomatterhowmuchorlittleisinstock.

SCOPEThisSOPappliestoallfacilitieswhichindentcommodities.


Record/Form Name

• Stock Register

• Bin Card

• RTD Form

• Indent Form

• IR Form


• PurchaseOrder/LetterofAcceptance(LOA)

• RateContracts

PROCEDURE

Thisprocedurecomprisesoftwosteps:

1. Determining the quantity to indent.

2. Submitting the indent to issuing store/Procurement Agent.


1. Determine quantity to indent1.1 NACO Level


1.1.1 Processindentquantitiesfromforecastingtools (Refer to Page No. 83 Table 7)

Indent Form, Forecasting Tool

1.1.2 Preparetheindentformforsubmissionandapprovalwithnecessarydetails. Indent Form

28


1.2 SACS WIC


1.2.1 AggregateindentedquantitiesfromDAPCUandSA-ICTCs. (Refer to Page No. 83 Table 7)

Indent Form/ Forecasting Tool

1.3 DAPCU, SA-ICTC and FICTC


1.3.1 Preparetoindentproducts. (Refer to Page No. 83 Table 7)


1.3.2 Daypriortoscheduledindent,conductphysicalinventorycounttoverifycommoditylevels.

--

1.3.3 Notediscrepancies,ifany,betweenStockRegister/IMS/BinCardandphysicalinventoryinStockRegister.

Stock Register/IMS Bin Card (for DAPCU WIC only)

1.3.4 Compute averagemonthly consumption using last 3months of consumptionunlessdirectedotherwise.


1.3.4.1 1. For product in full supply:-ReviewissuesdatainStockRegister/IMSforownfacilitytogetconsumptiondata.

1.3.4.2

2. For products that have been stocked out at any point in the last 3 months:-AggregateaveragemonthlyconsumptionfromIndentandIssues/ReceiveFormsforallrequestingfacilities:

• SACSaggregatesDAPCU/SA-ICTCIndentandIssue/ReceiveForms

• DAPCUStoreaggregatesSA-ICTCsIndentandIssue/ReceiveForms(whereverDAPCUexists)

• For non-DAPCU districts, SA-ICTCswill send directly to SACS orWICswithintheState

• SA-ICTCaggregateFICTCsindentandIssue/ReceiveForms

Stock Register/IMS Laboratory Register /IMSIndent Form

1.3.4.3 3. For products that are stocked out at both indenting and requesting facilities:-ReviewissuesdatainStockRegister/IMSforownfacilityforthemostrecentperiodduringwhichtheproductwasavailable.

1.3.5 CalculatehowmuchofeachcommodityisrequiredforlevelstobebroughtuptomaxlevelsusingtheIndentForm.

Stock Register / IMS Indent Form/ Laboratory Register

1.3.6 Preparetheindentforsubmissionandsigntheformwithnecessarydetails. Indent Form

2.Submit indent to issuing store / Procurement Agent;2.1 NACO Level


2.1.1 RequestingDivisionsubmitsIndentFormtoProcurementDivisionofNACO(Refer to Page No. 83 Table 7)

Indent Form

2.1.2 ProcurementDivisionsubmitsapprovedindenttoProcurementAgentsofNACO

--


2.2 SACS, DAPCU WIC, SA-ICTCs and FICTCs

Steps Instruction /Activities LMIS Tolls Used

2.2.1 SubmitIndentFormtoissuingfacilities (Refer to Page No. 83 Table 7)

Indent Form



� Commoditylevelsareassessed.

� Orderquantitiesarecalculated.

� IndentFormiscompleted.

� IndentFormisapprovedandsubmitted.

REFERENCES

A.NOTEALLAPPLICABLEReferencepolicies/laws/regulation


Receive and Store Commodities

PURPOSEReceivingisthesupplychainprocessofacknowledging,inspecting,andloggingreceivedcommoditiesintoinventory.Errorsinreceivinghavearippleeffect.Ifanindent/issues/packaginglistareimproperlyfilledorcommoditiesare counted incorrectly when received, then inventory levelswill be inaccuratewhich canresultinoverstockorstock-out.Similarly,ifcommoditiesareputawayincorrectly,thenthereisriskoflosingproductduetoexpiryorstaffwillwastetimelookingforproductatthetimeofissue.

SCOPEThisSOPappliestoallfacilitieswhichreceiveandstorecommodities.


Record/Form Name

• Stock Register/IMS

• Bin Card

• Indent Form

• Issue and Receive Form (IR Form)


• Invoice

• PackingList

• CertificateofAnalysis(CoA)

• ConsigneeReceiptCertificate(CRC)

• ConsigneeAcceptanceCertificate(CAC)

• GoodsReceiptNote(GRN)


PROCEDURE

Thisprocedurecomprisesoftwosteps:

1. Receive commodities which includes inspecting and recording receipts.

2. Store (Put away) commodities.

29



1. Receive commodities which includes inspecting and recording receipt:1.1 SACS WIC and DAPCU WIC


1.1.1 AsperthePurchaseOrder/NOA,warehousereceivesthegoodsalongwithconsignmentdocuments.

Email/IMS /NACO

Checkcompletenessoffollowingdocuments: Purchase Order (in case of local procurement)InvoicePacking List Delivery Note

1.1.2.1 • Twocopiesoforiginalinvoicesignedbyauthorizedsignatory

• PackingList/Transportreceipt/DeliveryNote

1.1.2 1.1.2.2 Ifanydiscrepancyisfound,reportthesametoNACO/ProcurementAgent.IncaseofmismatchbetweenPO,shipmentdetails,andinvoice;donotacceptcommoditiesuntilwrittenconfirmationisprovidedtoresolvethediscrepancy.

1.1.3 VerifyquantitiesissuedarethesameasrecordedonthePurchaseOrder/Invoice/packaginglist/COA

Purchase Order (In case of local procurement)InvoicePacking ListDelivery Note

1.1.3.1 IfquantitiesareNOTthesameasPurchaseOrder/invoice/packaginglist,donotacceptcommoditiesuntilwrittenconfirmationfromissuerisprovidedthatquantitydeliveredislessthannotedonthePurchaseOrder/invoice/packaginglist/deliverynote.

1.1.4

Inspectcommoditiesforphysical,chemicalormanufacturingdefects. (Refer to Page No. 81 Table 3)

1.1.4.1 Ifdamageisfound,rejectcommoditiesandreturntosupplierforreplacementForHIVTestingKits:checktheHEATmarkerindicatorbeforeacceptingshipment.

--

1.1.4.2 Ifnodamageisfound,acceptorderandgenerateGoodsReceivedNote(GRN)andprovidealldocumentstoProcurementAgent/NACO

--

1.1.5

Endorsethesupplier/CMSSdocumenti.e.IssueSlipcumAcknowledgmentReceipt/TransportReceipt/DeliveryNote

Purchase Order (in case of local purchase),Invoice,Issue Slip cum

Acknowledgment Receipt, Transport Receipt/Delivery Note

1.1.5.1 Receiverfilescopiesofallsignedforms(asnotedincolumntotheright).

1.1.5.2 Supplier/ProcurementAgentreceivescopyofforms.

1.1.6 Ifdocumentsarefoundinorderandquantitiesandqualityofcommoditiesarecorrect,acceptthegoodsinWIC.

--

1.1.7 CompleteallentryofreceivedcommoditiesinIMS IMS and Stock Register

OK

OVERHEAD


1.2 SA-ICTC and FICTC


1.2.1 Receivemail/IMSnotificationfromSACSWIC/DAPCUWICthatcommoditiesarereadyfordispatch.(Refer to Page No. 83 Table 6)


1.2.2 Receivecommoditiesatissuingfacility. --

1.2.3 VerifyquantitiesissuedarethesameasrecordedontheIRForm:

IR Form/IMS, STN1.2.3.1 IfquantitiesareNOTthesameasIRForm,donotacceptcommodities

untilwrittenconfirmationfromissuerisprovidedthatquantitydeliveredislessthannotedontheIRForm/STN.

1.2.4 Conduct preliminary physical inspection for quality of shipment. (Remember – a package can be damaged but the commodity can still be usable.) (Refer to Page No. 81 Table 3)

1.2.4.1 Ifqualityproblemordamageisfound,notifyissuer.Quarantinegoodstillissuesareresolved.

--

1.2.5 Sign IR/STN Form to confirm receipt:–Issuingfacilitysigns,stampsandkeeporiginal–Receivingfacilitysignsandstamps1copyandreturntotransporterof

shipment–Receivingfacilitykeeps1copyforfiles.

