STATE LEVEL TRAINING ON MALARIA PROGRAMME IMPLEMENTION_PSM.pptx

State level

1. STATE LEVEL TRAINING ON MALARIA PROGRAMME IMPLEMENTION FOR IMPACTS SUPPORTED STATE MALARIA HEALTH PRODUCTS LOGISTICS AND SUPPLY CHAIN MANAGEMENT

2. Introduction The Nigerian Government is determined to accelerate and intensify its efforts on malaria elimination within a 10 years plan. Thus, the NMEP’s strategic plan is designed around a comprehensive package of preventive services to reduce the disease burden and increase curative services addressing the priority of rapid scale up To successfully achieve its goal and objectives, the programme is to ensure that all malaria health products needed are made available, affordable and accessible. To accomplish this, the NMEP has designed a Malaria Products Logistics Management System ( MPLS) Standard Operating Procedure (SOP) to manage the products efficiently and effectively. This document is to guide the uninterrupted availability of malaria health products at the facilities in line with the goal of the National Malaria Strategic Plan of achieving a parasite prevalence of less than 10% and reduce mortality attributable to malaria to less than 50 deaths per 1,000 live births by 2025

3. Goal Provide guide to ensure uninterrupted availability of malaria products at the facilities in line with the goal of the National Malaria Strategic Plan Provide procedures for the efficient and effective logistics management of Malaria products 1 Serve as a reference material for healthcare staff in performing tasks related to the management of Malaria products 2 Simplify and standardize the work required for the functioning of the Malaria Products Logistics Management System ( MPLS ) 4 Objectives The Malaria Products Logistics System ( MPLS ) manual aims to achieve five objectives SOURCE: Malaria Product Logistic System (MPLS) SOP 3 Maintaining adequate supplies of malaria products and maintaining optimal inventory at all levels. Monitoring logistics activities at all levels, including service delivery points 5

4. The manual outlines the steps required for performing five tasks and the personnel that should make use of the guide Tasks Maintain adequate supplies of malaria health products and optimal inventory at all levels Order malaria health products from the Federal Medical Stores, Zonal Hubs, State Central Medical Stores (SCMS) etc. Receive, store and issue malaria health products Monitor logistics activities at all levels, including service delivery points Record and report usage of malaria health products All personnel and program management staff with logistics responsibilities at the Federal and zonal levels State Malaria Elimination Programme (SMEP) Managers State Logistics Management Coordinating Units (LMCUs) State CMS Pharmacists Local Government Area (LGA) Logistics Management Coordinating Units (LMCUs) Facility level store pharmacists or personnel responsible for malaria health products User of the manual SOURCE: Malaria Product Logistic System (MPLS) SOP

5. There are three service categories of malaria products Prevention Diagnosis Category Treatment Product Insecticide treated nets (ITN) Rapid diagnostic Test ( RDT ) Unit 1piece 1kit Sulphadoxine 500mg + Pyrimethamine 25mg 1 x 3 Tabs AL1 (Artemether 20 mg + Lumefantrine 120 mg) 1 x 6 tabs AL 2 (Artemether 20 mg + Lumefantrine 120 mg) 1 x 12 tabs AL 3 (Artemether 20 mg + Lumefantrine 120 mg) 1 x 18 tabs AA 1 (Artesunate 25 mg + Amodiaquine 67.5 mg) 1 x 3 tabs Uncomplicated AA 2 (Artesunate 50 mg + Amodiaquine 135 mg) 1 x 3 tabs AA 3 (Artesunate 100 mg + Amodiaquine 270 mg) 1 x 3 tabs AA 4 (Artesunate 100 mg + Amodiaquine 270 mg) 1 x 6 tabs Quinine (300mg) Tablet Severe Quinine injection (300mg/1ml) 2ml ampoule Artesunate suppository (50mg) Each Artesunate injection (60mg/1ml) 1ml vial Artemether injection (80mg/1ml) 1ml ampoule SOURCE: Malaria Product Logistic System (MPLS) SOP Manual Sulphadoxine (250/500mg) Pyrimethamine (12.5/25mg) + Amodiaquine (75/150mg) 1 x 1 x 3 Tabs AL 4 (Artemether 20 mg + Lumefantrine 120 mg) 1 x 24 tabs

