Table of Contents
Chapters
- A New Look at Logistics
- Clients Come First
- People and Performance
- The Role of Information
- Forecasting and Procurement
- Distribution
- Toward Contraceptive Security
Highlights
- Programs face funding crisis
- Benefits of better logistics
- Improving staff performance
- Tips on building policy support
- Checklist: Assessing the supply chain
- How to make accurate forecasts
- Push or pull distribution
- The commercial sector can help
This issue of Population Reports was prepared in collaboration with the DELIVER Project of John Snow, Inc.
Published by the Population Information Program, Center for Communication Programs, The Johns Hopkins University Bloomberg School of Public Health, 111 Market Place, Suite 310, Baltimore, Maryland 21202, USA
Volume XXX, Number 1,
Winter 2002
Series J, Number 51
Family Planninng Programs
Recording and Reporting Data
A good LMIS records and reports data from all facilities in the supply chain. In general, LMIS data are recorded on stock-keeping records (store ledgers, inventory control cards, bin cards), transaction records (requisition and issue vouchers, packing slips), and consumption records (service records, daily activity registers).
Recording and reporting data are often difficult, especially where programs lack modern information technologies. In the Philippines in 1991, for example, data on consumption of contraceptives either were not available at all or were not put in the hands of supply chain managers. Instead of being allocated on the basis of clients’ use, contraceptives were allocated to provinces in equal amounts, causing widespread supply imbalances. In 1997, after an LMIS had been developed as one step in strengthening the logistics system, data collection and record keeping improved. The program could allocate contraceptives on the basis of client consumption, reallocate overstocks to understocked areas, and monitor and evaluate performance better (82).
In many developing countries LMIS reports move from the service delivery level to more central levels on a fixed timetable (7, 60, 77). A better approach is to link reporting to resupply—such as when the LMIS report is also the request for new supplies. In Ghana, for example, contraceptive resupply is based on the dispensed-to-client data submitted through the LMIS. Because resupply depends on receipt of these reports, reporting rates come close to 100%, and stocks are adequately resupplied (28).
Another effective strategy is to gather LMIS data when supplies are delivered (150). In Bangladesh, for example, staff from service delivery points pick up monthly supplies from their sub-district stores and submit a monthly consumption report at that time. The sub-district stores can use these data to determine the quantities of supplies that service delivery points need (83).
In Turkey a “topping up” delivery system simultaneously gathers logistics data and delivers the right amount of contraceptive supplies. In this system a distribution officer with a fully stocked vehicle visits each health facility every four months. The officer makes a physical count of supplies on hand, calculates the average monthly consumption based on the total supplies on hand at the previous delivery visit, calculates a new maximum stock level, and then “tops up” the clinic stocks to that level. This system has substantially re-duced stockouts and in some cases has eliminated them (40).
Automation. Programs prepare logistics reports by processing LMIS data either manually or by computer. At the service delivery and intermediate levels, logistics data processing is almost always manual. At the central level, however, computer processing is more common, particularly as the volume of data grows and reports become more complex.
As family planning programs manage more and more supplies, a computerized LMIS becomes essential. With automation, the quality, timeliness, and use of logistics data improve dramatically—because more supplies can be tracked, sites can be monitored regularly, data can be quickly aggregated, analyzed, and submitted to decision-makers, and information can be shared easily. Also, as family planning priorities, method mixes, organizational structures, and clients’ needs change, computerized LMIS systems make it easier to respond.
There is further reason to automate LMIS in countries where family planning is being integrated with other health programs or decision-making is decentralizing. Computerized data processing is necessary to manage a wider array of products within integrated systems or to provide data to a larger number of managers within decentralized ones (7, 48).
Linking with Other
Information Systems
Health information systems (HIS) are essential to health service delivery organizations. In developing countries where HIS are being improved, many people are asking whether to include the contraceptive LMIS in an umbrella HIS. Similarly, an increasing number of countries are considering integrating their contraceptive LMIS with their pharmaceutical LMIS.
Health Information Systems. In many developing countries the contraceptive LMIS is better developed and more sophisticated than the HIS, often because the contraceptive LMIS has received more donor support (102). Thus the contraceptive LMIS may attract the attention of policy-makers who want to upgrade the HIS.
Merging the two systems is rarely appropriate, however, because they have different purposes, serve different users, and therefore have different operating requirements (49). HIS collect service statistics such as rates of health center use and types and number of health problems treated, information on births and deaths, surveillance data, and financial and management data. Compared with the contraceptive LMIS that reports data frequently and in great detail, HIS typically capture less detail and report information infrequently. For example, although a HIS may track the stock levels of 10 to 20 representative products, it does not provide enough data to manage the logistics systems—that is, data on quantities of all supplies provided to clients, stock levels, or losses at all facilities.
Some countries have tried to merge HIS and LMIS functions but found that slower reporting and loss of vital logistics details compromise the LMIS (85). The two systems, however, can be made compatible and complementary. For instance, summary LMIS data on stockouts can be reported to the HIS for planning purposes.
Pharmaceutical LMIS. Integrating the contraceptive LMIS with a country’s pharmaceutical LMIS is more likely to succeed than trying to merge the LMIS and HIS. In most countries the contraceptive LMIS and the pharmaceutical LMIS historically have been separate, but they are similar in design and intended function. In merging the two systems, careful consideration must be given to the total volume of data processing required. For example, a contraceptive LMIS that effectively tracks 5 to 10 items manually will not easily be expanded to track an additional 1,000 pharmaceutical items.
Integrating the two systems usually will require automation, at least at the central levels of the supply chain. Retraining logistics staff also may be needed at all levels of the system. Integration often takes years to accomplish and does not always succeed.
