KINGDOM OF CAMBODIA
DEPARTMENT OF DRUGS, FOOD AND COSMETICS
MINISTRY OF HEALTH
LOGISTICS MANAGEMENT MANUAL
FOR
DAY 1
DAY 2
DAY 3 / Session 1
Workshop Goal
Workshop Objectives
Workshop Schedule
Introductory Activities
Session 2
Introduction to Procedures Manual
Session 3
Overview of the Cambodian Essential Drugs Distribution and Logistics Management System.
Session 4
Logistics Management Responsibilities
Session 5
Storage guidelines.
Session 6
Conducting Physical Inventory.
Session 7
Physical Inventory (Activity Review)
Session 8 (Part 1& Part2)
Recording and Reporting.
Session 9
Stock status review
Session 10 (Part 1 & Part 2)
Calculating How Much to order
Session 11
Logistics Monitoring & Supervision
Workshop evaluation
Closing Ceremony
Workshop Schedule
Day 1
8.00 – 9.00 Registration and Opening speeches (60 mns.)
9.00 – 10.00 Introductory Activities (60 mns.)
10.00 – 10.15 Coffee Break
10.15 – 12.00 Introduction to the Procedures Manual (30 mns.)
Overview of Cambodian Essential Drugs Distribution and
Logistics Management System (30 mns.)
Logistics Management Responsibilities (45mns.)
12.00 – 2.00 Lunch
2.00 - 3.15 Storage Guidelines ( 135 mns.)
3.15 - 4.00 Tea Break
4.00 - 5.00 Storage Guidelines (Continued)
Day 2
8.00 – 10.00 Conducting a Physical Inventory (120 mns.)
10.00 – 10.15 Coffee Break
10.15 – 12.00 Physical Inventory (Activity Review) –20 mns.
Recording and Reporting Part 1 & Start of Part 2( 85 mns.)
12.00 – 2.00 Lunch
2.00 - 3.45 Recording and Reporting Part 2 (165 mns.)
3.45 - 4.00 Tea Break
4.00 - 5.00 Recording and Reporting(Part 2 cont.)
Day 3
8.00 – 10.30 Recording and Reporting (Part 2 continued) – 30 mns.
Reviewing Stock Status (60 mns.)
Calculating How Much to order (Part 1) 60 mns.
10.30 – 10.45 Coffee Break
10.45 – 12.00 Calculating How Much to Order
(Part 2) Assignment (95 mns.)
12.30 – 2.00 Lunch
2.00 - 3.30 Exercises Presentations (45 mns)
Logistics Monitoring and Supervision(30 mns)
Workshop Evaluation (15 mns)
3.30 - 3.45 Tea Break
3.45 - 5.00 Closing Ceremony – Certificate Presentation.
SESSION 1:
INTRODUCTORY ACTIVITIES
SESSION 2:
INTRODUCTION TO PROCEDURES MANUAL
SESSION 3:
OVERVIEW OF THE CAMBODIAN ESSENTIAL DRUGS DISTRIBUTION AND LOGISTICS MANAGEMENT SYSTEM
SESSION 4:
LOGISTICS MANAGEMENT RESPONSIBILITIES
SESSION 5:
STORAGE GUIDELINES
NOTE TO TRAINER:
The JOB AID is designed to be reviewed with participants. Trainer should review the content of each JOB AID by covering the following points.
Request participants to turn to relevant page where they will find relevant JOB AID that will help them performing a specific task.
- A JOB AID is a simple tool that helps you perform a task.
- A JOB AID lists the STEPS that are needed to perform a task.
- Each STEP in a JOB AID is usually listed in the order in which the task should be performed.
- Any time you need to perform a logistics task you can refer to the particular JOB AID for that task. Follow the STEPS to perform the task.
- JOB AIDS are useful for tasks that are not performed on a daily basis. For example : How to report on "Damaged and Expired Drugs". This task may need to be performed whenever the situation arises. For this reason you do not need to memorize the steps but instead, you can refer to the JOB AID each time you need to report.
