PHARMACEUTICAL

SUPPLY CHAIN MANAGEMENT FOR

LOCAL HEALTH FACILITIES
 WHY SCM? WHY LGUs

¡ Over 40% of total health expenditures

¡ Approximately 65% of total OOP
¡ Over 30% of Philhealth reimbursements

¡ Over PhP7 billion allocation in DOH budget

¡ Budget allocations vary widely across LGUs,
but are nonetheless substantial

¡ Frontline & basic health services & goods

¡ Doubts on efficiency of current system to
deliver
¡ Gaps in the SCM system among LGUs
2
 BACKGROUND

¡ [Aug 2014] Pilot Workshop of the

Leadership, Governance and Transparency in
Pharmaceutical Management (LGTPM) Program for 10
pilot Municipalities

¡ In progress reports submitted by these LGUs, certain

gaps in the local government supply chain
management were noted, particularly in forecasting
and monitoring.

3
 BACKGROUND

¡ As a follow-through initiative, a Workshop on

Pharmaceutical Supply Chain Management for Local
Health Facilities was conducted in June 2015 for twenty
(20) municipalities.

¡ The Department of Health – Pharmaceutical Division

(DOH-PD) allowed the partner organizations to pilot
SCM training modules and materials developed under a
technical grant from the World Health Organization
(WHO).

4
 WHO/ DOH SCM TRAINING MODULES

TOOLS / DOCUMENTS

¡ Instructional Design
¡ Trainer’s Manual
¡ Activity Manual
¡ Participants’ Manual
¡ Slide Presentations
¡ Reference Materials

5
 WHO/ DOH SCM TRAINING MODULES

MAJOR TOPICS

¡ Quality and safety of medicines and other

health products
¡ Drug management cycle – issues and
challenges
¡ Selection of medicines
¡ Procurement of medicines
¡ Storage and distribution of medicines
¡ Use of medicines
¡ Pharmaceutical donations
¡ Disposal of pharmaceuticals
6
 BACKGROUND

¡ One major lesson from the pilot run with LGUs was to
develop a separate orientation course for local
leaders (to complement the DOH technical training
modules for local health workers)

¡ Despite the technical capacity of LGUs, common issue

raised was the lack of political and policy support at
the local level to intensify and sustain the efforts on
SCM

7
 KEY TAKEAWAYS

¡ Leadership is key.
¡ A total health system approach is necessary.
¡ The multi-stakeholder approach works, and must be
strengthened.

¡ LGU access to medicines initiatives must align with

the national medicines policy framework.
SOME POLICY INITIATIVES OF PILOT LGUs
 NEXT STEPS/ RECOMMENDATIONS

ON THE TRAINING MODULE

¡ Develop an operations manual, compile a

compendium of relevant laws and standard forms, and
document best practices

¡ Integrate a module on the roles and

responsibilities of the LCE, members of the LGU health
team, and other stakeholders in the SCM process to
ensure accountability

1
0
 DIFFUSION STRATEGY

¡ Through the WHO Sub-national Initiative, the

revised SCM executive course was initially
conducted in DOH region 11 Health Leadership and
Governance Program (HLGP) partner LGUs.

¡ The course is now part of the capability building

support for mayors and municipal health officers
onboard the leadership program to capacitate
them in medicines governance and local health
systems development

1
1
THANK
YOU!
12
 Health Leadership & Governance
Session Outline
Program
Department of Health Convention Hall (May 16, 2013)

MOU Extension for 18 months signed last March 21, 2016

 HLGP CYCLE 2: Program Components
Session Outline

Health
Bridging Leaders Leadership and
Fellowship Management
Program for Program (HLMP)
DOH Regional
Directors and Provincial Municipal
OFIM Leadership and Leadership and
Governance Governance
Program (PLGP) Program (MLGP)
Training for
HLGP City Leadership
Coordinators, and Governance
DMOs & Program (CLGP)
Provincial Health
Team Leaders Academic
(PHTLs) Partners Program
(APP)
 Health LeadershipSession
& Governance
Outline Program
Cycle 2 Objectives
The Program aims to create an immediate impact on achieving the PHA
and health SDGs by improving local health systems in the priority
provinces, cities and municipalities thru improved leadership and
governance on health.