Indent Form/Issue and Receive Form /IMS/STN Form

1.2.6 Receivethecommoditiesinstockregister/IMS Stock Register / IMS

2. Store (Put away) commodities:2.1 SACS WIC and DAPCU WIC


2.1.1 Putawaycommoditiesaccordingto“FEFO”(FirstExpiry,FirstOut)topreventexpiry;andplaceolderproductsabovethenewerones.

--

2.1.2 Storethegoodsonpallets,shelvesandinWIC.(Refer to Page No. 45 Figure 9) --

2.1.3 RecordreceiptinStockRegister/IMS,BinCard. StockRegister/IMSBinCard

2.2 SA-ICTC, FICTCs


2.2.1 VerifyquantitiesissuedarethesameasrecordedontheIR/STNsForm: (Refer to Page No. 83 Table 7)

Indent Form, IR Form, STN

2.2.1 2.2.1.1 Receivecommoditiesatissuingfacility.

IR Form/ IMS STN2.2.1.2 IfquantitiesareNOTthesameasIRForm,donotaccept

commoditiesuntilwrittenconfirmationfromissuersaysthatquantitydeliveredislessthannotedontheIRForm.

2.2.2 Conductfinalphysicalinspectionforquality.(Refer to Page No. 81 Table 3)

2.2.2.1 Checkforphysical,chemical,ormanufacturingdefects. --

2.2.2.2 Verifyexpirydate.Iftheexpirydateislessthan90daysaway,thenreturnthecommoditiestothesourceofsupplytopreventanydispensingofexpiredcommoditiesbymistake.

--

2.2.2.3 Verifybatchnumbers.


2.2.2.4 Ifqualityproblemordamageisfound,notifySACSQuarantinegoodstillissuesareresolved.

--

2.2.3 RecordcommodityinformationontheStockRegister/IMS. Stock Register/IMS

2.2.4 Putawaycommodities: • Ifthelabelonlystatesthedateofproduction,calculatetheexpirydateand

addtheperiodofstorageontheshelf.

• Writedownthedateofexpiryonthecardboardboxinlargeboldnumbersorletters.

--

2.2.5 Storecommoditiesaccordingto“FEFO”(“FirstExpiry,FirstOut”)topreventexpiry

--

2.2.6 AllHIVTestingKitsmustbekeptbetween+2°Cand+8°CduringstorageattheSACS/DAPCU/ICTC/FICTClevel

2.2.7 MonitorthetemperatureofWIC/ILRthroughoutthesupplychainmanagement:Effectivemonitoringandrecord-keepingachievesthefollowingobjectives:a.verifythatHIVTestingKitsstoragetemperaturesarewithintheacceptablerangesof+2°Cto+8°CincoldroomsandILRb.detectionofout-of-rangestoragetemperaturessothatcorrectiveactioncanbetaken;c.detectionofout-of-rangetransporttemperaturessothatcorrectiveactioncan be taken

Temperature recording sheet



� Commoditiesarereceived.

� Damagedorexpiredstockhasbeenseparatedfromusablestock.

� StockRegisters/IMSandBinCardshavebeenupdated.

� RTDFormhasbeencompleted(ifnecessary).

� Commoditiesareputaway.

REFERENCES



Issue and Dispense Commodities

PURPOSEIssuingisthesupplychainprocessofreceivingandfulfillingindents.Forservicedeliverypoints,dispensingisthesupplychainprocessofissuingcommoditiestoclients.

SCOPEThisSOPappliestoallfacilitieswhichissueanddispensecommodities.


Record/Form Name

• Indent Form

• Stock Register

• Bin Card

• IR Form

• IMS Dispensing

• Daily Dispense Register (DDR)


• N/ANote: ONLY SACS Store and Regional Stores uses Bin Cards. A Bin Card is not required at other facilities because inventory levels are such that a Stock Register is sufficient for monitoring inventory.


1. Receive and review indent.

2. Issue commodities according to the indent.

Forservicedeliverypoints:

1. Dispense to clients.


1. Receive and review indent:1.1 SACS WIC, DAPCU WIC, ICTC and FICTC


1.1.1 ReceiveIndentFormfromreportingfacility.(Refer to Page No. 83 Table 7.0) Indent Form

1.1.2 ReviewIndentFormtoconfirmcalculations.Correctifneeded. • Ifcorrectionsaremade,notifyindentingfacility.

Indent Form

30


2. Issue commodities according to the indent between facilities:2.1 SACS WIC, DACPU WIC, ICTC and FICTC


2.1.1 Aggregateallindentsfromtherequestingfacilitiesfordistributionplanning Indent Form

2.1.2

CheckstockavailabilityintheStockRegister/IMStofinalizethequantitytobeissued:

Indent FormStock Register/ IMS

2.1.2.1 Ifproductisavailableinenoughquantity,fulfilltheIndentFormrequest.

2.1.2.2 Ifproductisnotavailableinenoughquantity,rationtheindentedquantity.


2.1.2.4 Ifsubstitutionisnotpossibleanddemandisurgent,informtoNACO/SACStosupportonrelocationfromotherstates/facilities

2.1.2.5 Ifsubstitutionisnotpossibleanddemandisnoturgent,waittillproductbecomesavailablethroughProcurementAgent/SACS

2.1.3 Developthedistributionplanforapproval Distribution Plan

Calloremailindentingfacilitiestoupdateonapproveddistributionplan

2.1.4 CompleteIR/STNFormasperapproveddistributionplan IR/STN Forms

2.1.5 SelecttheavailableproducttobeissuedbyFEFO(“FirstExpiryFirstOut”). IR/STN Forms

2.1.6 Prepareshipmentofcommodities,asperIR/STNForm IR/STN Forms

2.1.7 Notifyreceivingfacilitythatindentisreadytobeshipped. IR/STN Forms

2.1.8 RecordtheissuedquantityinStockRegister/IMS/BinCard. Stock Register / IMS

3. Dispensing:3.1 SA-ICTC and FICTC


3.2.1 CheckstockavailabilityintheStockRegister/IMStofinalizethequantitytobeused:

IMS/ Stock Register

3.2.1.1 IfHIVtestkitsareavailableinenoughquantity,fulfilltheprescription.

3.2.1.2 IfHIVtestkitsisnotavailable,findthesubstituteproduct,ifpossible.

3.2.1.3 Ifsubstitutionisnotpossibleanddemandisurgent,informSACS/DAPCUWICforemergencyrelocation

3.2.1.4 Ifsubstitutionisnotpossibleanddemandisnoturgent,waittillproductisavailableatSACS/DAPCU

3.2.2 SelecttheHIVtestkitstobeusedbyFEFO(FirstExpiryFirstOut). --

3.2.3 Usethetestforpatient --

3.2.4 RecordusedtestinIMS/LabRegisteratSA-ICTC IMS /LR

3.2.5 RecordtotalusedtestquantityintheIMS / LR and update the Stock Register at the end of the day

IMS /Stock Register




EffectivenessCriteria/CriteriaforIssue Completion:

� IndentFormiscompleteandaccurate.

� Indentquantitiesarevalidated.

� DistributionPlanisapproved.

� Issuequantityispicked.

� Issuesquantityisreadyforpackagingandshipping.

EffectivenessCriteria/CriteriaforDispensingCompletion:

� Clientiscounselled.

� Commodityisdispensed.

� DailyDispensingRegisterisupdated.

� StockRegister/IMSareupdated.

REFERENCES



Distribute Commodities (Packaging and Transportation)

Distributionofcommoditiestoallfacilities

PURPOSEDistributionisthesupplychainprocessafterissuingofcommoditiesagainsttheindents.

SCOPEThisSOPappliestoallfacilitieswhicharechargedwithdistributionofcommodities.


Record/Form Name

• Indent Form

• IR Form

• STN from IMS


• Distribution Plan

• Route Plan

• Dockets

PROCEDUREThisprocedurecomprisestwosteps:

1. Packaging of commodities (including cold chain).

2. Distribution of commodities according to the indent and issue.


1. Packaging of commodities:1.2 SACS-WIC, DAPCU-WIC and ICTC (Cold Chain)

Steps Instruction /Activities LMIS Tools

1.2.1 Aggregateallissuequantityasperapproveddistributionplanforkits IR and STN

1.2.2 WhilepackagingofHIVtestkitsfortransportationconsiderthefollowingtomaintainthetemperatureat+2°Cto+8°Cduringtransit.EnsurethattheHEATmarkerindicatorisintactbeforepackingfortransportation.

--

31

OK

OVERHEAD


1.2.3 Useaninsulatedandtemperature-monitoredcoldboxfortransportationofKits --

1.2.4 Useenoughrefrigeratedicepackstomaintainthecoldchainat+2°Cto+8°C

Usetemperatureloggerincoldchainboxtomonitorthetemperaturewhileintransit

1.2.2 Instruction for filling and checking the Ice Packs:

1.2.2.1 Ifnewemptywaterpacks:Filleachpackwithcleanwater,uptothefillline.Donotover-fill;leavealittleairspaceatthetop.Fixthecapontightly.