Point out that JOB AIDS will usually provide the types of information as followed:
TASK
COMPLETED BY
WHEN TO PERFORM
PURPOSE
Most JOB AIDS are then divided into several colums. The first column might give the STEPS in the order in which they are to be performed. The other columns might include ACTIONS, NOTES (which is an explanation of the ACTION). And most JOB AIDS will give EXAMPLES that will help clarify each ACTION.
SESSION 1INTRODUCTORY ACTIVITIES
SESSION GOAL:Participants and facilitators will form an effective learning group.
LEARNING OBJECTIVES:
By the end of this session participants will be able to:
1.Discuss the goal and objectives of the workshop.
2.Develop a list of group norms.
TIME:60 minutes
MATERIALS:
Newsprint paper; Felt markers; Masking tape
Prepared Flipcharts:
1.Training Goal and Learning Objectives:
2. “Workshop Schedule”
TRAINER PREPARATION:
Trainer should ensure that all flipcharts have been prepared in advance of the session, and that all overheads and handouts are ready for distribution.
As participants arrive, trainers should welcome them and ask them to write their name on a name tag (or name tent). Assist them with marking pens and request that they write the name they want to be called during the workshop.
LEARNING ACTIVITIES:
1.Participant and Trainer Introductions (Interactive Presentation) - 20 minutes
Welcome participants to the four-day workshop. Comment that it is a good idea to know each other before getting started, though many of them probably already know each other. Display the following questions which have been written on flipchart paper before the session and ask each participant to stand up and introduce themselves using these guidelines:
Flipchart Prepared Beforehand
PARTICIPANT INTRODUCTIONS1.Name
2.Location of Facility where you Presently Work
3.Total number years in present profession
NOTE: Trainers should feel free to change the above questions. Possible other questions could be about favorite foods, most admired person in the world, etc.
Trainers should begin by introducing themselves, using the same guidelines.
Request participants to wear their name tags (or display their name tents in front of where they sit) throughout the workshop as it will help the trainers remember their names.
2,Ice-Breaking Exercise (Interactive) - 20 minutes
Distribute a small blank piece of paper to each participant. Ask them to take a few minutes and find ONE WORD that they believe describes them. Give examples such as “short”, “Intelligent”, “shy”. Instruct them to write that word on the paper. When finished, they should give the paper to the trainer.
When the trainer has all the piece of paper, distribute one piece to each participant. Hopefully participants will not get the piece of paper they wrote, but if this happens, re-distribute it.
Then instruct participants to locate the person in the room that they think matches the one-word description on their paper. In order to do this they will need to move around the room.
OPTIONAL: If time allows, after all participants have been matched with their one-word descriptions, trainer can request that they go around the room and tell everyone the one word they identified to describe themselves.
3.Review of Workshop Logistics (Lecturette) - 5 minutes
Take a few minutes and review the following logistics:
oArrangements for tea and lunch
oLocation of washrooms/toilets
Point out that reimbursement of travel expenses and per diems will be done during breaks and at the close of the day. (NOTE: Do not discuss details of travel reimbursement, per diem rates, or tea and lunch breaks at this time.)
4.Training Goal and Learning Objectives (Lecturette) - 10 minutes
Display Overhead 1.c, “Training Goal and Learning Objectives”. Request a participant to read the goal aloud. Then ask other participants in turn to read the Learning Objectives. Trainer should comment briefly on the objectives as they are reviewed.
When review is completed, distribute a copy of Handout 1.e, “Training Goal and Learning Objectives”, to each participant. Trainer should also post the flipchart of the Goal and Objectives on the wall where it should remain for both days.
Comment that the content of this workshop has been identified based on a careful review of the knowledge and skills participants will need to effectively manage the Hospital drugstore.
Remind participants of their vast experiences as noted during the self-introductions.
5.Group Norms (Brainstorm) - 5 minutes
Introduce this activity by explaining that since participants will be working closely together for the next two days, it is important to agree on behaviors, or norms, that all participants, and trainers, will follow. Explain that a group norm is a behavior that all participants, and trainers, will agree to follow during the two days.
