Distribution management

Topics to be covered Logistics The primary management goal A well-run distribution system Distribution cycle Steps to follow in designing a distribution system Distribution net work Problems in the system Distribution management A significant budget goes to storage & distribution Transportation cost may exceed the value of the drugs distributed to some locations especially in large countries. The most serious problem that health programs are managed by well qualified health personnel who lack logistics experience. Logistics

It is the science and art of getting The right amounts of : The right things to : The right place(s) at: The right time. The primary management goal Is to maintain A steady supply of drugs & Supplies to facilities where they are needed While ensuring that resources are being used in
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The most effective way. A well-run distribution system should: Maintain a constant supply of drugs. Keep drugs in a good condition. Minimize drug losses Rationalize drug storage points. Use available transport efficiently Reduce theft and counterfeit Provide information for forecasting drug needs A good distribution system is a cost-effective system Distribution cycle

distribution cycle: drug procurement:

Distribution sequence intersects with procurement at the point at which drugs are available for delivery to the health facilities. distribution cycle: port clearing: involves : Identifying shipments as soon as they arrive in port, Processing all importation documents, Completing any customs requirements, Storing drugs properly until they leave the port, Surveying the shipment for losses and signs of damage,& Collecting the drugs as soon as they have been cleared. Port can be managed directly or through an agent distribution cycle: receipt and inspection Central stores staff must carry out a complete
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Inspection of every Ship-ment as soon as it is received from the port or local supplier Inspector should check for damaged and missing items& for compliance with contract conditions Effective inventory records& procedures are the basic for: Coordinating the flow of drugs through the distribution system and The primary protection against theft& corruption. Distribution cycle: storage: Proper location,Proper construction, Proper organization and Proper maintenance of storage facilities All the above help in Maintaining drug quality, minimizing theft, and maintain regular supply to health facilities distribution cycle : requisition of supplies The forms & procedures: Are a key part of the inventory control system and they vary from: Country to country From one level to another within the same country distribution cycle :requisition of supplies The forms & procedures should be designed to simplify distribution by: Facilitating inventory control, Providing an audit trial for tracing the flow of drugs, Assisting in financial accounting, and Listing drug issued The warehouses may make deliveries or the health facilities can collect their supplies Cost-effective choices between carriers need to be made. Local factors that must Be considered in transport Planning include: Vehicle breakdowns,Seasonal variations in access routes,
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Safety along specific supply lines. distribution cycle :dispensing to patient: The distribution process achieves its purpose when drugs reach: Hospital wards, Out patient clinics, Health centers, orCommunity health workers Note: these drugs should be appropriately prescribed and dispensed to patient(s) distribution cycle: consumption reporting: The closing link in the distribution cycle is the flow of information on consumption and stock balances back up the distribution system to the procurement office for use in quantifying procurement needs. Steps to follow in designing a distribution system: Determine the number of storage levels. Determine the location of storage sites Decide at which level of the supply system decisions will be made concerning orders Fix resupply intervals or frequency of placing orders. Select a method for distributing drugs to user units Steps to follow in designing a distribution system: cont.. Select an appropriate mode of transport. Develop a set of feasible and economical delivery routes and workout a practical delivery schedule Estimate operating costs and asses the cost effectiveness of contracting for storage and transport at one or more levels Distribution net work: A public drug distribution system may require several layers of stores, each with clear functions Primary stores: Generally serve a whole country or region and may or may not supply health facilities directly Cont Intermediate stores:
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Receive drugs from the primary stores, Their size is determined by: The demand of the health facilities and The frequency of the supply by the primary stores. May be independent but are often on the site of a regional or district hospital. Health facility stores: Pull and push system in a distribution system: Pull system: level of the system determines Types and quantities of drugs Needed and places order in the supply Sources ( a warehouse in the system Or a commercial supplier) . This type of the system is sometimes Called : an independent demand or requisition system. Conditions favoring a pull system Lower level staff are competent in assessing needs and managing inventory Sufficient supplies are available at supply sources to meet all program needs A large range of products is being handled Field staff are regularly supervised, and performance is monitored. Push system: Supply sources at some level in the system Determine what types and Quantities of drugs will be Delivered to lower levels A delivery plan is made at The beginning of planning period usually a year ,and supplies are delivered according to the plan This is also called allocation or a ration system . Conditions favoring a push system: Lower level staff are not competent in inventory control. Demand greatly exceeds supply thus making rationing a necessity. A limited number of products is being handled.
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Disaster relief is needed, or the situation calls for short term supply through prepacked kits. Losses due to poor distribution management:

Damage (incorrect storage or transport conditions) Theft of stock Misdirection of stock. Unnecessary supplies in stock. Supplies that expired before they can be used. Problems: Problems in the system Failure to comply with sop. Inadequate reporting of shortageBy peripheral health facilities , andExcessive losses due to theftDrugs shortage occurs Because roads are closed During periods of heavy rains Major transport problems, such as lack of fuel, lack vehicle in working order, aris poor administration: what to do about it? Review and strengthen: Supervision, Administrative procedure ,and Reporting standards. It may be necessary to change personnel and/or provide incentives to improve performance
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2-seasonal variation: Review delivery intervals and delivery quantities to take account of predictable weather hazards. Deliver more supplies when the weather is good. Transport problems Lack of fuel Lack of vehicle What is the scope of the problem?. Use Ur brain!