1.2.2.2 Donotrefillwaterpacksunlesstheyhaveleaked.Ifthereisaleak,topupthewaterandmakesurethecapisfixedsecurely.

1.2.2.3 Beforeuse,holdeachpackupsidedownandsqueezeittomakesureitdoesnotleak.Ifthepackisfounddamaged,discarditandreplacewithanewpack

1.2.3 Instruction to freeze Ice Packs (It takes 24 hours or more to fully freeze ice packs):

--

1.2.3.1 Puttheice-packsuprightinthefreezercompartmentoftherefrigerator/deepfreezerandclosethedoor.

--

1.2.3.2 Leaveice-packsinthefreezerforatleast24hourstofreezesolid.After24hourstheyshouldbereadytouse.

--

1.2.3.3 Aftereachdeliveryputthemeltedice-packsbackinthefreezerassoonaspossible.

--


1.2.4

Instructiontoconditionice-packs(Frozenicepacksarenotsuitableforimmediateuse):

--

1.2.4.1

Conditionedfullyfrozenice-packs: • Leftatroomtemperatureforashorttime(itmaytakeover30

minutesiftheroomiscold)

• Allowfrozenice-packstositatroomtemperatureuntiltheicebeginstomeltandwaterstartstoform

• Checktoseeifeachice-packhasbeenconditionedproperlybyshakingitandlisteningforthesoundofwatermovinginside

1.2.5

Instructiontopackthecoldchainboxes: --

1.2.5.1 Theicepackshouldbeplacedasshowninthepicture --

1.2.5.2 ThedigitaltemperatureloggershouldbeplacedafterplacingtheHIVTestingKits

--

1.2.5.3 Closetheboximmediatelyafterplacingtheicepack,testingkitsandtemperaturelogger

--

1.2.5.4 Resetthetemperatureloggereverytimeyoupackthecoldchainboxwithkits

--

1.2.6 Packallkitsincoldchainboxesperfacility IR and STN

1.2.7 Markthecoldchainboxeswithfacility’sname IR and STN

2. Distribution of commodities according to the indent and Issue:2.1 SACS WIC, DACPU WIC, ICTC and FICTC


2.1.1 Selectanappropriatetransportationmodelbasedonthevolumeofthetotalboxestobedistributed:

• Dedicatedvehicle:forHIVTestingKits

• Fulltruckload(FTL):Forhighvolumeshipment

• Reefervehicle:forhighvolumetransferofHIVTestingKitsbetweenfacilities

IR/STN Forms

Distribution and Route Plan (Not LMIS Part)

2.1.2 Developrouteplanbasedondistributionlistinconsultationwithtransporter

2.1.3 Sharerouteplanfordistributionwiththetransporter

2.1.4 HandoverIR/STNformintriplicate:I. TransporterissuesdocketagainstIR/STNII. TransporterprovidesonecopyofdockettotheconsignorFilethedocumentsatyourlocation

IR/STN Form , Docket


2.1.5 Handoverthestockstothetransporterontheagreeddateandtime Docket (Transport document)

2.1.6 Tracktheshipmentuntilsignedandstampedproofofdelivery(POD)isreceived

PODs (Docket and IR/STN)

2.1.7 Allowfacilitiestoverifycorrectnessofissueandvisuallyinspectcommodities.

Docket, IR/STNs2.1.7.1 Ifanyerrorsarefound,immediatelyinformtoissuingfacilities

2.1.7.2 SignIR/STNFormtoconfirmreceivingofcommodities: • Keep1copyatreceivingfacilities

2.1.7.3 Returnsignedandstampedcopytotransporter

2.1.8 Recordanyvariancesduringthetransportationandclaimtotransportorinsurancecompanyasnecessary.

Stock Register/ IMS


ForthisSOPtobecompletedaccuratelyandcompletely,thefollowingcriteriamustbemet:

EffectivenessCriteria/CriteriaforDistributionCompletion:

• PackingofKitscompletedasperinstruction

• Distributionplannedandproductsmovedtofacilities

• IR/STNFormsignedhandedovertotransporter

• Receivingfacilityuponreceiptofcommoditiestoacknowledgereceipton:

o IR/STNandtransportdockets o Onecopyremainswithreceivingfacilities o Onecopysignedandstampedandreturnedtoissuerfortheirrecord

REFERENCES



Annexures


Cold Chain Management of HIV/RPR Kits

INTRODUCTION

ThismoduledescribeshowtocalculateHIVtestvolumesandevaluatethecoldchaincapacityrequirements.Toensurethatsufficientcoldchaincapacityisavailablewhereandwhenitisneeded,itisimportantto:

• Recognizetheimpactofkitpresentationsandpackagingonstoragevolumes;

• KnowhowtotranslateHIVkitneedsintoannualvolumesandstoragevolumes;

• Estimatethenetstoragecapacityprovidedbyallmodelsofcoldchainequipment;

• Identifyandquantifycoldchaincapacitygaps;and

• Exploretherangeofsolutionsthatcanpotentiallyaddresscapacitygaps.

AvailabilityofsufficientcoldchaincapacityiscrucialtotheoptimalperformanceofHIV/AIDsprogramme.ThismoduledemonstrateshowtocalculatethevolumeofHIVtestkitsthatmustbestoredandtransported.Thisvolumeiscomparedwiththenetstoragecapacitiesofexistingcoldchainequipmenttoidentifywhereacoldchaincapacitygapexiststoday,orwhenacoldchaincapacitygapisanticipatedinthefuture.Whenacoldchaincapacitygapisidentified,thenextstepistoidentifyandevaluatepotentialsolutions.Potentialsolutionsmay include procurement of new equipment, but may also include the use of alternative presentations,implementing equipment repair, changing the frequency of deliveries, or modifying the structure of thecurrentcoldchain.

OBJECTIVES

Theobjectivesofthismodulearetodemonstratehowto:

a) EstimatethepackedvolumeofHIVtestkitsdeliveredbytheNACO

b) EstimateastoragevolumeforeachHIVtestkitbasedonannualneedsandthesupplychainstructure

c) AggregatethestoragevolumesofalltheHIVtestkitsinthenationalAIDScontrolprogramtodeterminethecoldchaincapacityrequirements

d) Estimatethenetstoragecapacityofcoldchainequipment

f) Estimatetransportstoragecapacityrequirement

CALCULATING TEST KITS VOLUME

1. Calculating packed volume of HIV test kitsStep 1:Measurethedimensionsofsecondarycarton

Measurethreedimensionsofthecarton:length(L),width(W)andheight(H),illustratedinFigure1.

I


Figure 1:SecondarypackagingofWBFPT

ThecurrentdimensionsofHIVtestkitssuppliedbyNACOareasfollows:

Table 1.0: Dimension of kits

Name of KitKit Dimension (cm3)

Length (L) Width (W) Height (H)

HIV(Rapid)1stAntigen(HIV1) 11.50 9.50 12.50

HIV(Rapid)2ndAntigen(HIV2) 18.00 12.00 7.00

HIV(Rapid)3rdAntigen(HIV3) 16.00 8.00 8.00

WholeBloodFingerPrick(WBFP) 24.00 14.00 8.00

Step 2 : Calculatethevolumeofsecondarycartonusingthefollowingformula:

Volume(cm3)=lengthxwidthxheight

Table 2.0: Volume of Secondary Cartons

Name of Test Volume of Kit (cm3)

HIV(Rapid)1stAntigen 1365.63

HIV(Rapid)2ndAntigen 1512.00

HIV(Rapid)3rdAntigen 1024.00

WholeBloodFingerPrick 2688.00

Step 3 :Countthetotalnumberoftestsinthesecondarycarton

Table 3.0: Total Test in secondary packing

Name of Kit No. of Tests/kit

HIV(Rapid)1stAntigen 48

HIV(Rapid)2ndAntigen 30

HIV(Rapid)3rdAntigen 20

WholeBloodFingerPrick 50

2. Estimating kit storage volumeStep 1:Determinetheannualvolumebasedontheannualneed

TheannualneedismeasuredasthenumberoftestsofeachtypethatmustbedeliveredtoaSACSordistrictWalk-in-coolerorservicedeliverypointtotesttheintendedtargetpopulation,andwillincludeadditionalteststhatmustbedeliveredtoaservice-deliverypointtoaccommodateunavoidablewastage.


