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Lessons Learned: Strengthening Laboratory Supply Chains. Ronald Brown, MA, CLS(NCA), CHE, MT(ASCP). August 16, 2006. JSI/DELIVER Country Experience. Countries of work: Ghana, Kenya, Uganda, Zambia Interventions include: Laboratory Services and System Assessments,
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Lessons Learned: Strengthening Laboratory Supply Chains Ronald Brown, MA, CLS(NCA), CHE, MT(ASCP) August 16, 2006
JSI/DELIVER Country Experience • Countries of work: Ghana, Kenya, Uganda, Zambia • Interventions include: • Laboratory Services and System Assessments, • Logistics System Design and Rollout, • Forecasting and Quantification, • Standardization, • Procurement, • Donor Collaboration
I. Assessments of laboratory systems are critical for identifying areas for improvement and serve as a baseline for monitoring. • In one country, the assessment enabled stakeholders to: • Identify key policy issues requiring attention, including roles and responsibilities for procurement and distribution of lab supplies. • Develop a costed implementation plan that identified funding implications and gaps associated with each scenario.
II. Stakeholder collaboration through a coordinating body can reduce duplication and maximize limited resources. • In another country, a national laboratory technical working group composed of MOH, donors, NGOs/FBOs, and other stakeholders developed an operational plan that: • outlines each stakeholder’s current and planned activities, • will be used to monitor progress, • will serve to help mobilize resources
III. Standardization of laboratory techniques and tests is key for effective supply management. • Standardizing laboratory procedures by level is critical for: • accurate quantification and procurement • efficient and effective management of lab supplies and supply chains • development of a system-wide quality assurance schemes • The standardization process should be representative and consultative to ensure effective implementation
Benefits of Standardization • In one country, the standardization process involved representatives from all levels in the system and resulted in: • Reduction of the number of items in the system by 10 fold • Definition of standard operating procedures for testing services, instrumentation by level, and procedures for logistics management • Efficiency and economy of scale in procurement of supplies for CD4 count, ALT, Creatinine testing • Opportunity for an external QA program
IV. In the absence of usage data, service statistics data should be used for quantification and procurement • In two countries where usage data was not available for quantification: • Standardization of the test menu, techniques and supplies was conducted • The number of supplies necessary for each test, service statistics and adjustments for stockouts were used to estimate needs • Results of the quantification were used for national procurement decisions
V. Systematically designing a logistics system is a necessary step in enhancing availability of laboratory supplies • In another country a key system design decision was to link procedures for ordering and resupply to logistics reporting, thus increasing the likelihood of reporting rates
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