6. Other treatment category of malaria products Category Product Unit SOURCE: Malaria Product Logistic System (MPLS) SOP Manual Treatment ASPY - Artesunate (20mg)+ Pyronaridine (60mg ) 1 x 9 tabs DHP 1 - Dihydroartemisinin (20mg) + Piperaquine (160mg) 1 x 3 tabs DHP 2 - Dihydroartemisinin (40mg) + Piperaquine (320mg) 1 x 3 tabs AMQ - Artesunate / Mefloquine (100mg/200mg FDC ) 1 x 9 tabs Uncomplicated APQ 1 - Artemisinin (20mg ) + Piperaquine (160mg) 1 x 6 tabs APQ 2 - Artemisinin (40mg ) + Piperaquine (320mg ) 1 x 6 tabs APQ 3- Artemisinin (62.5mg ) + Piperaquine (375mg ) 1 x 6 tabs DHP 3 - Dihydroartemisinin (80mg) + Piperaquine (640mg ) 1 x 3 tabs

7. Logistics

8. Introduction to Logistics A Robust and a functional logistics system must be capable of providing these Rights; Right Products Right Quantity Right Condition/quality Delivered… Through the Right Transport To the Right Place At Right Time a nd the Right Cost To the right People

9. Logistics Cycle

10. The inventory control system requires each storage facility to establish and maintain the maximum and minimum stock levels for each malaria health product Source: Malaria Products Logistics System (MPLS) SOP Manual Definitions Maximum stock level: the level above which inventory levels should not rise under normal conditions Minimum stock level: the level below which inventory levels should not fall below under normal conditions The maximum stock level is set high enough to guarantee adequate supply at all times, but low enough to prevent overstock and wastages Level MaxSL MinSL EOP Service delivery point 4 2 1 State 6 3 2 National/Zonal 10 5 3 MaxSL : Maximum stock level; MinSL : Minimum stock level; EOP: Emergency order point

11. COMMODITY FLOW MALARIA PRODUCTS FOR ROUTINE 1/2: Product flow Blue Solid line : products flow from Supplier to Federal and State State to service delivery point ( Health facilities) Community level Information flow Black broken lines: Forward information flow Red broken lines : Reverse information flow The reporting is considered re-order and determines resupply LMD Plan is at the State level notifying the Federal level Reporting tools for information flow are stated at the edge of the broken lines

12. COMMODITY FLOW 2/2 Campaign products flow is similar though slight differences; Product flow Blue Solid line campaign products for supply moves directly to the State Red Solid line campaign products goes back to the State through the LGA Information flow Black broken lines: Forward information flow from SDP back to National through LGA and State. Red broken lines : Reverse information flow for reversed products. The reporting is considered re-order and determines resupply Reporting tools for information flow are stated at the edge of the broken lines

13. Tools and Systems in the Revised MPLS SOP IRV (Issue and Receipt Voucher) : Tool for Issuing and receiving products Delivery Note/ Waybill and Proof of Delivery (POD) : Document accompanying products that is ascertains product delivered BFSR (Bi-Monthly Facility Stock Report) : Two months report from health facilities Stock Card : Keeping Inventory of transaction of products in stock at stores and health facilities. DCR (Daily Consumption Register) : For Triangulation and Reconciliation of Logistics and service data at Facility SOH Summary Form : Collation of consumption of products across service dispensing points of a health facility, for triangulation of logistics with service data. RTF (Return/Transfer Form) : For reverse logistics as well as re-distribution of products ADR (Adverse Drug Reaction) Form : Pharmacovigilance also use of Med safety application. R-LISD (Request/Returning for Loan, Inter-State Distribution, Swapping and Donation) NHLMIS (Nigeria Health Logistics Management Information System) : electronic logistics data information repository

14. Purpose Users Track commodities Record receipts issues, losses and adjustments Record changes in stock balances Summarize information from bin cards for each products Stock card 1 Facility Pharmacist/person responsible for products at the facility/Storekeeper Primary, Secondary and tertiary facilities’ store managers Report on opening balance, quantity received & dispensed, losses, adjustments, stock on hand, number of patients per product, expiration date < 6 Calculate order quantities Bi-monthly facility stock report 2 Facility Pharmacist OR Person responsible for products at the facility LGA LMCU Each LMIS form has specific purposes and designated users (1/2) LMIS form Trigger picking and packing at the State CMS Serve as a proof of delivery Issue and Receipt Voucher (IRV) 3 State LMCU Facility Pharmacist or Person responsible for products at the facility OR Receiving Officer/ Receiving Storekeeper Track consumption of Malaria health products by clients who visit the health facilities daily Daily consumption register 4 Health Facility focal person responsible for malaria health product management SOURCE: Malaria Product Logistics System (MPLS) SOP