AnnualNeed(No.ofTests) ÷ No.oftests/kit X Volumeofkit(cm3) = AnnualVolume(cm3)

Thus,iftheannualneedofHIVtestsisasgivenintablebelow,theannualvolumerequiredforeachkitwillbeasfollows:

Table 4.0: Annual needs calculation

Kits Annual Need (No. of Tests)

÷ No. of tests/kit XVolume of kit

(cm3)=

Annual Kit Volume (cm3)

HIV(Rapid)1st 120000 ÷ 48 X 1365.63 = 3414075

HIV(Rapid)2nd 20000 ÷ 30 X 1512.00 = 1008000

HIV(Rapid)3rd 20000 ÷ 20 X 1024.00 = 1024000

WBFP 400000 ÷ 50 X 2688.00 = 21504000

Step 2:Determinethevolumepersupplyinterval

Annualkitvolume ÷ Numberofsupplyintervalseachyear = Testvolumepersupplyinterval

TheHIVtestkitsaresuppliedeveryquarteri.e.fourtimesinayear.

BasedonannualvolumescalculatedinStep1,thevolumepersupplyintervalwillbeasfollows:

Table 5.0: Supply planning with intervals

Kits Annual kit Volume

(cm3)÷

Number of supply intervals each year

=Kit volume per supply

interval (cm3)

HIV(Rapid)1st 3414075 ÷ 4 = 853519

HIV(Rapid)2nd 1008000 ÷ 4 = 252000

HIV(Rapid)3rd 1024000 ÷ 4 = 256000

WBFP 21504000 ÷ 4 = 5376000

Step 3: Calculatethevolumeofthesafetystock

Safetystock(No.ofTests) ÷ No.oftests/kit X Volumeofkit(cm3) = Volumeofsafetystock(cm3)

ThesafetystockforHIVtestkitshavebeendefinedas2monthsatstatelevel.ThusbasedontheannualneedsdefinedinStep1,thevolumeofsafetystockofeachkitwillbedeterminedasfollows:

Table 6.0: Safety Stock calculation

Kits Safety stock (No.

of tests)÷ No. of tests/kit X

Volume of kit (cm3)

=Volume of safety

stock (cm3)

HIV(Rapid)1st 5000 ÷ 48 X 1365.63 = 142253

HIV(Rapid)2nd 833 ÷ 30 X 1512.00 = 41983

HIV(Rapid)3rd 833 ÷ 20 X 1024.00 = 42650

WBFP 16667 ÷ 50 X 2688.00 = 896018

Step 4:Addthevolumeofthesafetystocktothevolumepersupplyinterval

Kitvolumepersupplyinterval + Volumeofsafetystock = KitStorageVolume


Inaboveexample,thefinalstoragevolumeofkitsforeachsupplyintervalwillbeasfollows:

Table 7.0: Final storage volume

Kits Kit volume per supply

interval (cm3)+

Volume of safety stock (cm3)

= Storage Volume (cm3)

HIV(Rapid)1st 853519 + 142253 = 995772

HIV(Rapid)2nd 252000 + 41983 = 293983

HIV(Rapid)3rd 256000 + 42650 = 298650

WBFP 5376000 + 896018 = 6272018

Total 7860423

CALCULATING COLD CHAIN STORAGE CAPACITY

Thekeytermsusedtodescribestoragespaceinsidecoldchainequipmentareasfollows:

Gross Volume Shelf Volume Net Storage Capacity

Themeasuredvolumeoftheairspaceinsidetheinternalcompartmentofamodelofcoldchainequipmentwiththedoororlidshut.

Theaggregatedvolumeofalldesignatedequipmenti.e.baskets,shelvesorpalletbaysinamodelofcoldchainequipment.Thisvolumeincludesonlyareaswherekitscanbestoredsafely.

Theestimatedvolumeavailableforstoringkitsandassociatedsuppliesinsideamodelofcoldchainequipment,takingintoaccountpackingefficienciesandairspacerequirements.

Notethatwhilegrossvolumeandshelfvolumecanbemeasured,netstoragecapacityisanapproximatevalueusedforplanningpurposesinordernottooverestimatethetotalvolumeavailableforstorage.Shelfvolumeisonlyrelevantforwalk-incoldroomsandnotforvaccinecarriersandcoldboxes,whichhavenoshelvesorinnerstoragedivisions.

Utilization factor

Theutilization factor accounts for the fact that it is not usually possible to use 100%of available storagecapacityduetotheimpactofhandlingpractices,packagingdimensionsandotherpracticalities.Itisdefinedasanumberlessthanonethatismultipliedbytheshelfvolumeofwalk-incoldroomsorbythegrossvolumeofrefrigerators,freezers,vaccinecarriersandcoldboxesinordertoestimatetheusablenetstoragecapacityofthoseequipment.Inthisdocument,WHOrecommendedutilizationfactorof0.67hasbeenusedforwalk-incoldroomsaswellasallotherequipment.

Cold Chain Storage Equipment

Walk-In-Coolers DeepFreezers IceLineRefrigerators


1. Calculating net storage capacity of a Walk-in-coolerStep 1: Measuretheshelvingunitdimensionsincentimetres(cm)

Table 8.0: Example of Dimensions of Shelves

Shelves Dimensions (cm)

Shelflength(l) 150

Shelfwidth(w) 50

Coldroomstackingheight(h) 210

Numberofshelves(n) 5

Shelfthickness(t) 2

Floortobottomshelf(b) 5

Step 2:Calculatethevolumeofshelvesincm3

Widthxlengthx(height–[distancefromfloortobottomshelf+numberofshelvesxthicknessofeachshelf])

AsperdimensionsmentionedinTable8thevolumeofshelveswillbeasfollows:

50x150x(210-[5+(5x2)])=1462500cm3

Step 3:Calculatetotalshelfvolume

SUM(shelfunitvolumes)i.e.addthevolumeofeachshelfintheWICtoobtainthetotalshelfvolumeofWIC.IfaWIChas10shelvingunitsofdimensionsasperTable8,thentotalshelfvolumewillbe=10shelvingunitsx1462500cm3=14625000cm3

Step 4:Calculatenetstoragecapacity

Shelfvolumexutilizationfactor=14625000cm3x0.67=9798750cm3

Thisstoragecapacity isadequateenoughtoaccommodatethekitswithrequirementofstoragevolumeof7860423 cm3calculatedinTable7:Finalstoragevolume.Thus,theWalk-in-coolerwithshelvesofdimensionsasperTable8,canaccommodatethefollowingno.ofHIVtest:

Table 9.0: Calculation of no. of tests that can be stored in Walk-in Cooler

KItsStorage

Volume (cm3)÷

Volume of kit (cm3)

= No. of kits XNo. of

tests/kit= No. of tests

HIV(Rapid)1st 995772 ÷ 1365.63 = 729 X 48 = 34992

HIV(Rapid)2nd 293983 ÷ 1512.00 = 194 X 30 = 5820

HIV(Rapid)3rd 298650 ÷ 1024.00 = 292 X 20 = 5840

WBFP 6272018 ÷ 2688.00 = 2333 X 50 = 116650

Total 7860423 3548 163302

Figure 2:Walk-InCooler


2. Calculating net storage capacity of Ice Lined Refrigerators (ILR) and Deep FreezersNetstoragecapacityforILRsanddeepfreezers= Gross volume (cm3) X Utilization Factor

Thus,netstoragecapacityofa500LitresILR/Deepfreezer=500LX1000X0.67=335000cm3

Asperconsumptionofkits,thisnetstoragecapacitywillbedividedbetweenthekits.Tocalculatethis,consumptionpercentageofeachkitneedstobededucedasfollows:

(AMCofeachtests÷totalofAMCofalltypesoftests)X100

IfpercentageconsumptionofeachtestsisasperTable10,thenthenet storage capacity of335000cm3 can store the following no. ofkits:

Table 10: Calculation of no. of tests that can be stored in ILR

Kits% Kits consumption at

facilityNet storage volume divided as

per kit consumption (cm3)Approximate no. of

kits that ILR can store

HIV(Rapid)1st 21% 68836 50

HIV(Rapid)2nd 5% 18356 12

HIV(Rapid)3rd 8% 27534 27

WBFP 66% 220274 82

Total 100% 335000 171

• Grossvolumeisusuallyreportedbythemanufacturerforagivenmodelofcoldchainequipment.

• Ifgrossvolumeisnotavailable,itcanbemeasuredbymultiplyingtheheight,lengthandwidthoftheinternalrefrigeratedspaceasifthelidwereclosed.

Domestic Refrigerators

Domesticrefrigeratorsarenot recommendedforstorageof testkitsandshouldbe replacedwithWHOapprovedequipmentas soonaspossible.When measuring the gross volume of a domestic refrigerator, do notincludethevegetablestorageordoorareas.Theseareasshouldbeloadedwith water-filled coolant-packs or water bottles or otherwise be madeofflimitstotestkitsstorage.Thefreezercompartmentsindomestic-stylerefrigeratorsaresuitableonlyforpreparingandstoringfrozenice-packs.

