1. CLICK TO ADD TITLE [DATE][SPEAKERS NAMES] The 6th Global Health Supply Chain Summit November 18 -20, 2013 Addis Ababa, Ethiopia Human Resource Capacity for Supply Chain Management: Training Pharmacy Assistants for Deployment to Health Centers in Malawi Phillip P. Chinula

2. Presentation Overview Human Resources in Supply Chain management in Malawi context Pharmacy Assistant Training Program Program Progress to date Successes and Challenges in Implementation Way forward

3. Human Resources for Supply Chain in Malawi According to the 2011 Health Sector Strategic Plan (HSSP), there are only five pharmacists in the country’s public health sector to fill an estimated 90 positions. Only 24% of the established positions for Pharmacy Technicians are filled. No Pharmacy personnel available in health centres Medicines and medical supplies management and dispensing done by non-pharmacy staff such as nurses, medical assistants, community health workers, and attendants Pharmacy / Supply Chain workforce results in lots of problems: Poor medicines management leading to Stock outs, wastage etc Poor dispensing quality Limited and/or inaccurate data including LMIS reporting from health centers

4. The Pharmacy Assistant Training Program The Pharmacy Assistant Training Program sets outs to address three main factors that affect over all medical supply chain performance namely; –Human resources, –Access to information, and –Availability and use of commodities. Program partnership with Malawi Ministry of Health, VillageReach and the University of Washington Global Medicines Program and supported by the Barr Foundation and USAID | DELIVER project. Overall goal of MOH to train and deploy 650 Pharmacy Assistants Program launched in 2012

5. Structure/design of PA program Divided into two cohorts: –5 months at district hospital in 1st year and at health center in 2 nd year. –5 months on campus learning theory Students are contributing to improving pharmacy management and supply chain needs at district hospitals and health centers during training while gaining relevant experience and training. 2 year certificate program with emphasis on practical learning and supply chain management. Ten weeks of orientation in pharmaceutics, pharmacology, and medicines and medical supplies management.

6. Progress to date 50 students (27 male and 23 female) recruited and enrolled in March 2013 will graduate in 2015 24 Pharmacy Technicians oriented and trained as preceptors. Developed practical training support tools: Student Workbook and Preceptor Guide Monthly supervision at district hospitals supervision by MCHS faculty and program partners 25 students successfully completed 5 months practicum at district hospitals and exchanged with those that were on campus

7. Successes so far Successes Students are learning - 100% student retention 11 district hospitals have 2-3 students helping to alleviate the burden on district pharmacies Improvements in terms of observing dispensing standards, adherence to storage conditions, and LMIS reporting rates at district facilities with PA students. Institutional support (MOH, DHOs, MCHS) indication of progress and sustainability

8. Improvements in compliance to Storage Conditions

9. Improvements in adhering to dispensing standards

10. Additional Outcomes District Health Officers and Medical Officers at practical sites routine report that the students are contributing to improved performance at the district pharmacies. Pharmacy Technicians have reported that their mentorship role has pushed them into refreshing and exploring further their professional knowledge MCHS lecturers monthly presence at health facilities supervising students has increased professional interaction and experience sharing with Pharmacy Technicians. –This has benefited not only students, but all pharmacy staff including Pharmacy Technicians and the facilities and patients in general

11. Challenges MOH Pharmacy staff turnover at national and district levels Some preceptors not available at practicum sites at times due to other training commitments Shortage of permanent lecturers at the MCHS Recruitment of students who will remain in rural areas

12. Way Forward Recruitment of 100 students to enroll in March 2014 with emphasis on rural commitment Recruitment of additional permanent lecturers at MCHS Planning for health center attachment Secure funding for additional cohort to start in 2015

13. Thank you Program information also available at www.villagereach.org