15. Purpose Users Report on movement of health products from one health facility to another and to report on expiries Return/transfer form 5 Store Pharmacist Person responsible for products Storekeeper Collate the total number of health products in a facility to help in understanding the facility SOH Monthly SOH summary form 6 Health Facility focal person responsible for malaria health product management Each LMIS form has specific purposes and designated users (2/2) LMIS form Know the number of patients that were treated within a reporting period using a particular health Bimonthly Patient Per Regiment Form 7 Health Facility focal person responsible for malaria health product management SOURCE: Malaria Product Logistics System (MPLS) SOP

16. Roles and Responsibilities in State SCM Implementation Partners ( NSA) Technical Support: Offers technical expertise in malaria prevention and treatment, supporting state health initiatives. Execution of ITN Distribution Campaigns :. Procurement and Distribution of Anti-Malaria Commodities: Procures and distributes essential anti-malaria commodities, ensuring quality and compliance. SMC Campaign Implementation in States: providing financial, technical, and logistical support . Build capacity and support State on Logistics and Supply chain Management State LMIS Data Officer: Data Entry and Maintenance: Responsible for entering logistics and health product data into the LMIS accurately and promptly. Data Quality Assurance: Conducts regular checks on the integrity and accuracy of data within the LMIS, ensuring that it aligns with actual supply chain activities. Reporting and Analysis: Generates regular reports using LMIS data for decision-makers, offering insights into the performance of the health product supply chain . State Logistics Management Coordinating Unit Coordinator Overall Logistics Coordination: Coordinates logistics for all health products, ensuring an efficient and timely supply chain. Collaboration with NSAs on Distribution: Works with NGOs to plan and execute distribution strategies, optimizing last-mile delivery. Reporting on Supply Chain Metrics: Generates and analyzes logistics reports, identifying areas for improvement and implementing corrective measures. State Logistics Management Coordinating Unit Coordinator Detailed Logistics Planning: Develops detailed logistics plans, considering factors like transportation, warehousing, and distribution. Collaborative Distribution Planning with NSAs : works with NSAs to plan the distribution of health products, optimizing efficiency. Inventory Tracking and Reporting: Tracks inventory levels, generates reports, and provides insights to improve inventory management.

17. Personnel Roles and responsibilities PSM logistics officer IP agents PSM NMEP unit Communicates with the various Stores on information relating to MHP inventory Notifies Zonal Warehouses/State CMSs of the health products to be delivered to State from Federal Medical Stores Provides coordination and oversight for Federal, Zonal and State CMS when required Monitors national stock levels and shares information with donors and stakeholders Receives and reviews distribution plans sent by Zonal warehouse and states product There are defined roles and responsibilities for key personnel in the logistic system (1/4) Level SOURCE: Malaria Product Logistics System (MPLS) SOP NMEP PSM officer IP Data Officer Receives the Last Mile Distribution (LMD)/Plan from the State Logistics Management Coordinating Unit (LMCU) Reviews the State LMD Plan to confirm completeness and accuracy Aggregates State LMD/Plan from all the States into a central database to produce national level data Shares route plans with State LMCU at least 48 hours before commencement of Distribution Provides logistics data for national quantification and procurement planning Monitors the performance of the logistics system by reviewing reporting rates and other KPIs Sends feedback to the states on the LMD/Plan Share the final approved LMD plan with National Stakeholders and State LMCUs Federal medical store Warehouse manager Receives malaria health products from manufacturers or suppliers Follows good storage practices to manage the store Issues malaria health products to Zonal Warehouses Monitors stock levels of malaria health products at the Federal stores Conducts monthly physical count of malaria health products and shares the information with NMEP/PSM Unit/IP