CALCULATING COLD CHAIN TRANSPORTATION CAPACITY

Todeterminetheavailablecapacityfortransportoftestkits,itisnecessarytounderstandhowtodeterminenetstoragecapacityinpassivecontainers,refrigeratedvehiclesandtraditionaltrucks

Transportation Equipment

ColdBoxes&Carriers RefrigeratedVan TraditionalTrucks

Figure 3:IcedLinedRefrigerator

Figure 4: DomesticRefrigerator


1. Calculating net storage capacity of Cold boxes and carriersUsethefollowingproceduretocalculatethenetstoragecapacityofcoldboxesandcarriers:

Step 1: Loadthecoldboxorcarrierwiththenumberoffrozencoolant-packsdesignatedbythemanufacturer.

Step 2: Measureincentimetrestheminimuminternaldimensionsofthestoragecompartment,takenbetweenthebulginginternalfacesofthefrozencoolant-packs.Whenmeasuringtheheight,considerthattheheightwillbelimitedbythebottomofthelidwhenitisinplace.

Step 3: Multiplytheminimuminternaldimensions(length,widthandheight)tocalculatethegrossvolumeincm3.

Step 4: WHOrecommendsmultiplyingthegrossvolumebyautilizationfactorof0.67inordertoestimatenetstoragecapacity.

2. Calculating net storage capacity of Refrigerated vehiclesInmostcases,themanufacturerofeachvehiclewillprovideagrossvolumeforitsequipment.Calculatenetstoragecapacitybymultiplyingthegrossvolumebythestandardutilizationfactorof0.67.

3. Calculating net storage capacity of Traditional trucks and vansTocalculatenetstoragecapacityofnon-refrigeratedtrucksorvansusedtotransportcoldboxes,itisnecessarytoknowboththeexternaldimensionsofthecoldboxesandtheinternaldimensionsofthecargoareaofthevehicles.

Step 1: Measureinternaldimensionsoftruckbed

Table 11: Example of dimensions of truck

Truckbedlength(cm) 410

Truckbedwidth(cm) 171

Truckbodyheight(cm) 173

Step 2: Measureexternaldimensionsofpassivecontainer

Table 12: Example of dimensions of cold box

Containerlength(cm)+1cm 49.6+1 50.6

Containerwidth(cm)+1cm 25.2+1 26.2

Containerheight(cm)+1cm 49.9+1 50.9

Atleast1cmmustbemaintainedforclearancebetweencoldboxes

Step 3: Determinemaximumlayers,consideringexternalheightofcoldboxesandinternalheightoftruckbed.

• Internalheightoftruckbedis173cm

• Externalheightofcontaineris50.9cm

• Maximumnumberoflayers=173÷50.9=3layers

Step 4:Determinemaximumnumberofcontainersperlayer,consideringexternallengthandwidthofcoldboxesandinternallengthandwidthoftruckbed.

• Internallengthoftruckbedandexternallengthofcoldboxes=410cm÷50.6cm=8boxes

• Internalwidthoftruckbedandexternalwidthofcoldboxes=171cm÷26.2=6boxes

Figure 5:TraditionalTruck


• Calculatedcontainersperlayer=8x6=48boxes

Step 5: Calculatemaximumnumberofcontainers

• Maximumnumberofcontainersperload=48boxesx3layers=144boxes

Step 6: Calculatemaximumnetstoragecapacitybymultiplyingmaximumnumberofcontainersbynetstoragecapacityofeachcontainer.Inthisexample,coldboxofnetstoragecapacityof15500cm3areused.

• Maximumnetstoragecapacity=144boxesx15500cm3=2232000cm3

IfpercentageconsumptionofeachtestsisasperTable12,thenthenetstoragecapacityof2232000cm3 can storethefollowingno.ofkits:

Table 13: Calculation of no. of tests accommodated in cold boxes in traditional trucks

Kits% Kits consumption

at facilityNet storage volume divided

as per kit consumptionApprox no. of kits that a truck

with cold boxes can store

HIV(Rapid)1st 21% 458630 336

HIV(Rapid)2nd 5% 122301 81

HIV(Rapid)3rd 8% 183452 179

WBFP 66% 1467616 546

Total 100% 2232000 1142

Withvehicles,itisalsoimportanttoaggregatetheweightofthecoldboxestodetermineifthemaximumweightoftheloadiswithinlimits.Ifnot,thenthenumberofcoldboxesmustbereduced,bringingtheweightwithinlimitandreducingthetotalnetstoragecapacityofthevehicle.


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INDENT

IND

ENT

FORM

Indent FormII


Indent Form Job Aid Indent Form Job Aid

Purpose Tracksthemovementofinformationandcommoditiesbetweenhigherlevelandlowerlevel–fromrequesttoissueandtoreceipt.Itisusedto:

• Placeindents • Issuecommoditiesagainstanindent • Recordreceipt

FacilitiesWhereUsed Allfacilities

UsedtoMakeTheseDecisions

• Determinehowmuchtoindentandissue • Confirmcommoditylevelsatanypointintime

Usingthefollowinginstructions,fillineachfieldintheoverviewsection:

HowtoComplete“Part1”section—

1. Facility Name Notethenameofthefacilitywhoismakingtheindent

2. District Notethenameofthedistrictwherethisfacilityislocated

3. Date Prepared Notethedatethattheindentispreparedon(usethefollowingpattern:MONTH/DATE/YEAR(e.g.DD/MM/YYYY)

4. Reference No. ThisnumberisauniqueidentifierusedtotrackIndentfromstarttofinish.

5. Reporting Period Notethereportingperiodduringwhichthisindentisbeingplaced

Using the following instructions, fill in each field in the tracking section:¬¬¬

How to Complete “Part 2" Section—

THE INDENTER COMPLETES THESE FIELDS

6. S. No. Numbereachline(e.g.thefirstlineis#1)

7. Product Notethenameoftheproductbeingindented

8. Unit of Measure Notetheunitofmeasurefortheproductbeingindented

9. Opening Balance….

LookintheStockRegisterandfindtheopeningbalanceforthereportingperiodforthecommoditybeingindented.Recordthisnumber.Thisis“A”.

10. Quantity Received…

LookintheStockRegisterandfindthequantityreceivedforthecommoditybeingindentedduringthisreportingperiod.Recordthisnumber.Thisis“B”.

11. Quantity Consumed…

LookintheStockRegisterandfindthequantityconsumedforthecommoditybeingindentedduringthisreportingperiod.Recordthisnumber.Thisis“C”.

12. Physical Count RecordthenumberofcommoditiesnotedduringthePhysicalCount.Thisis“D”.

13. Losses IfanylossesarenotedintheStockRegister,BinCard,and/orfoundduringphysicalcount,recordthisnumberasanegativenumber.Thisis“E”.

14. Adjustments IfanyadjustmentsarenotedintheStockRegister,BinCard,and/orfoundduringphysicalcount,recordthisnumberasanegativeORpositivenumberdependingonifit’sanadjustmentINTOthefacility(whichwouldbepositive)orOUTofthefacilitywhichwouldbenegative).Thisis“F”.

15. Closing Balance/ Stock on Hand

Determineyourclosingbalance(thisis“G”).Checktheaccuracyofthebalanceafterrecordingyourphysicalcountby:

• AddOpeningBalance(“A”)and“QuantityReceived(“B”) • SubtractQuantityConsumed(“C”) • IFany,subtractlossesornegativeadjustments(“E”) • IFany,addpositiveadjustments(“F”)

16. Days Out of Stock Ifthecommoditywasoutofstockforanydays,notethenumberofdays.Thisis“H”.


17. Average Monthly Consumption (AMC)

FollowingtheSOP,computetheaveragemonthlyconsumptionforthecommoditybeingindented.Thisnumberiskeyasitwillbeusedtoensurethatenoughcommoditiesareindentedtocoverfutureanticipatedconsumption.Thisis“I”.

18. Max Months of Stock (MOS) Quantity

MultiplythemaxstocklevelasdeterminedbytheSOPbytheAMC.Thiswilltellyoutheabsolutemostquantityyoushouldindenttomeetdemand.Thisis“J”

19. Quantity on Order Lookatpastindentsanddetermineifanycommoditieshavebeenorderedbutnotyetreceived.Ifthereareanycommoditiesonorder,notethisamount.(Wedothistopreventdoubleordering!)Thisis“K”.

