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Community Based Strategies -Final Report-Printed Kapchorwa District Local Government COMMUNITY BASED STRATEGIES TO ADDRESS BOTTLENECKS THAT AFFECT THE SUPPLY CHAIN FOR REPRODUCTIVE HEALTH/ FAMILY PLANNING COMMODITIES A CASE STUDY OF KAPCHORWA DISTRICT IN UGANDA FINAL REPORT March 2018 COMMUNITY BASED STRATEGIES 2 | Page FINAL REPORT | March 2018 | Kapchorwa District Local Government COMMUNITY BASED STRATEGIES TABLE OF Contents Table of Contents .................................................................................................................... ii List of Acronyms ...................................................................................................................... iii Acknowledgement .................................................................................................................. iv Foreword…………………………………………………………………………………………...............................…… vi 1. BACKGROUND ...................................................................................................................... 1 1.1 The supply chain for FP commodities in Uganda .......................................................... 1 1.2 Development related challenge .................................................................................... 1 1.3 Development related intervention and key players ...................................................... 1 1.4 Rationale of consultancy intervention .......................................................................... 1 1.5 Consultancy objectives ................................................................................................. 2 2. OperationaliZation OF KEY concepts ...................................................................... 3 2.1 Inventory management ................................................................................................ 3 2.2 Supply chain ................................................................................................................. 3 2.2.1 Supply chain bottleneck analysis ............................................................................... 3 2.2.2 Stock-out .................................................................................................................... 3 2.2.3 Stock accumulation .................................................................................................... 3 2.2.4 Stock expiration .......................................................................................................... 4 2.3 Community based strategies ......................................................................................... 4 2.4 Power mapping ............................................................................................................. 4 3. METHOD ............................................................................................................................... 5 3.1 Research design ............................................................................................................ 5 3.2 Selection of cases ......................................................................................................... 5 3.2.1 The case of Sipi HC3 .................................................................................................. 6 3.2.2 The case of Kapchorwa Hospital ............................................................................... 7 3.2.3 The case of Kaserem HC3 .......................................................................................... 7 3.2.4 The case of RHU HC2 ................................................................................................. 7 3.3 Research Questions ...................................................................................................... 8 3.4 Data collection .............................................................................................................. 8 3.5 Data analysis and presentation .................................................................................... 9 4.1.2 Kapchorwa Hospital ........................................................................................................... 11 4.1.3 Kaserem HC3HCIII .............................................................................................................. 12 4.1.4 RHU HC2 ................................................................................................................ ............ 12 FINAL REPORT | March 2018 | Kapchorwa District Local Government Page | 3 COMMUNITY BASED STRATEGIES 4. FINDINGS ..................................................................................................................................... 11 4.1 Occurrence of stock-out of FP commodities .......................................................................... 11 4.1.1 Sipi HC3 ............................................................................................................................ 11 4.1.5 National level ..................................................................................................................... 12 4.1.6 Key bottle necks associated with stock-out of FP commodities ......................................... 12 4.2 Occurrence of stock accumulation of FP commodities ......................................................... 13 4.2.1 Sipi HC 3 ............................................................................................................................. 13 4.2.2 Kapchorwa Hospital ........................................................................................................... 14 4.2.3 Kaserem HC3 ...................................................................................................................... 14 4.2.4 RHU HC2 ............................................................................................................................. 14 4.2.5 National level ..................................................................................................................... 15 4.2.6 Key bottlenecks associated with accumulation of FP commodities in the supply chain.... 15 4.3 Occurrence of stock expiries ................................................................................................ 16 4.3.1 SIPI HC 3 ............................................................................................................................ 16 4.3.2 Kapchorwa hospital ........................................................................................................... 16 4.3.3 Kaserem HC3 ..................................................................................................................... 16 4.3.4 RHU HC2 ............................................................................................................................ 16 4.3.5 National level ..................................................................................................................... 16 4.3.6 Key bottlenecks associated with expiration of FP commodities ........................................ 17 4.4 Recommendations - community based strategies ................................................................ 17 4.4.1 Power centres .................................................................................................................... 17 4.4.2 Community based strategies for Sipi HC3 .......................................................................... 18 4.4.3 Community based strategies for Kapchorwa hospital ....................................................... 19 4.4.4 Community based strategies for Kaserem HC3 .................................................................. 20 4.4.5 District level recommendations to address supply chain bottlenecks ............................... 21 4.4.6 Strategies to address supply chain bottlenecks at National level. ..................................... 22 AnneX ........................................................................................................................................ 32 4 | Page FINAL REPORT | March 2018 | Kapchorwa District Local Government COMMUNITY BASED STRATEGIES List OF Acronyms ADS: Alternative Distribution Strategy DHO: District Health Officer FP: Family Planning HC: Health Centre HMIS: Health Management Information System HUMC: Health Unit Management Committees IUD: Intra-Uterine Device MoH: Ministry of Health MTC: Medicine Therapeutic Committee NMS: National Medical Stores RHU: Reproductive Health Uganda SACCO: Saving and Credit Cooperative organization SOH: Stock on Hand UHMG: Uganda Health Marketing Group VHT: Village Health Team FINAL REPORT | March 2018 | Kapchorwa District Local Government Page | 5 COMMUNITY BASED STRATEGIES ACKNOWLEDGEMENT This study report is on an intervention that identified and addressed challenges to commodity security, and that enabled the Kapchorwa community to develop a community led strategy to monitor and track family planning supplies to the final user. Kapchorwa District Local Government extends its sincere appreciation to its partners, especially Reproductive Health Uganda (RHU) and to all organizations that supported and contributed to the process of developing this study report. We also acknowledge the Population Action International (PAI) Opportunity Fund, supported by the Bill & Melinda Gates Foundation, for its financial support that contributed to the development of this report. We also want to recognize the role of the Consultancy, Access Global Ltd, who successfully led the development process to its conclusion. We extend special recognition
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