18. Personnel Roles and responsibilities There are defined roles and responsibilities for key personnel in the logistic system (2/4) Level SOURCE: Malaria Product Logistics System (MPLS) Warehouse manager Zonal warehouse Receives malaria health products from FMS Follows good storage practices to manage the store Issues malaria health products to Health facilities Monitors stock levels of malaria health products at the Zonal warehouse Conducts monthly physical count of malaria products and shares the information with NMEP/PS Unit/IP/FMS/NPSCMP Receive LMD plans from States Implement approved LMD plans from NMEP/IP Share copies of signed proof of delivery (POD) with State LMCUs within 2 weeks post-delivery in collaboration with the State LMCU Coordinator State Director of Pharmaceutical Services (DPS) Approves the Last Miles Distribution Plan from the State LMCU within 24hrs upon receiving the LMD Plan State Malaria Elimination Program (SMEP) SMEP manager Convenes bi-monthly review meetings with the LGA malaria focal persons within the first 10 days of the month following the review period in collaboration with the State LMCU Coordinator Ensure that MPLS timelines are strictly to be adhered to. State logistics officer (SMEP) Ensure the effective management of malaria health products, including storage, distribution, utilization, reporting of logistics data in line with the Malaria Products Logistics System ( MPLS) SOP Conduct bi-monthly review meetings with the LGA malaria focal persons/LGA malaria logisticians Prepare LMD Plans

19. Personnel Roles and responsibilities State LMCU State Malaria Elimination Program (SMEP) Coordinates the bi-monthly review meetings In collaboration with the SMEP Manager Reviews and validates the Bimonthly Facility Stock Reports (BFSR) from the health facilities on or before 10th day of the reporting month Support LGA LMCU officers to upload validated BFSR into the NHLMIS Prepares and reviews State LMD Plan and share with stakeholders on or before 12th day of reporting month Submits the LMD Plan to NMEP/PSM Unit/ NPSCMP/IP by the 15th day of the month following the reporting period Provide OJT to the LGA malaria focal persons/LGA LMCUs Submit Supervisory Visit Feedback Forms to LGA LMCU after each facility visit for follow up action Receive route plans from NMEP/PSM/IP/ and share with the LGA LMCU and secondary/tertiary health facilities at least 24 hours before commencement of distribution Receive signed PODs from the Zonal warehouse Support the Assessment of the third-party logistics providers (3PLs) on performance during the distribution rounds Places emergency orders to the Zonal warehouse and share with IP when required There are defined roles and responsibilities for key personnel in the logistic system (3/4) Level SOURCE: Malaria Product Logistics System (MPLS) SOP State Central Medical Store Pharmacist in Charge Receives approved LMD plan (ITN and State procured health products) from LMCU Supervise picking and packing of each facility order no later than 5 days after approval Receives malaria health products from the suppliers and keeps a copy of signed IRVs Supervises the update of the Bin Card/Stock Card after each transaction Supervises the conduct of physical inventory for all malaria health products for monthly report Conducts a physical count and shares stock status report with LMCU and relevant stakeholders Monitors stock levels and informs LMCU of available stock and gap that needs to be filled

20. Personnel Roles and responsibilities LGA LMCU LGA LGA LMCU Coordinator assigns health facilities (HF) to members (not more than 3 HF per day) for collection and validation of BFSR, adverse drug reaction reports (ADR) Follows up with facilities to ensure the BFSRs are prepared prior to the visit Visits health facilities within the LGA to collect the completed BFSR not later than the 5th of the month following the reporting period (MFRP) Upload collected and validated BFSR into the NHLMIS no later than 10th of the MFRP Receive route plans from State LMCU at least 24 hours before commencement of distribution Provide on the job training on completing the BFSR and updating the Bin Cards/Stock Card s after each transaction to the person responsible for managing the malaria health products Attend bi-monthly malaria review and report validation meetings at the State There are defined roles and responsibilities for key personnel in the logistic system (4/4) Level SOURCE: Malaria Product Logistics System (MPLS) SOP LGA malaria focal person/LGA malaria logistician Facility LGA LMCU Coordinator assigns health facilities (HF) to Visit assigned health facilities to collect completed BFSR Provide OJT to health facilities staff during facility visits Drop a copy of Supervisory Visit Feedback Forms to facilities after each visit for follow up action Support redistribution of health products within the LGA and inform State LMCU Provide oversight function for the activities of 3PL in the LGA Store Pharmacist Issues malaria health products to the dispensing areas within the facility and updates the DCR Updates the Stock Card after each transaction; conducts physical inventory at the end of every month; and fills the Monthly SOH Summary Form Receives supplies, completes and signs the PODs/IRV upon receipt of products Completes the BFSR no later than the 5th of the MFRP & Bimonthly Patient Per Regimen Form Upload LMIS reports into the NHLMIS no later than 5th of MFRP period Monitors stock levels at the facility and places emergency orders when required Store Pharm. Technician Designate responsible for products