20. Quantity Requested

Determineindentquantity(L)by: • Find“maxstockquantity”(“J”) • Subtract“closingbalance”(“G”) • Subtract“quantityonindent”(“K”)

21. Signatures (bottom of form)

Whenindentispreparedandapproved,itneedstobesignedanddated: • Thepersonpreparingthe indentshouldsignwithnameanddesignationand

signatureandrecordthedateofpreparation • Thepersonwhoapprovesthe indentshouldsignwithnameanddesignation

andsignatureandrecordthedateofapproval


Issues and Receive (IR) Form

FROM FACILITY

NAME/ADDRESS: DISTRICT:

TO FACILITY

NAME/ADDRESS: FORM NO: (pre-printed number)

DATE FORM CONTACTPREPARED: DETAILS

(MONTH, DATE, YERAR)

S. Indent Expiry Issue No. Received No. Product UoM* Quantity Batch No. Date Quantity Boxes Quantity Remarks (Ref No.)

1

2

3

4

5

6

Issues by: Signature: Date: (FULL NAME, DESIGNATION)

Transported by: Signature: Date: (FULL NAME, DESIGNATION)

Received by: Signature: Date: (FULL NAME, DESIGNATION)

• Unit of Measure

Issue and Receive Form III


Issue and Receive Form Job Aid Issue and Receive Form Job Aid

Purpose Tracksthemovementofinformationandcommoditiesbetweenhigherlevelandlowerlevel–fromissuetoreceipt.Itisusedto:

• Issuecommoditiesagainstanindent • Recordreceipt

FacilitiesWhereUsed Allfacilities


• Issuecommoditiesaspertheapprovedindent • Confirmcommoditylevelsatanypointintime

Using the following instructions, fill in each field in the overview section:

How to Complete “Part 1” section—

1. From Facility Name/Address

Notethenameandaddressofthefacilitywhoisissuing

2. District Notethenameofthedistrictwherethisissuingfacilityislocated

3. To Facility Name/Address

Notethenameandaddressofthefacilitywhoisreceiving

4. Form No. pre-printednumber

5. Date Form Prepared

Notethedatethattheindentispreparedon(usethefollowingpattern:MONTH/DATE/YEAR(e.g.MM/DD/YYYY)

6. Contact Details Notethecontactdetailsofreceivere.g.Pharmacist

Using the following instructions, fill in each field in the tracking section:

How to Complete “Part 2” Section—

THE ISSUER COMPLETES THESE FIELDS

7. S. No. Numbereachline(e.g.thefirstlineis#1)

8. Product Notethenameoftheproductbeingissued

9. UOM* Notetheunitofmeasurefortheproductbeingissued

10. Indent Quantity (Ref.no.)

NotetheIndentFormnumber

11. Batch no Notethebatchnumberofproduct

12. Expiry Date Notetheexpirydateoftheproducts

13. Issue quantity Notethequantityissued

14. No. boxes Notethetotalnumberofboxes

15. Received Quantity Notethetotalquantityreceivedbyreceivingfacility

16. Remarks Noteanyimportantinformationforissuingfacility

17. Signatures (bottom of form)

WhenIssues/ReceiveFormispreparedandcompleted,itneedstobesignedanddated:

• Thepersonwho issuestheproductgshouldsignwithnameanddesignationandrecordthedateofpreparationofIRForm

• Thepersontransportingthecommoditiesshouldsignwithnameanddesignationandrecordthedateofdelivery

• Thepersonwhoreceivestheissueshouldsignwithnameanddesignationandrecordthedateofreceipt


BIN CARD

FACILITY NAME: DISTRICT:

STOCK

BIN CARD NO.: (pre-printed number) REGISTER NO.:

UNIT OF

PRODUCT: MEASURE:

(PRODUCT NAME, DOSAGE FORM, STRENGTH)

BATCH NO.:

LOCATION: EXPIRY DATE: (MONTH, YEAR)

Date Indent Form (DD/MM/YY) Reference No.

Balance Brought Forward

Balance Carried Forward

Balance Signature Remarks

Quantity

Received Issued Losses and Adjustments

Bin CardIV


Bin Card Job Aid Bin Card Job Aid

Purpose Recordsinformationaboutasingleproductbylotnumberorbatchnumber: • EveryitemrecordedonaBinCard,inthatlot,willhavethesameexpirydate. • Trackswhereacommodityisinagivenfacilityandatwhatquantitylevels.

FacilitiesWhereUsed

SACSandRegionalWarehouse


• Setcommoditylevelsthatwewouldliketokeepinthestoreinindenttomeetdemand • Confirmcommoditylevelsatanypointintime • Decidehowmuchtoindent • InformFEFOdistribution/wheretoissuecommodity

Using the following instructions, fill in each field in the overview section:How to Complete “Part 1” section—1. Facility Name NotethenameofthefacilitywherethisBinCardisbeingused2. District NotethenameofthedistrictwherethisBinCardisbeingused3. Bin Card No. Thisnumberispre-printedandusedasanaccountingmethodtotrackaparticularbatch4. Stock Register

No.NotethepagenumberoftheStockRegisterwherethissamecommodityisbeingtracked

5. Product: NotetheproductbeingrecordedonthisBinCardandrecordthefollowing: • ProductName • DosageForm • Strength

6. Unit of Measure

Notetheunitofmeasurefortheparticularcommodity

7. Batch No. Notethebatchnumberforthisparticularcommodity8. Location Notetheshelvinglocationinthestoreorwarehouse(ifnotapplicable,skip)9. Expiry Date NotetheExpiryDatefortheparticularcommodityinthisformat:MONTH/YEAR(e.g.

MM/YY)Using the following instructions, fill in each field in the tracking section:How to Complete “Part 2” Section—10. Balance

Brought Forward

WhenanewBinCardisbeingstarted,findtheclosingbalancefromthepreviousBinCardwhichisnowfull.ThatclosingbalancefromthefullBinCardnowbecomestheopeningbalanceonthisnewBinCard.

11. Date Notethedatethatthecommodityisbeingreceived,issued,oradjusted/lossnoted12. IR Form Ref

No.NotetheIRFormreferencenumberonwhichthecommodityisbeingmovedsothatbothformscanbeconnectedandthemovementofthecommoditycanbetraced

13. Received Ifacommodityisreceivedintothestoreanditisthesamebatch/lotnumber,recordthequantitybeingreceived(rememberonlyonebatch/lotisrecordedperBinCard)

14. Issued Whenacommodityisissued,recordthequantitybeingissued15. Losses &

AdjustmentsWhenacommoditylossoradjustmentisbeingnoted,recordthequantitythatwaslostorbeingadjusted.

• Alosscanbeduetoanyreasonincludingdamages,expiryorpilferages • Anadjustmentiswhencommodityisreceivedfromafacility,ormovedtoadifferent

facilitybutthisadjustmentmustbefromtheSAMEbatchorlot.Ifitisadifferentbatch/lotthenanewBinCardmustbestarted.

16. Balance Oncecommoditiesarereceived,issued,orlosses/adjustmentsarenoted,calculatethenewbalancebyeither:

• Addingreceiptsand/orinboundadjustments • Subtractingissuesand/orlossesand/oroutboundadjustments

17. Signature Allreceipts,issues,and/orlosses/adjustmentsshouldbenotedwithasignatureofthepersonwhoreceived,issued,orrecordedloss/adjustment

18. Remarks Explainalllossesandadjustmentsandanyotherifneeded.Ifneeded,noteanyrelevantremarksorclarifyingdetails.


PRO

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Stock RegisterV


Stock Register Job Aid Stock Register Job Aid

Purpose Recordsalldetailedinformationknownaboutacommodityinagivenlocation. • Recordsinformationaboutallthelotsorbatchesofasingleproduct. • Itmaybeasummaryofmanybincardsforaparticularproduct in facilities

wherebincardsarebeingused.FacilitiesWhereUsed AllfacilitiesUsedtoMakeTheseDecisions

• Confirmcommoditylevelsatanypointintime • Decidehowmuchtoindent • InformFEFOdistribution/wheretoissuecommodity

Using the following instructions, fill in each field in the overview section:HowtoComplete“Part1”section—1. Facility Name NotethenameofthefacilitywherethisStockRegisterisbeingused2. District NotethenameofthedistrictwherethisStockRegisterisbeingused3. Product: NotetheproductbeingrecordedonthisStockRegisterandrecordthefollowing:

• ProductName • DosageForm • Strength

4. Item Code Notetheitemcodeforthecommoditybeingrecordedonthisform5. Unit of Measure NotetheunitofmeasurefortheparticularcommodityUsing the following instructions, fill in each field in the tracking section:HowtoComplete“Part2”Section—6. Balance Brought

ForwardWhenanewStockRegisterisbeingstarted,findtheclosingbalancefromthepreviousStockRegisterwhichisnowfull.ThatclosingbalancefromtheoldnowbecomestheopeningbalanceonthisnewStockRegister.

