RAVREDA – AMI USAID Project report, Colombia 2009

1. RAVREDA – AMI USAID Project report, Colombia 2009 SUPPLY CHAIN MANAGEMENT OF MALARIA MEDICINES & SUPPLIES, Supervision Tool pilot test experience in GUYANA

2. Regions and facilities visited

3. Republic of Guyana, Regions and places visited in the course of pilot test of supervision tool. Region 1 Mabaruma Hospital, White Water H post Region 7 Bartica Hospital, Karrau Creek H.postItaballi H post • Region 8 Hospital • Tumatumari, • Health Post Region 9 Lethem Hospital, Karasabai H.post Tiger Pond, H.post

4. IDENTIFIED PROBLEMS

5. IDENTIFIED PROBLEMS

6. Availability and usage of medicines: Indicators 9 total health facilities supervised (two visits) • % of medicines available at the time of the visit 60 % • % of medicines in enough amount to cover requirements until next delivery 100 % • % of laboratory supplies in adequate amount until next delivery 67 % • % of all the health facilities visited that had on each and every one medicines at the time of the visit 100 % • % of all the visited establishments that having all medicines in sufficient amount to cover requirements until next delivery 33.3% • % of all the health facilities visited having on all the necessary supplies of laboratory. 100 % • % of all the health facilities visited that counted on supplies of laboratory in sufficient quantity to cover requirements until next delivery. 66.6 %

7. Conclusions • Indicators pilot attends revealed a low percentage because no second visit were made to 2 facilities in region 9 • Answering questionnaire amount to 1 – 1.5 hrs • Most questions require verification with documents • Application of the supervisory tool at the facility level indicates that the tool proved to be well understood by both interviewer and interviewee, it provides the relevant data and it assists the stratification process according to needs However • It may be difficult to apply on a routine basis due to transportation problems. • Further, it is evident that supervisory visits are inadequate in the region. This may be as a result of:- • Lack of transportation • Lack of funding to purchase transportation services • Lack of communication between departmental heads • Failure to develop, integrate and /or implement cohesive work plans • Inadequate monitoring of CRIV requests for medicines and supplies. • Submission of weekly reports i.e • unclear directive as to where to submit weekly reports eg.7 • inadequate monitoring of weekly reports submission • Strengths • The tool accurately reflect the situation in the facility and the Region • Assist in identification and solve or problem Collects data that compliments decision making • provide corrective feed back to identified problems on supervisory visit • provide opportunity for on – the job training.

8. RECOMMENDATIONS • The Malaria program is now part of the Primary Health Care Services, therefore the following recommendations are proposed. • Development of an integrated work plan. • Education of health workers at sub–regional level, emphasis on:- • Medicines & diagnostics availability for prompt diagnosis and treatment. • Relationship between forecasting for planned activities and availability of Medicines & supplies. • Quality control • Increased Supervisory visits to health facilities