21. There are twelve defined steps to follow while filling the issue and receipt voucher Locate the section “RECEIPTS” 1 Receipts section Enter the qty received for each product after counting to ensure the qty received matches the qty issued 2 Qty in figure column Add any comments regarding the quantity received; for instance, Only received 5 out of the 6 AL (1 x 12 tablets) 3 Remarks Locate the section “TO BE COMPLETED BY RECEIVING STOREKEEPER” 4 Receiving storekeeper Enter the date you received the products 5 Date Write your signature as this confirms receipt of products Signed 6 Write your designation/title 12 Designation Write your signature 11 Signed Write the date you receive the products 10 Date Locate the section “TO BE COMPLETED BY RECEIVING OFFICER” if you have one 9 Receiving Officer Write your name, designation/title and phone number 8 Designation Ensure that you mandatorily capture the time of receipt on the signed IRV Time 7 The task is only complete when: Quantity received has been counted and compared with the quantity issued under column 4 Quantity received and counted has been entered under column 9 The person receiving the products has entered the name designation, signature, date, time and phone number A copy of the IRV has been sent to the State LMCU/CMS SOURCE: Malaria Product Logistics System (MPLS) SOP

22. A snapshot of Issue Receipt Voucher SOURCE: Malaria Product Logistics System (MPLS) SOP

23. Visual inspection/handling damaged goods Visual inspection is the process of examining products and their packaging by sight to look for physical defects When to conduct Visual Inspection; when receiving Issuing using supplies when conducting a physical count, when examining expired or damaged products. What to check during Virtual Inspection Package and product integrity: Check for damage (tears, perforations, water, or oil stains) to packaging and products. Manufacturing defects: Incomplete supply, missing or illegible identification information. Labelling : Make sure that products are labelled with the date of manufacture, expiration, lot number and manufacturer’s name . How to handle damaged products Isolation: Separate from useable products Keep Away from reach Label the container where the damaged products are kept

24. There are eleven storage guidelines that must be adhered to at all storage facilities (1/2) SOURCE: Malaria Product Logistics System (MPLS) SOP Details Storage guideline Recommendation Pests are less attracted to the storeroom if it is regularly cleaned and disinfected Clean and disinfect the storeroom regularly 1 Keep food a nd drink out of the storeroom If possible, schedule regular extermination to eliminate pests Extreme heat and exposure to direct sunlight can degrade products and dramatically shorten shelf life; thus, temperatures in the storeroom should not exceed 25 o C Direct sunlight raises the temperature of the product and can reduce its shelf life Store products in a dry, well-lit, well ventilated storeroom - out of direct sunlight 2 Store supplies in their original shipping cartons Protect storeroom from water penetration 3 Repair the storeroom so that water cannot enter Stack supplies off the floor on pallets at least 10 cm high and 30 cm away from walls as moisture can seep through walls and floors Water can destroy both supplies and their packaging If the packaging is damaged, the product is still unacceptable to the patient even when the product is not damaged Keep fire safety equipment available, accessible, and functional, and train employees to use it 4 Place well-maintained fire extinguishers at suitable positions in the storeroom If a fire extinguisher is not available, keep sand or soil in a bucket nearby Train the staff in the use of the available fire safety equipment Stopping a fire before it spreads can save expensive supplies and the storage facility The right equipment should be available; water is able to put out paper fires but is ineffective on electrical and chemical fires Limit storage area access to authorized personnel and lock up controlled substances 5 Conduct physical counts on a regular basis to verify inventory cards Lock the storeroom To prevent theft and pilferage, lock the storeroom and/or limit access to personnel other than authorized staff ; however, this should not prevent appropriate distribution Thus. a spare set of keys should be kept in the office of the In-Charge