7. S. No. Numbereachline(e.g.thefirstlineis#1)8. Transaction Date Notethedatethatthecommodityisbeingreceivedorissuedfromthestorein

thefollowingformat:DAY/MONTH/YEAR(e.g.DD/MM/YY)9. Received from /

Issued ToNotethefacilitywhois:

• IssuingthestocktothisstoreOR • ReceivingthestockFROMthisstore

10. Order / IR Form Reference No.

NotethereferencenumberforthePurchaseOrderorIRFormonwhichtheproductwasissued

11. Batch No. Notethebatchnumberfortheproductbeingreceivedorissued12. Expiry Date NotetheExpiryDatefortheparticularcommodityinthisformat:MONTH/YEAR

(e.g.MM/YYYY)13. Quantity Received

(+)Notethequantityofthecommoditybeingreceived

14. Quantity Issued ( - ) Notethequantityofthecommoditybeingissued15. Loss / Adjustment Ifapplicable,noteanylossesoradjustments:

• Record lossesasanegativenumber(e.g.expiries,damagesetc.) • RecordadjustmentsINTOthefacilityasapositivenumber(transfer-in) • Record adjustmentsOUTofthefacilityasanegativenumber(transfer-out)

16. Balance Determineyourclosingbalanceby: • TakeOpeningBalanceandeitheraddthereceiptorsubtracttheissue • Ifapplicable,addadjustments • Ifapplicable,subtractlossesornegativeadjustments

17. Remarks Whereneeded,makeremarksaboutreceiptsorissuesorlossesoradjustments18.BalanceCarried

ForwardWhenthepageisfilledin,notetheclosingbalance.Thisbalanceiscarriedforwardandistheopeningbalanceonthenextpage.


Return, Transfer and Discard (RTD) Form

FROM FACILITY

NAME: DISTRICT:

TO FACILITYNAME: FORM NO: (pre-printed number)

DATE FORMPREPARED: (MONTH, DATE, YEAR)

S. Unit of Batch Expiry IR Form No. Product Measure No. Quantity Date Reference Reason for Transfer/Discard No.

1

2

3

4

5

6

RTD FormVI

Return/Transfer/ Discard Prepared by: Signature: Date: (FULL NAME, DESIGNATION)

Return/Transfer/ Discard Approved by: Signature: Date: (FULL NAME, DESIGNATION)

Return/Transfer/ Discard Accepted by: Signature: Date: (FULL NAME, DESIGNATION)


RTD Form Job Aid Return / Transfer/ Discard (RTD) Form Job Aid

Purpose Tracksthereturn,discard,transferordiscardofcommodities: • If commodities are being returned for any reason, note commodities being

returned

• Ifdamaged,disposeasperStateGovernmentpolicy-notecommoditiesbeingdisposedatfacilityorbeingreturnedtoissuingfacilityforsafedisposal

• If commodities are being transferred from one facility or another for anyreason,notecommoditiesbeingtransferred

FacilitiesWhereUsed AllfacilitiesUsedtoMakeTheseDecisions


• Decidehowmuchtoindent

• InformFEFOdistribution/wheretoissuecommodityUsing the following instructions, fill in each field in the overview section:HowtoComplete“Overview”section—1. From Facility Name Notethenameofthefacilitywhoisinitiatingthereturn,transfer,ordiscard2. District Notethenameofthedistrictofthefacilitywhoisinitiatingthereturn,transferordiscard3. To Facility Name Notethenameofthefacilitywhoisreceivingthereturn,transferordiscard4. Form No. Thisnumberispre-printedandusedasanaccountingmethodtotrackareturn,transfer5. Date Form Prepared Notethedatethattheformispreparedon(usethefollowingpattern:DATE/

MONTH/YEAR)Using the following instructions, fill in each field in the overview section:HowtoComplete“Form”section—6. S. No. Numbereachline(e.g.thefirstlineis#1)7. Product Notethenameoftheproductbeingreturned,transferredordiscarded8. Unit of Measure Notetheunitofmeasurefortheproductbeingreturned,transferred,or

discarded9. Quantity Notethequantityofproductbeingreturned,transferred,ordiscarded10. Expiry Date Notetheexpirydateofproductbeingreturned,transferred,ordiscarded11. IR Form Reference

No.NotethereferencenumberfortheoriginalIRFormonwhichtheproductwasoriginallyissued

12. Reason for return/ transfer/discard

Notethereasonforthereturn,transferordiscard

13. Other comments or reasons for return/ transfer/discard:

Noteanyadditionalcommentsorinformationforareturn,transferordiscard,asneeded.

THE ISSUER COMPLETES THESE FIELDS:14.Signatures(bottom

ofform)Whenreturn/discard/transferformispreparedandapproved,itneedstobesignedanddated:

• Thepersonpreparingthereturn/transfer/discardshouldsignwithnameanddesignationandsignatureandrecordthedateofpreparation

• Thepersonwhoapprovesthereturn/transfer/discardshouldsignwithnameanddesignationandsignatureandrecordthedateofapproval

THE RECEIVER COMPLETES THESE FIELDS:15.Signatures(bottom

ofform)Whenreturn/transfer/discardisaccepted,itneedstobesignedanddated:

• Thepersonacceptingthereturn/transfer/discardshouldsignwithnameanddesignationandsignatureandrecordthedateofacceptance


GOODS RECEIPT NOTE (GRN)

INDENT NO. GRN NO. GRN DATE

DOCUMENTATION DELIVERED WITH GOODS DETAILS

DESCRIPTION OF INDENT STATUS DETAILS

PLEASE COMPLETE ONE GRN PER DELIVERY

Waybill No. (AWB No.) /Docket No.

Supplier Tax Invoice No.

Supplier Packing List

(Other)

Line Item Code Item Description UoM Qty. on Qty. Discrepancy Comments No. PO/NOA Received (damaged/ Incorrect items)

1.

2.

3.

4.

5.

Complete Order

Part shipment with the balance pending

Final shipment completing the Order

Part shipment with balance from PO cancelled

SUPPLIER

Name:

Company/Organization:

Position:

Date:

Transport Details:

Signature:

STAFF RECEIVING GOODS

Name:

Company/Organization:

Position:

Date:

Transport Details:

Signature:

Goods Receipt Note (GRN)VII


GRN Job Aid Goods Receipt Note Job Aid

Purpose GoodsReceivedNoteistherecordofgoodsreceivedbythestorein-charge/pharmacist.Afterreceivingthegoods,stockledgerisupdatedmentioningtheGRNnumberalongwiththedateofreceipt.

FacilitiesWhereUsed SACSandRegionallevelstoresUsedtoMakeTheseDecisions

• Makeaphysicalsurveyregardingthenumberofpacks,physicalconditionsetc.

• Openthepacks,markthemandmakephysicalverificationofthequantityreceived.Thisverificationtobemadewiththechallanandtheindent

• If any disputed or short materials found, then inform to the supplier/procurementagent/NACO

Using the following instructions, fill in each field in the ‘DOCUMENTATION DELIVERED WITH GOODS’ section:16. Way Bill No. (AWB)/

Docket No.Enterthedocketdetails,AWBnumberreceivedalongwiththeconsignment

17. Supplier Tax Invoice No.

EntertheuniqueTaxInvoiceNo.(fromsupplier)orIssue-cum-acknowledgementNo.(fromprocurementagent)

18. Packing List CheckandEnterwhetheritemssuppliedisinaccordancewiththePackingListitems

19. Other MentionanyotheradditionaldocumentslikeBatchQualityCertificateetc.alongwiththeconsignment

Using the following instructions, fill in each field in the ’DESCRIPTION IN INDENT STATUS’ section:1. CompleteOrder Tickwhentheentirequantityindentedhasbeenreceivedinonetime2. Partshipmentwith

thebalancependingTickwhenonlyapartquantityhasbeenreceivedandmentionthebalancequantitypendingfordelivery

3. FinalshipmentcompletingtheOrder

Tickwhenthelastlotscheduledagainsttheindentedquantityhasbeenreceived

4. PartshipmentwithbalancefromPOcancelled

Tickwhenthepartlotorsupplyagainsttheindentedquantityhasbeenreceivedandmentionthequantitythathasbeencancelledforsupply