These will be accomplished mainly thru:

1. Leadership and governance support from key officials of the DOH

Central and Regional Offices;

2. Training support by academic partners;

3. Development and strengthening of health leadership and governance

capacities of local chief executives and public health leaders;
 HLGP CycleOutline
Session 2

Health Leadership and

Management Program (HLMP)

Provincial Leadership and

Governance Program (PLGP)

HLGP Cycle 2 Municipal Leadership and

Programs Governance Program (MLGP)

City Leadership and

Governance Program (CLGP)

Academic Partners Program

(APP)
 ScopeSession
and Coverage
Outline

The HLGP Cycle 2 will be implemented by

the DOH Central and Regional Offices in
partnership with ZFF and Academic Partners
in all LGUs who commit to actively
participate in the program
 Municipal Leadership and
Governance Program ver 2.0
 Paradigm for MLGP v2

Effective leaders and empowered citizens

embodying the principles of BL and PHC
in building resilient health systems to
support achievement of the Philippine
Health Agenda (PHA) and Sustainable
Development Goals (SDGs) on health,
ultimately contributing to health equity
 Program Components

• MLGP ver 2
Leadership • Municipal Health Systems Strengthening Program
• Barangay Health Leadership and Management
Development Program
• Practicum with Coaching

• Primary Health Care Health System Roadmap

Health System • Technical Workshops on Local Health Systems
Development

• Community Leadership Development

• Community Engagement Activities
Community • Community-Based Health Programs
Ownership and
Participation
 Leadership Development

Leadership Capacity Building Program Participants

Municipalities MLGP Cycle ver 2 18 months, 3-module Mayor and MHO
leadership program

(Six-month Practicum:
Coaching and Monitoring)
Municipal Health Municipal Deep Dive Mayor with Municipal Guiding
System Experience Coalition (ex. Expanded Local
Strengthening Two-day municipal BL Health Board) - department
Program orientation and SDH heads, chiefs of hospitals,
modules MLGOO, MSWDO, DepEd, etc
Communities Community One-module leadership Barangay Health Boards,
(Barangay) Health program for the community Community Leaders/Groups
Leadership and Representatives
Management (Practicum: Coaching and
Program Monitoring)
 MLGP Training and Practicum Design

Leadership
BL Inputs
Acts

MODULES
1-3
Health
Technical
System
Inputs
Changes
 Access to Medicines Health Information Health Service
Leadership and Governance Health Financing Health Human Resource
and Technologies System Delivery

Expanded and Functional 100% Philhealth Coverage Complete RHU Staff

Local Health Board for the Poor Complement Functional Electronic
Functional Health
Health Information
Collaborative, comprehensive, Facilities
System
participatory, and evidenced- LGU Health Human
Accredited Health Facilities
based Municipal Investment Resource Adequacy
Planning for Health (MIPH)
Functional Patient Functional Referral
Tracking System System
Community Engagement
Community IEC on Philhealth Barangay Health Human
Activities with Intersectoral
Services Resource Adequacy
Participation Policy support for
Medicines Management Complete Health
Profiling of Vulnerable
RHU Human Resource Service Packages for
Population
Accreditation all Life Courses
Barangay Health Worker
Functional Barangay Health Management of Philhealth Registration and
Governance Body Reimbursements Accreditation Health Promotion
Data on Social Services
Trained Medical Doctor Determinants of Health

Trained Public Health Nurses

Trained Rural Health
LGU Health Budget Allocation Midwives Disease Prevention
(At least 15% of IRA) Trained Barangay Human and Control Services
Resource
Barangay Investment Plan for
Data Reporting and
Health/ Barangay Adequate Compensation for
LGU Supply Chain Utilization Curative Services
Development Plan RHU Staff
Actual Budget Utilization Management System
(100%) Implementation of Magna
Rehabilitative Services
Carta for Public Health
Workers
Collaborative and Inter-
Functional Performance
sectoral Health Policy
Evaluation and Rewards Patient-Centered Care
Development, Implementation
System for RHU Staff
and Monitoring Essential Medicines
Policy support on provision of Functional Performance
funds for subsidies and social and Basic Health Mortality Reviews
Evaluation System for Emergency Supplies
protection Barangay Health Station
Policy support for Building Patient and Client
Resilient Health Systems (BHS) Staff Feedback Mechanism
Barangay visits/ reach-out
activities
 MLGPSession
ModuleOutline
1 Journey

-Expanded Local Health

Practicum M1-M2
Board
-Deep Dive and MHSSP
-Community Health
Summits

-Philhealth
Practicum M3 to M5

MODULE -Health Information Roadmap MONTHL

System
1: Grounding -Service Delivery Network
Practicum Y
and Visioning Mapping and Profiling Accomplish- COACHIN
-Health Emergency ments G
Systems
Practicum M6

-Reportback Preparations
-BL Competency
Assessment
 MLGP Session
Module Outline
2 Journey