25. There are eleven storage guidelines that must be adhered to at all storage facilities (2/2) SOURCE: Malaria Product Logistic System (MPLS) SOP Details Storage guideline Recommendation Pallets keep the products off the floor, so they are less susceptible to pests, water and dirt damage Stack cartons at least 10cm off the floor, 30 cm away from the wall and other stacks, and no more than 2.5m high 6 Stack pallets 30 cm away from the walls and each other to promote air circulation and ease movement of stock, cleaning and inspection Do not stack cartons more than 2.5m as the weight of the products may crush the cartons at the bottom If cartons are particularly heavy, stack cartons < 2.5m Use shelving where pallets use is inappropriate Exposure to insecticides and other chemicals may affect the shelf life of medical supplies Old files and office supplies may get in the way and reduce space for medical supplies or make them less accessible Store medical supplies away from insecticides, chemicals, old files, office supplies and other materials 7 Remove clutter from the storeroom regularly to avail more space for storage Some medical procedures use flammable products, such as alcohol, cylindered gas, or mineral spirits Store flammable products separately from other products 8 Store flammable products near a fire extinguisher and away from other products FEFO (First- to- Expire, First Out) is a method of managing drugs by their expiry date in a storage facility Store health commodities to facilitate FEFO procedures & stock management 9 Issue drugs that will expire first, regardless of when they were received at the health facility Identification labels make it easier to follow FEFO and make it easier to select the right product Arrange cartons with arrows pointing up, and with ID labels, expiry dates, and manufacturing dates clearly visible 10 Store items according to manufacturer’s instructions on the cartons, including paying attention to the direction of the arrows Designate a separate part of the storeroom for damaged and expired goods Dispose of damaged or expired products; remove them from inventory immediately and complete the transfer memo to return commodities to CMS Separate damaged or expired products from usable commodities Do not dispense expired drugs to the patients 11

26. There are eleven defined steps to conduct a physical count Count unopened or complete cartons first. Count all the units that are in open boxes, shelves, etc., in the store room and add them together 1 Counting Add up the total units from the unopened cartons, open boxes on shelves etc. to the total number of units of the HP available known as Quantity on Hand 2 Addition Write the serial no , continuing from the last entry Write the date for the MCO “Issued to or Received from: You should have “MCO” already written 3 Monthly Close Out Addition of the quantities received for the month under the “Monthly Close Out” 4 Quantity received Addition of the quantities issued for the month under the “Monthly Close Out” Losses: addition of the losses for the month under the “Monthly Close Out” 5 Quantity issued/loss Write the serial number continuing from the last entry Fill all columns except “A”, “E” and “F” Incidental PC 6 Sign and write any comments related to losses or adjustments noted during the physical count 11 Signature/remarks Record the Adjustment on the Inventory Control The adjustment is documented in the same row as the transaction of the physical count. 10 Record adjustment Subtract the calculated Stock Balance from the quantity of physical count 9 Determine adjustment Write in the quantity of the physical count in the “Stock balance” Compare the previously recorded stock balance to the Physical Count balance 8 Stock balance Leave this column blank until after you have completed the physical count Adjustment 7 SOURCE: Malaria Product Logistics System (MPLS) SOP The task is only complete when: The actual stock on hand has been counted and recorded in the Stock balance column on the Stock Card Adjustments have been calculated and recorded in the Adjustments column on the Stock Card Adjustments have been documented and if there is any difference in stock, it is explained in the Remarks column

27. There are thirty-three (33) defined steps to follow while filling the stock card (1/3) Enter the name of the facility where the products are stored e.g. Health Clinic Furfuri , FMC Lokoja, etc 1 Name of facility Enter the name of the LGA where facility is located e.g. Bungundu 2 Local Govt. Area Enter the name of the state where facility is located e.g. Zamfara 3 State Enter the product name, dosage form & strength e.g. SP 500 mg + 25 mg tablet 4 Product Enter the unit used for issuing and receiving this product e.g. pack of 3 tablets 5 Unit Write the serial number Serial number 6 Enter the date the transaction is made 12 Date Enter the number corresponding to the entry of the transaction; Enter only one transaction per line 11 Serial No Sign and add any comments or remarks 10 Signature/remarks Take the last n o entered in the “Stock balance” column on the previous Stock card, & write that exact n o in this column 9 Stock balance Write B/F for “Brought Forward” in the column then draw a line through to the “balance” column 8 Received from/issue to Write the date you are transferring quantities to the new Stock Card Date 7 SOURCE: Malaria Product Logistic System

