2. Monitoring & Evaluation – FPS Grant Activities By Mary Kama, GMU

3. A department of the Ministry of Health EXPANDING HEALTH OPPORTUNITIES Outline 1.Role of FPS to Grant 2. FPS Grant Activities 3. Link to Supply Chain Management 4. Monitoring of Impact of IM Trainings 5. Analysis & Findings of Supervisory Visits 6.Way forward

4. A department of the Ministry of Health EXPANDING HEALTH OPPORTUNITIES How Grant activities contribute to MoH Strategies Strategic Goal 3 HSS is undertaken at all levels in the MoH Obj 8.5 -Proportion of popln with access to affordable essential medicines on a sustainable basis -80% of facilities rated service satisfactory Obj 8.9: M&E - Strengthening the M&E framework Corporate Plan – Output 10 http://www.health.gov.fj/files/reports/Corporate%20Plan%202011.pdf -Elimination of stock out of medicines from present 100/month -% of goods (incl. all stock at FPS + HFs) overstocked/ annum = <5% -% of goods expired+ value (incl. all stock at FPS + HFs) per year = <5% -Total volume of stock at one point in time @ 80% (Universal Access) Includes Vitals (71 out 100)

5. A department of the Ministry of Health EXPANDING HEALTH OPPORTUNITIES Why FPSC is CRITICAL to the Nation? COMMON GOODS that are used my the majority of the population to improve quality of life Essential Medical & Diagnostic Supplies Vital Medical & Diagnostic Supplies

6. A department of the Ministry of Health EXPANDING HEALTH OPPORTUNITIES 1. Role of FPS to Grant FPS activities contribute to 3 out of the 10 objectives of the grant To contribute to health systems strengthening Strengthen Laboratory Services Strengthen Pharmaceutical Supply Management

7. A department of the Ministry of Health EXPANDING HEALTH OPPORTUNITIES 2. FPS Grant Activities Under the Grant, total of 160+ activities FPS has 6 in Y1 & 5 in Yr 2 1.Revision of SOPs 2.Training of Trainers (19) in Meds Supply Mx 3.Training of 144 nurses by SDHSs + FPSC 4. Supervisory Visits to H/Facilities by SDHs 5.Procurement of identified Lab Commodities + HIV-RDKs 6.Procurement of Lab supplies for DST & Liquid Culture

8. A department of the Ministry of Health EXPANDING HEALTH OPPORTUNITIES 3. Link to Supply Chain Management Good Waste Management Good Supply Chain Management Order…….. Stock Taking Keeping Proper Records Organize Supplies…… FEFO Monitoring & Evaluation Receive supplies. …Quality Assurance Health Systems Strengthening

9. A department of the Ministry of Health EXPANDING HEALTH OPPORTUNITIES 4. Monitoring of Impact of IM Training Done through Supervisory Visits using Checklists Checklists are monitoring Tools IM Checklists – Vital Medicines Lists; Storage Conditions Aim – Score 100% in storage room conditions & maintain 100% vital medicines availability in health facility On-Site refresher trainings & Reporting

10. A department of the Ministry of Health EXPANDING HEALTH OPPORTUNITIES 5. Analysis & Findings of S/Visits Health Facility Coverage Category# visitedTotal% Sub-div level 155100 Sub-div level 2101663 Health Center Level A 81267 Health Center Level B 61060 Health Center Level C 175730 National Referral center 2367

11. A department of the Ministry of Health EXPANDING HEALTH OPPORTUNITIES 5. Analysis & Findings of S/Visits % Availability (Tracer Medicines) 100%14 90 - 99%13 80 - 89%11 70 - 79%5 60 - 69%3 <60%1

12. A department of the Ministry of Health EXPANDING HEALTH OPPORTUNITIES 5. Analysis & Findings of S/Visits PF Target Facility Coverage DivisionTotal Target Health Facilities Total covered % Central281864% Eastern2000% Western321031% Northern231878%

13. A department of the Ministry of Health EXPANDING HEALTH OPPORTUNITIES 5. Analysis & Findings of S/Visits Grant PF Target Health Facilities Attended IM TrainingStationTotal Score (Checklists) Store room Conditions (/10) Vital List (%) YesWaiyevo Health Center9100 YesTaveuni Sub-divisional Hosp10100 YesSavusavu Health Center10100 YesSavusavu Sub-divisional Hosp10100 YesRabi Health Center994 YesNatewa Health Center894 YesSaqani Health Center1094 YesNabouwalu Health Center994 YesNabouwalu Sub-divisional Hosp987 YesDreketi Health Center1087 YesTukavesi Health Center1081 YesWainunu Health Center978 YesNakorovatu Health Center1075 YesLekutu Health Center972 YesLabasa Health Center866 NoSeaqaqa Health center894 NoWainikoro Health Center494 NoKorotasere Health Center984 NoVuna Health Center681 Summary - 4/19 health facilities had 100% stock availability (target H/facilities), 3 of nursing stations had 100% availability. Nurses managing 11 /19 H/Fs that scored >80% in both vital list & storeroom conditions, attended Inventory Management training. However, Nurses managing 4/19 HFs who attended IM trainings scored between 66% to 78% in both checklist categories. The remaining nurses DID not attend IM training BUT scored >80% in both categories.

14. A department of the Ministry of Health EXPANDING HEALTH OPPORTUNITIES 5. Analysis & Findings of S/Visits Generic Issues Identified Medicines not used by HFs therefore not ordered BUT allocated to health facility HFs continue to receive short expiry medicines from FPS + Late arrival of stock Incorrect use of stock cards Is the FPSC Order Form user friendly? Storage capacity Poor inventory management practices – HFs incl of labs More monitoring support by divisional supervisors + FPSC Poor supply stability – out of stock Communication

15. A department of the Ministry of Health EXPANDING HEALTH OPPORTUNITIES 6. Way Forward 1. Alignment to Strategic Objectives – all work together 2. Possibility for FPS to review order form 3.More supervisory visits – can be co-funded by the Grant 4.Practice new knowledge learnt in IM 5.FPSC to work with divisions/program Managers to improve forecasting ( procurement planning 6.Improve checking process at FPS dispatch 7.Improve communication 8.Capacity building opportunities 9.Improve storage capacity 10.Improve supply chain 11.Lab, Dental, X-ray to develop a vitals list