Practicum M1-M2
-BHLMP
-Team Development
Activities

MODULE -Service Delivery

Practicum M3 to M5

2: Deepening Network: Referral System Roadmap MONTHL

-The Complete RHU
Leadership: Practicum Y
Packages: Life Course
Managing Approach Accomplish- COACHIN
Change -Gender-Sensitivity & ments G
Cultural Competence
Practicum M6

Reportback Preparations
BL Competency
Assessment
 MLGPSession
ModuleOutline
3 Journey

Practicum M1-M2
-MHSSW M2
(SDH and ISC)
-BHLMP M2

MODULE
-BHLMP M2
3: Building
Practicum M3 to M5

-Resilient Health Systems Roadmap MONTHL

Resilience -Institutionalizing Gains
Practicum Y
Towards thru Policy
-Supply Chain Accomplish- COACHIN
Sustainable Management ments G
Change
Practicum M6

Reportback Preparations
BL Competency
Assessment
 Diffusion of SCM learnings to DOH HLGP (old roadmap)
Municipal Basic Health System’s Technical Roadmap
Leadership & Access to Medicine & Health information
Health Financing Health Human Resource Health Service Delivery
Governance Technology System

Health Human B Presence of Brgy. Health Station

Resource Adequacy at a (1 BHS:1 Barangay or 1 BHS per
LGU Budget for the RHU Accomplished r Catchment)
Health (MD 1:20,000) Baseline Data a
(15% IRA) (Nurse 1:20,000) Collection n Maintenance and Operations
g
a Utilization

H y
ea H
lth e
R a
M Municipal es lt
un Health Action ou h
Plan Presence of I
ici rc Essential Medicine
pa e n
at the RHU fr Available and Accessible Transportation
l G RHU HHR (Stock Basis)
H en a for Emergency
Actual budget Competency
ea er s
Utilization
lth ati tr
Regular Data u
G on (95% Utilization) Gathering and
ov an c
Recording t
er d
na M u
nc an r
D e
e ag at
e a Sustainable Maternal Health Care
m R C Initiatives
en H oll
t U ec Pre-Natal Services (at least 80%)
Expanded and an tio M
Functional Full Implementation of Dr a Post Natal Services (at least 80%)
d n,
Local Health Magna Carta for ug t
BLGU Health Budget B Ut
Board Public Health Workers M e Facility-Based Deliveries (85%)
H iliz
an r
(5% of Barangay S ati Skilled Birth Attendants (85%)
ag n
IRA) R on
e a
es an Sustainable Breastfeeding Initiatives
m l
ou d Maternal/Infant
en a
rc Installed Performance Inf Death Review Exclusive Breastfeeding for Infants
t RHU Medicine n
e Management System or (70%)
Sy Tracking and d
m m
4-in-1 Accreditation st Inventory System C Newborns Initiated Breastfeeding (85%)
an ati
e h
ag on
Functional m il Sustainable Essential Intrapartum and
e Di
Barangay m ss d Newborn Care Initiatives
Health Human Monthly Updated C
Health en e Health Data a Sustainable Infant and Child Care
Governance t Resource Adequacy in mi Board Initiatives
2
Body BHS na r
e 7
(with functional Lo tio Fully Immunized Child (95%)
 Leadership and Health Financing Health Human Resource
Access to Medicines and Health Information Health Service
Governance Technologies System Delivery
Expanded and Functional 100% Philhealth Coverage Complete RHU Staff Functional Electronic Functional Health
Local Health Board for the Poor Complement Health Information Facilities
Collaborative, comprehensive, System
participatory, and evidenced- LGU Health Human Resource
Accredited Health Facilities
based Municipal Investment Adequacy Functional Patient Functional Referral
Planning for Health (MIPH) Tracking System System
Community Engagement
Activities with Intersectoral Community IEC on Philhealth Barangay Health Human
Services Resource Adequacy
Participation LGU Supply Chain Complete Health
RHU Human Resource Management System Profiling of Vulnerable Service Packages for
Accreditation Population
all Life Courses
Functional Barangay Health Management of Philhealth Barangay Health Worker
Registration and
Governance Body Reimbursements Data on Social Health Promotion
Accreditation
Determinants of Services
Trained Medical Doctor
Health
Trained Public Health Nurses
Trained Rural Health
LGU Health Budget
Allocation (At least 15% of Midwives Disease Prevention
Trained Barangay Human and Control Services
IRA)
Resource
Barangay Investment Plan for
Data Reporting and
Health/ Barangay Adequate Compensation for
Development Plan RHU Staff Policy support for Utilization Curative Services
Actual Budget Utilization Medicines Management
(100%)
Implementation of Magna Rehabilitative Services
Carta for Public Health
Workers
Collaborative and Inter-
Functional Performance
sectoral Health Policy Evaluation and Rewards Patient-Centered Care
Development, Implementation
System for RHU Staff
and Monitoring Essential Medicines and
Policy support on provision
Functional Performance Basic Health Emergency Mortality Reviews
of funds for subsidies and
Evaluation System for Supplies
social protection
Policy support for Building Barangay Health Station Patient and Client
Resilient Health Systems (BHS) Staff Feedback Mechanism
Barangay visits/ reach-out
activities
 Capability Building Support:
SCM Executive Course for local leaders