28. There are thirty-three (33) defined steps to follow while filling the stock card (2/3) Enter the no of the IRV if the transaction is a receipt When issuing, enter the no of ISSV used 13 SIV/SRV Number Write the store you received the products from or the area of your facility you issued to 14 Received from/issue to Enter the batch number of the health products you received/issued 15 Batch number Enter the expiry date of the health products you received/issued 16 Expiry date Enter the quantity you received with a red pen 17 Quantity Received Enter the quantity you issue Quantity issued 18 Enter the date of closing the month 24 Date Enter the number corresponding to the entry of the transaction; 23 Serial No Sign and add any comments or remarks regarding the transaction e.g. enter the reasons for any losses 22 Signature/remarks If receiving products: Add the “Qty Received” to the Balance from previous row & then enter the new balance If issuing products: subtract the “Quantity Issued” from the Balance If recording a loss or adjustment: Add the PAQ to the balance or subtract the loss/NAQ from the previous row 21 Stock balance Enter adjustments either + ve or - ve in the appropriate column & explain in the “Remarks” column 20 Adjustments Enter the exact amount of losses to the inventory on this date & explain in the “Remarks” column Losses 19 SOURCE: Malaria Product Logistics System SOP

29. There are thirty-three (33) defined steps to follow while filling the stock card (3/3) Write “Monthly Close Out” 25 To/From Add all the quantity received for the month and enter the total in the “Quantity received” column 26 Quantity Received Add all the quantity issued for the month and enter the total in the “Quantity issued” column 27 Quantity Issued Add all the losses for the month and enter the total Conduct a physical count before filling the “adjustments”, “Balance” and “Remarks” columns 28 Losses Conduct a physical count and enter balance 29 Stock balance Calculate the adjustment once you have conducted the physical count and enter the difference as a positive or negative adjustment under their respective columns Adjustments 30 If you have completely filled the last line of the front page of the Stock Card, continue on the back page If you have filled the last line of the back of the Stock Card continue with a blank new stock card 33 Continuation Enter adjustments either + ve or - ve in the appropriate column & explain in the “Remarks” column 32 Adjustments Sign and add any comment or remarks regarding the transaction For example, 5 packs of SP were returned from the dispensary area but not entered on the Stock Card Signature/Remarks 31 SOURCE: Malaria Product Logistics System SOP The task is only complete when: A Stock Card has been completed for each product managed in the store The name of the health facility, State, LGA, product description and the unit of the product in the store have been written at the top of each Stock Card Each transaction is recorded on the Stock Card as it occurs Each transaction is recorded on the Stock Card as it occurs

30. A snapshot of the stock card SOURCE: Malaria Product Logistics System (MPLS) SOP

31. There are eleven defined steps to follow while filling the Daily Consumption Register Write the state, LGA, ward and health facility name 1 Location Write the month and year Write the date of transaction Tick the appropriate week during the reporting period 2 Date Write the name of the patient that is receiving the malaria health product 3 Name First visit tick: if the patient visited the health facility for the first time in the bi-monthly reporting period Re-visit, tick: if the patients is revisiting the HF in the same reporting period 4 Reporting period Write the weight of the patient receiving the Malaria health product Tick whether the patient is < or > 5 years 5 Weight & age Write “Y” for Yes or “N” for No depending if the patient is pregnant or not Pregnant 6 This will be the sum of the previous cumulative page and the current page total till the end of the month (i.e. the cumulative total for the month) 11 Cumulative Add the total of entries under the respective column. This should be done once the sheet is filled 10 Page total Indicate the source of the MHP 1 by ticking in the box under “GF” “DRF” or “PMI” If the health product is from a source different from those mentioned above, write the name 9 Source Indicate the number of LLIN issued to visiting patients where necessary 8 LLIN Tick the type of presentation ( uncomplicated; clinical or severe ) for pregnant and non-pregnant patient Treatment regimen: enter the no of doses of the MHP dispensed to the visiting patient Malaria presentation 7 SOURCE: Malaria Product Logistics System (MPLS) SOP The task is only complete when: The Name, Ward, LGA and State of the health facility are filled Relevant fields in the DCR are filled

32. A snapshot of the Daily Consumption Register (DCR) SOURCE: Malaria Product Logistics System (MPLS) SOP NATIONAL MALARIA ELIMINATION PROGRAMME, PRODUCT DAILY CONSUMPTION REGISTER

