Limited Efficiency in the Drug Supply Management and Rational Use of Drugs

Preface

Effective management is considered to be a prime responsibility of every institution of the Royal Government including the Ministry of Health, Provincial and Municipal Health Authorities, Operational Districts as well as health facilities throughout the country. The logistics management of the drug supply system is indeed an important function within the Ministry of Health.

In line with the Ministry of Health's objectives and particularly in accordance with the National Health Coverage Plan, the management of the drug supply system has been revised and improved, based on modern logistics management techniques. In 1998, the Department of Drugs, Food and Cosmetics of the Ministry of Health (DDF) and the Reproductive and Child Health Alliance (RACHA), a program funded by the United States Agency for International Development (USAID), initiated a national logistics management training workshop for operational district level. The impact of the training was somewhat limited, mainly due to field implementation practices still lacking quality and consistency during the post-training period. The following factors are still perceived to be weaknesses of the system: - Limited efficiency in the drug supply management and rational use of drugs. - Stock level of essential drugs and pharmaceuticals still facing stocked out and over-stocked situations. The percentage of commodities reaching expiry date, prior to being used, also remains high. -Supervision activities of the drug supply system still lacking quality and effectiveness. As a remedial action, the DDF and RACHA have closely worked together to review, update and develop " The Logistics Management Manual for Operational District Pharmacists". Dissemination of these manuals will heavily focus on involving workshop participants with role play exercises closely related to their day to day tasks closely with the ultimate aim of consolidating Operational Pharmacists skills in logistics management as well as building up their capacity to effectively conduct supervision activities. We strongly believe that official endorsement and adoption of this Manual through the various workshops will provide clear guidance to all management level of the health sector, including essential drug supervisors and other personnel in charge of logistics management throughout the supply system. It is hoped that this manual will not only help solve current shortcomings but also serve as a guiding principle to develop and improve essential drug logistics management in Cambodia. We wish to express our thanks to the review committee who has made valuable contribution to the development of this Manual. We sincerely hope that all health officials, including health managers, provincial pharmacists, operational district pharmacists and other personnel involved with essential drugs logistics management, will make every effort to read, analyze and convert knowledge gained into effective practices.

Dr. Richard B. Sturgis Professor Eng Huot Program Manager Director General for Health RACHA Ministry of Health Acknowledgements Heartfelt thanks are kindly extended to the following persons:

Dr Eng Huot, Director General for Health who has pledged support and made valuable recommendations to the development of this manual in accordance with the National Health coverage Plan.

Mr Chou Yin Sim (Deputy Director General for Health) and Dr Richard B. Sturgis (RACHA Program Manager) for their valuable recommendations and full support to the development of this manual.

Dr Lo Veasna Kiri, Deputy Director, Planning and information Department Dr Chi Mean Hear, Deputy Director, Hospital Services Department Dr Klem Sokun, Director of Pursat Provincial Health Department Dr Lao Vanna, Deputy Director of Kampot Provincial Health Department Mr Oum Noeum, Deputy Director of Siemreap Provincial health Department Mr Chea Chhiv Srong, Director, Central Medical Stores Mr Ty Kim Sour, Deputy Director, Essential Drug Bureau Mr Kov Buntor, GSP consultant (KfW) Mr Lun Borithy, Logistics Advisor (RACHA) Mr Va Sokea, Team leader, Essential drug Management Unit

Essential Drug Management and Rational Drug Use Supervisors at central, provincial and Operational District levels (Battambang, Prey Veng, Pursat, Siemreap and Kampot Provinces- Chhouk and Sonikum Operational Districts)

RACHA Provincial Logistics Support Officers (Kampot, Pursat and Siemreap)

The Manual Review Committee for cordially collaborating together to develop and finalize the manual. The Reproductive and Child Health Alliance (RACHA), a health Project funded by the United State Assistance for International Development (USAID) is especially acknowledged for its technical and financial assistance towards the development of the Manual.

Department of Drugs, Food and Cosmetics Manual Development Review Committee

Dr Chroeng Sokhan, Deputy Director -Drug, Food and Cosmetics Dpt. (Chairman) Dr Lo Veasna Kiri, Deputy Director - Information and Planning Dpt. (Vice Chairman) Dr Chy Mean Hear, Deputy Director - Hospital Services Dpt. (Vice Chairman) Dr Klem Sokun, Director of Pursat Provincial Health Dept. (Member) Dr Lao Vanna, Deputy Director of Kampot Provincial Health Dept. (Member) Mr Oum Noeum, Deputy Director of Siemreap Provincial health Dept. (Member) Mr Chea Chhiv Srong, Director, Central Medical Stores (Member) Mr Ty Kim Sour, Deputy Director, Essential Drug Bureau (Member) Mr Kov Buntor, GSP consultant (KfW) (Member) Mr Lun Borithy, Logistics Advisor (RACHA) (Member) Mr Va Sokea, Team leader, Essential drug Management Unit (Member) Mr Ngeth Monino, Essential Drugs Supervisor (Member) Mr Ouk Kann Kosal, Essential Drugs Supervisor (Member) Mr Suon Rasy, Essential Drugs Supervisor (Member) Mr Khieu Sochealy, Team Leader, Supply and Statistics (EDB) (Member) Mr Tep Keila, Coordinator, Rational Drug Use (Member) Dr Sok Srun, Team Leader, Rational Drug Use (Member) Dr Chi Sivuthy, Rational Drug Use Supervisor (Member) Dr Sao Sokunna, Rational Drug Use Supervisor (Member) Dr Sin Touch, Rational Drug Use Supervisor (Member) Mr Kho Vireak, Provincial Pharmacist - Battambang (Member) Mr Oeun Samuth, Provincial Pharmacist - Prey Veng (Member) Mr Be Seng Hour, Provincial Pharmacist - Pursat (Member) Mr Eng Kheang, OD Pharmacist - Sotnikum (Member) Mr San Thirith, OD Pharmacist - Chhouk (Member) Mr Pel Channdan, RACHA Provincial Support Officer (Kampot) (Member) Mr Sin Kosal, RACHA Provincial Logistics Support Officer (Pursat) (Member) Mr Moob Harch, RACHA Provincial Logistics Support Officer (Siemreap) (Member) Mr Ou Sovanndara, RACHA Provincial Logistics Support Officer (Siemreap) (Member) Mr Horn Marong, RACHA Logistics Support Assistant (Member)