On the top of a piece of flipchart paper write “GROUP NORMS”. Then ask if anyone has a group norm they would like for everyone in the group to follow. When the idea is given trainer should check with the remaining participants and seek consensus that everyone agrees to follow that particular norm (behavior).
NOTE: some common group norms are: “no smoking”; “raise hands before speaking”; “start and end on time”; etc.
Trainers should also feel free to offer suggestions for group norms.
Trainer should spend no more than 10 minutes on this activity. If at the end of 10 minutes only 2 or 3 norms are listed, move on. It is not important that the list include numerous norms. When finished, thank participants for their assistance in developing the list.
Post the flipchart on the wall close to the exit door so that participants can easily see it. Flipchart should not be removed during the 3 days.
SESSION 2INTRODUCTION OF THE LOGISTICS
PROCEDURES MANUAL
SESSION GOAL:Participants will be introduced to the Logistics Management Manual for Referral Hospital .
LEARNING OBJECTIVES:
By the end of the session participants will be able to:
1.Discuss the general content of the Logistics Management Manual for Referral Hospital.
2.Discuss how the Procedures Manual can be used to get answers to questions when they return to their work settings.
TIME:30 minutes
MATERIALS:
Copy of Health Centre Procedures Manual for each participant.
TRAINER PREPARATION:
The Logistics Management Manual for Referral Hospital should be distributed before beginning Session 3. Distribute a copy to each participant and ask them to write their names on the outside cover.
LEARNING ACTIVITIES:
1.Overview of Procedures Manual (Lecturette) -
Explain that the copy they have been given is theirs to keep. Emphasize that it should be kept in their office, and that if they leave their present facility they should leave the Procedures Manual behind for the person who comes into that facility.
Explain that the Procedures Manual was developed as a reference guide to help participants when they return to their jobs. Explain that the Procedures Manual covers in detail all aspects of the Logistics at Referral Hospital level that they need to know in order to carry out their responsibilities effectively.
Comment that this Manual is the single most important document they will take with them from this training, as it contains the answers to nearly every question they may be faced when doing their job as Hospital Pharmacists. While they are encouraged to take the Manual home tonight and read through it, they will become very familiar with the content of the Manual in the next 3 days. Explain that the content covered in the three-day training is identical to the content covered in the Procedures Manual. The Manual will be used in every session in the next four days, and therefore they must be sure to bring the Manual with them to all sessions.
REVIEW MANUAL CONTENTS:
Request participants to open the Manual to the first page. Comment that on this page they will find a letter from the Director General for Health which states that the Procedures Manual jointly developed by RACHA and EDB has been reviewed and approved by the Ministry of Health for use by Referral Hospitals Logistics Personnel.
In the Appendices “Abbreviations”, provides a list of all the abbreviations and acronyms participants should know.
The “Table of Contents”, is an important part of the Manual. Comment that they will note from these pages that each chapter in the manual is given a title, and beneath the title are a series of questions. Point out that when participants return to their jobs they might have a particular question about Logistics Management. They should pick up their Procedures Manual and try to find the question in the Table of Contents first. Once they find the question, they will immediately be referred to the page on which the answer can be found.
Page 1, “Introduction”, explains why this manual was written and how Referral Hospital Pharmacists should use it.
Chapter 1 starting on page 4, “The Cambodian Essential Drugs Logistics Management and Distribution System ”. The chapter also provides explanation on how the system work.
Chapter 2 starting on page 8, “ Logistics Management Responsibilities”, is an important chapter as it lists all the responsibilities as Hospital Pharmacy Team and Operational District Pharmacist responsibilities are also outlined for your information since you are going to be working very closely with him/her.
Chapter 3 starting on page 11, “Storage guidelines”, provides important instructions and guidelines on how commodities should be stored. lt is also listing the shelf life of each of the core essential drugs and provides guidelines on how to store them to ensure that they are in the best possible condition when they are given to clients. In addition, the chapter explains how to determine the expiry dates of core essential drugs, how to protect against expiry by following First Expiry, First Our distribution principles, and what to do if core essential drugs are damaged or expired while at your facility.