33. There are eighteen (18) defined steps to document Bi-monthly facility stock Report (BFSR) ( 1/2) Write the name of the facility e.g . Health Clinic Furfuri . 1 Adjusted Consumption : Col I Write the name of the LGA where facility is located e.g . Bungudu 2 Name of LGA Write the name of the State where facility is located e.g. Zamfara 3 Name of State Write the months of the reporting period e.g. January –February 2019; March – April 2019 4 Reporting Period Write the date the report is prepared. e.g. 03/03/2019 (DD/MM/YYYY) 5 Report Prepared Date Opening Balance : Look at the BFSR of the last reporting period, the figure written in column G (physical stock) should be entered in column A (Opening Balance) on the current Facility Stock Report Complete Column A: 6 Add the total number of days out of stock for the reporting period. Note: If stock out for part of the day, count the whole day. 12 No. of Days Out of Stock: column H This is the quantity of stock on hand at the end of the reporting period. Note: this based on physical inventory done at the end of the reporting period. This physical count should tally with DCR and SOH MSF 11 Physical Stock: Col. G add adjustments for the reporting period. Add the adjustments under the MCO for last 2 months on the stock card. Note: the total + ve adjustment and total – ve adjustments separately 10 Adjustments: Column E Add the total losses for the reporting period. This can be found on the losses column of the stock card after monthly close out (MCO). N/B: Add the losses under the MCO for last 2 months on the stock card. 9 Losses (Column D) Enter total quantity dispensed throughout the review period. Quantity dispensed column of the DCR after the monthly close out at the end of the reporting period. N/B: Be sure to cumulate quantity dispensed after ensuring all entries are captured. 8 Quantity dispensed (Column C) Total quantity received including emergency order. Pry source is stock card (quantity received column ) after MCO at end of reporting period. Note: Add MCO for the last 2 months of the quantity received column of the stock card. Quantities Received (Column B) 7 SOURCE: Malaria Product Logistic System (MPLS) SOP

34. There are Eighteen (18) defined steps to follow while BFSR (2/2) NHLMIS automatically uses the consumption, if the facility didn’t experience stock out 13 Adjusted Consumption: Col I Add all the quantity received for the month and enter the total in the “Quantity received” column 14 Average Monthly Consumption: Col. J Auto calculated by NHLMIS 15 Quantity to order: Col. K Enter the different expiry dates and quantities of all the products that have 6 months or less shelf lif e (expiry) in the store or dispensary. 16 Product Expiri es by Batches : Column L Write any remarks or comments that you have. Especially losses and adjustments. 17 Remarks Write your name, sign and date of the report before it is collected by the LGA LMCU member designated to collect the report. Report Completed by (SDP) 18 SOURCE: Malaria Product Logistics System (MPLS) SOP The task is only complete when: The facility name, location and the reporting period are filled correctly Information from the stock card, DCR and SOH MSF have been transferred to column A, B, C, D, E, F, G, and L The Bi-Monthly Facility Stock Report is ready for collection by the LGA LMCU member A copy of the report is on file at the facility

35. A snapshot of the Bi- Monthly Facility Stock Report SOURCE: Malaria Product Logistics System (MPLS) SOP

36. Monitoring and Assessing the Conduct of Last Mile Distribution (LMD) of Malaria Health Products State LMCU and IPs will monitor & assess the conduct of LMD for efficiency and performance improvement by; On-time delivery In-full delivery LMD Completion time Proxy deliveries Time of delivery at health facilities from the time of pick up at the Zonal warehouse/State CMS Product losses/damages in-transit Time of receipt of Proof of Delivery (POD) by the State LMCU after delivery at the health facility is completed. The performance assessment will be carried out using the following: LMD spot checks visit, routine health facility visits, calls, and POD Reconciliation. This is achieved with the following tracking tools: Daily LMD update Feedback questionnaire for State/LGA LMCU POD Reconciliation and Assessment Tool The expected timelines for : Pick up at Zonal/State CMS and delivery to the last mile: 19 th to 20 th of LMD month Delivery of PODs to the State LMCUs: 4 th to 11 th of non-LMD month For completing and sharing the LMD monitoring report analysis: up to 25 th of non-LMD month

37. Calculations in Malaria Products Assessment and Distribution Orders Assessing Stock Status LMD Orders  

38. Reviewing Submitted BFSR on NHMIS …(1/3)

39. Reviewing Submitted BFSR on NHMIS …(2/3 )

40. Reviewing Submitted BFSR on NHMIS …(3/3 )

41. Generating and Submitting LMD on NHLMIS

42. LMD Order