Using the following instructions, fill in each field in the overview section:HowtoComplete“Form”section—1. Product Code EntertheuniqueItemorProductCodeinshort2. Product Description Describetheproduct/commoditymentioningthecorrectname,dosage,if

applicable3. Unit of Measurement

(UoM)Mentiontheunitinwhichthisproductiscountedormeasured

4. Quantity on PO/LOA MentionthequantitywhichiswrittenontheAWB/docket/Invoice/PO/LOA20. Quantity Received Physicallycountthequantityreceivedandmentionthequantity21. Discrepancy SubtracttheQuantityreceivedfromtheQuantityonPO/LOAandmentionthe

units.Incasetheresultiszero,thenmentionitas‘Nil’discrepancy22. Comments (damaged

/ incorrect items)Incaseofpositiveornegativenumber,mentionthequantityandcommentsalongwith

THE SUPPLIER COMPLETES THESE FIELDS:23. Signatures (bottom of

form)WhenGRNispreparedandapproved,itneedstobesignedanddated:

• The person delivering the consignment should signwith name, company,designationandsignature,transportdetailsandrecordthedateofpreparation

THE RECEIVER/STAFF RECEIVING COMPLETES THESE FIELDS:24. Signatures (bottom of

form)WhenGRNispreparedandapproved,itneedstobesignedanddated:

• The person accepting the GRN should sign with name, designation andsignatureandrecordthedateofacceptance


DA

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DRV

OTHERS

OTHERS

OTHERS

OTHERS

OTHERS

OTHERS

OTHERS

OTHERS

Next Visit Date

Remarks/Pill Count/Advance Event of Drugs

Patient Signature/Thumb Impression

DDR FormVIII


TLE

ZLN

ZL

TL

EFV

NVP

AL

ATVR

LPVR

RAL

RTV

DRV

OTHERS

OTHERS

OTHERS

OTHERS

OTHERS

OTHERS

OTHERS

OTHERS

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Next Visit Date

Remarks/Pill Count/Advance Event of DrugsPatient Signature/Thumb Impression

DAT

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Prod

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DDR Form Job Aid Daily Dispensing Register (DDR) Job Aid

Purpose Gathersdataonhowmanycommoditiesarebeingdispensedataparticularfacility.

• Recordsthequantityofeachproductreceivedbyacustomer(bynameorclientnumber)andbydate.

• At the last section of the DDR, the total quantity dispensed or used iscalculatedforeachproductandthenusedforreportingpurposes.

Facilities Where Used ServiceDeliveryPoint,e.g.,ART,LAC,SA-ICTC,FICTC

Used to Make These Decisions

• Setcommoditylevelsthatwewouldliketokeepinthestoretomeetdemand

• Decidehowmuchtoindent


Using the following instructions, fill in each field in the overview section:

How to Complete “Part 1” section—

1. Facility Name NotethenameofthefacilitywherethisDailyDispensingRegisterisbeingused

2. District NotethenameofthedistrictwherethisDailyDispensingRegisterisbeingused

3. Daily Dispensing Register Reference No.

Thisnumberispre-printedandusedasanaccountingmethodtotrackaparticularregister

Using the following instructions, fill in each field in the tracking section:

How to Complete “Part 2” Section—

4. Date Notethedatewhenacommodityisissuedtoapatient

5. Patient Name Notethenameofthepatienttowhomthecommodityisbeingissued

6. Quantity Issued Findthecommoditythatisbeingissuedtotheclientandrecordthequantityofthatcommoditybeingissued

At the bottom of each page:

7. Subtotal Quantity Dispensed (page)

Whenapageisfilledup,addupthetotalforhowmanycommoditieshavebeenissuedandnotethetotalinthebottomrow

At the end of the month:

8. Total Quantity Dispensed (All pages to date this month)

Attheendofthemonth,addupthetotalforeachofthedifferentcommoditiesissuedinthatmonthandnotethetotalinthebottomrowonthelastpage


Monthly/Quarterly Stock Report (MSP/QSP)IX

Mon

thly

/Qua

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ly S

tock

Rep

ort (

MSP

/QSP

)

FACI

LITY

NA

ME:

DAT

E PR

EPA

RED

:

REP

OR

TIN

G P

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DFR

OM

(DD

/MM

/YY)

(DD

/MM

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TO

SACS

:

REFE

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O.:

MA

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MO

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S O

F ST

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LEV

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MIN

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EVEL

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Repo

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by:

S

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:

D

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(F

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by:

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ReportS.No.

Products/Commodities

UnitofMeasure

BatchNumber

ExpiryDate

Manufacturer

Initialstock

Receiving

Issue

Transfer

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StockonHandatSACSandRegionalLevel

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FinalStockonHand(SOH)

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Monthly/Quarterly Stock Report (MSP/QSP) Job Aid Monthly/ Quarterly Stock Report Job Aid

Purpose RecordsalldetailedinformationknownaboutacommodityinagivenlocationforagivenreportingperiodatStatelevel

• Recordsinformationaboutallthelotsorbatchesofasingleproduct. • Recordsinformationonallinventorytransactionofasingleproduct..

FacilitiesWhereUsed AllFacilitiesUsedtoMakeTheseDecisions

• Confirmcommoditylevelsatanypointintime • Decidehowmuchtoindent • InformedFEFOdistribution/whentoissuecommodity

Using the following instructions, fill in each field in the overview section:How to Complete “Part 1” section—1. Facility Name NotethenameofthefacilitywherethisMonthly/QuarterlyStockReportis

beingused2. SACS NotethenameoftheSACSwherethisMonthly/QuarterlyStockReportisbeingused3. Date Prepared Notethedateonwhichthestockreportisbeingprepared4. Reference No. Notethereferencenumberforrecordonthisform5. Reporting Period Notethereportingperiodforwhichthestockinformationisbeingused6. Maximum Months of

Stock LevelNotethemaximummonthsofstocklevelmaintainedatthefacility

7. Minimum Months of Stock Level

Notetheminimummonthsofstocklevelmaintainedatthefacility

Using the following instructions, fill in each field in the tracking section:How to Complete “Part 2” Section—8. S.No. Numbereachline(e.g.thefirstlineis#1)9. Products/

CommoditiesNotetheproduct/commoditiesbeingrecordedonthisMonthly/QuarterlyStockReport

10.UnitofMeasure Notetheunitofmeasurefortheparticularproduct/commodity11.BatchNo. Notethebatchnumberfortheproduct/commoditybeingreceivedorissued12.ExpiryDate NotetheExpiryDatefortheparticularproduct/commodityinthisformat:

MONTH/YEAR(e.g.MM/YYYY)13.Manufacturer Notethenameofthemanufactureroftheparticularbatch14.InitialStock Notetheinitialortheopeningstockonthefirstdayofthereportingperiod15. Receiving Notethequantityofthecommodityreceivedduringthereportingperiod16.Issue Notethequantityofthecommodityissuedduringthereportingperiod17.Transfer Notethequantityofthecommoditytransferredtootherfacilityduringthe

reportingperiod18.Loss/Adjustment Ifapplicable,notequantityofanylossesoradjustmentsduringthereportingperiod:

• Recordlossesasanegativenumber(e.g.expiries,damagesetc.) • RecordadjustmentsINTOthefacilityasapositivenumber(transfer-in) • RecordadjustmentsOUTofthefacilityasanegativenumber(transfer-out)

19.StockonHandatSACSandRegionalLevel

DeterminethefinalStockonHandorclosingbalanceonthelastdayofthereportingperiodby:

• TakeOpening Balance and either add the receipt or subtract the issue ortransfers

• Ifapplicable,addadjustments • Ifapplicable,subtractlossesornegativeadjustments

20.StockonHandofFacilitiesatlowertier

Addandnotethetotalquantityofstockavailableatallfacilitiesatthelowertier,asreportedonthelastdayofthegivenperiod

21.FinalStockonHand AddtheavailablestockquantityatSACS/Districts/Facilityandstockonhandofthefacilitiesatlowertiertoarriveatfinalstockonhandavailableforthereportingperiod

22.ReportSign-Off Notethename,designation,signatureanddateofthepersonpreparingandapprovingthemonthlyorquarterlystockreport.


1. USAID | DELIVER PROJECT, Task Order 1. 2011. The Logistics Handbook: A Practical Guide for the Supply Chain Management of Health Commodities. Arlington, Va.: USAID | DELIVER PROJECT, Task Order 1.

2. Guidelines for the Storage of Essential Medicines and Other Health Commodities John Snow, Inc./DELIVER. 2003.

3. Strategic Supply Chain Management, Second Edition, The Five Disciplines for top performance | Shoshanah Gohen & Joseph Roussel

4. USAID | DELIVER PROJECT, Task Order 4. 2014. Guidelines for Warehousing Health Commodities. Arlington, Va.: USAID | DELIVER PROJECT, Task Order 4. Second edition (First edition 2005)

5. How to calculate vaccine volumes and cold chain capacity requirements. Geneva: World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO.

References

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