Analyze critical
Discuss medicines- elements of the drug
related issues of management cycle to
national and local identify areas for
importance in the improvement of
context of the medicines
Philippine governance in their
healthcare system respective localities

COURSE OBJECTIVES
 • Overview of the Philippine
healthcare system
• Relevant legislations
• Medicines management and the
drug management cycle (drugs
and therapeutics committee)
COURSE
• Selection and quantification
CONTENT (and funding)
(8 hours) • Procurement and Receiving
• Storage and Distribution
• Promotion of rational use of
medicines
• Pharmaceutical Donations
• Disposal of Pharmaceuticals
 Course Program
Time Session Objectives
After the session, the participants shall be able to:

8:00am-9:00am Expectations Check and -Explain the history and rationale for the course
Course Objective -Get to know one another in a welcoming, creative
manner
-Share expectations from the course
-Set the ground rules for the course
-Discuss the course content and process

9:00am-10:00 am Session 1: Overview of -Discuss the current health systems, policies and
the Current Health national programs to improves access to essential
Systems and Access to medicines
Medicines -Discuss the issues related to access to medicines
-Identify the factors that have contributed to the
current issues related to medicines access

10:00am -10:30 am Session 2: The Medicines -Explain basic concepts and phases of Medicines
Management Cycle Management Cycle or Supply Chain Management
-Appreciate the role of local government units in the
whole SCM cycle
 Course Program
Time Session Objectives
After the session, the participants shall be
able to:

10:30am-12:00 pm Session 3: The Current -Identify current Medicines Management

1:00pm-1:30 pm Medicines Management Practices of my LGUs
Practices of my LGUs (with -Explain the current gaps of the LGU’s SCM
group work) process
-Analyze the factors that may have
contributed to the SCM issues

1:30pm-2:30 pm Session 4: Case Scenario -Analyze the given cases related to

on Medicines Management Medicines Management Practices
Practices -Discuss the gaps and issues and solutions to
address them

2:30pm-3:30 pm Session 4: Planning -Formulate an Action Plan to be implemented

in support of local health systems
development

3:30pm-3:40 pm Synthesis
 Training strategies and activities
The national drug supply as
1. Lecture well as the capacity of a
health facility to deliver
uninterrupted, safe, and
effective care and treatment
to a patient are key factors
in determining the success
of health programs.

Philippine
Government
 Course strategies and activities
2. Group Work

Medicine
Supply Chain
Management
 Course strategies and activities
3. Discussion Local Health Board

Policy and Funding Support Leadership and

Governance

Health Financing

Pharmacy & Pharmacy and Therapeutics Access to medicines

Therapeutics Committee and technology
Committee Health Information
System

Health Human
Resource

Health Service
Delivery
 Course strategies and activities
INVENTORY
3. Cases RECORDS FOR RHU
Consider two Rural ITEM A
Health Units: RHU A and AUG SEPTEM OCTO
RHU B. UST BER BER

Both RHUs received 20 Atenolol 50 20

0 boxes
boxes of Atenolol 50 mg mg tablet boxes
tablets. INVENTORY
RECORDS FOR
In RHU A, 80% of the
ITEM RHU B
population are
hypertensive. AUG SEPTEM OCTO
UST BER BER
In RHU B, only 5% are
Atenolol 50 20
18 boxes
hypertensive.
mg tablet boxes
4. Plenary Discussion
PRACTICES
PRACTICES
PRACTICES
 5. ACTION PLANNING

ACTIVITIES TARGET TIMELINE

RESULT
 SUMMARY

¡ The prerequisite of the course: local leaders should

be onboard the DOH MLGP

¡ The SCM executive course complements the existing

DOH PD technical training modules for local health
workers

¡ The SCM executive course will be conducted by

regional PD coordinator (as resource person) in
coordination with regional HLGP managers (post-
MLGP module 3)
4
2