Chapter 4 starting on page 22, "Conducting a Physical Inventory" provides you instructions on how to conduct a physical inventory on a step by step basis.
Chapter 5 starting on page 24,"Recording and Reporting" describe the usages of the various forms applicable to Hospital stock movement and reporting cycle.
Chapter 6 starting on page 37, “Reviewing Stock Status”, this chapter describes why it is useful to know your stock status, it will help making the appropriate decisions to request commodities much more rationally.
Chapter 7 starting on page 41, “Calculating How Much to Order ”, This chapter is specifically about HOW to request supplies and HOW MUCH to request. It also gives explanations about the various formulas to be used for Essential Drugs Commodities.
Chapter 8 starting on page 45, “Logistics Monitoring and Supervision”, This chapter outlines why Logistics Supervision and Monitoring is required. It will help you ensure that better prepare yourself for Supervision visits.
At the end of the Manual you will find a series of annexes. Most of these annexes are blank copies of the various MoH forms, as well as copies that have been completed to demonstrate the correct way each form should be filled out. Emphasize that participants will become familiar with every page of this Manual in the next 3 days, and that they should bring their copy with them to each session.
SESSION 3OVERVIEW OF THE CAMBODIAN ESSENTIAL DRUGS DISTRIBUTION & LOGISTICS MANAGEMENT
SYSTEM
SESSION GOAL:Participants will gain a basic understanding on how Essentials Drugs and other commodities are being distributed in Cambodia.
LEARNING OBJECTIVES:
By the end of the session participants will be able to:
1.Describe the role of the Essential Drugs Bureau (EDB).
2.Describe the role of the central Medical Stores (CMS).
TIME:30 minutes
MATERIALS:
Flipchart paper, felt marker, masking tape
TRAINER PREPARATION:
Trainer should be very familiar with Chapter I in the Procedures Manual.
LEARNING ACTIVITIES:
INTRODUCTION AND BACKGROUND TO THE SYSTEM
Begin the session by explaining that in this session participants will get an overview of the system. Point out that this session is only intended to give some background information on the MoH National Drug Supply system; emphasize that they will learn more details of the system over the next 2 days.
Write the following on flipchart paper:
FLIPCHART PAPER
MoH EDB CMSMoH: Ministry of Health
EDB: Essential Drugs Bureau
CMS: Central Medical Stores
Ask participants to raise their hands if they know how drugs reach their Referral Hospital.
Ask a participant who has raised his/her hand to give a brief description of the system. If not mentioned by participant, trainer should point out that the Essential Drugs Bureau is responsible for forecasting Essential Drugs needs (excluding Special National Programme) submitted by all the Health Facilities in Cambodia and that the Central Medical Store are responsible for distributing Essentials Drugs and other commodities.
Point out that the Ministry of health, through EDB and CMS has established a distribution system designed to ensure that an adequate and continuous supply of essential drugs are available in health facilities nationwide.
2.CMS
The Central Medical Store (CMS) of the Ministry of Health is located in Phnom Penh and has the responsibility for clearing all imported goods and transferring them to the CMS. The CMS has two other major responsibilities: 1) manage the inventory within the CMS and 2) transport commodities to lower levels of the supply system according to amounts specified by the Essential Drugs Bureau (EDB). Based on EDB requests, the CMS supply to OD storerooms (in ODs where such storerooms exist), or they supply directly to Health Centers and Referral Hospitals, in ODs where an OD storeroom does not exist. It should be noted that in this case, the CMS will prepackage items for each health center/referral hospital and then send out all these packages together to the OD. Individual health centers and referral hospital staff then come to a designated point in the OD to receive their specific package of commodities. So, in effect, the CMS is directly supplying these health centers and referral hospitals.
The CMS manages transport for nearly 75 percent of the country. The other 25 percent (or 6 provinces) is managed by a private transport company.
- EDB
The EDB is a unit of the Ministry of Health. Its primary responsibility at this stage is to "quantify" the amounts of commodities to be given by the CMS to lower level stores. The EDB is also responsible for supervision and monitoring of lower level stores in the supply network.