MINISTRY OF HEALTH REPUBLIC OF GHANA HEALTH COMMODITY SUPPLY CHAIN MASTER PLAN September 2012 Table of Contents Acronyms ............................................................................................................................................. v Executive Summary ............................................................................................................................ vii Background ........................................................................................................................... vii Highlights of the Supply Chain Master Plan ......................................................................... viii Implementation Plan ............................................................................................................. xi Implementation Plan Costing ................................................................................................ xi Monitoring and Evaluation Plan ............................................................................................ xiii 1.0 Background ............................................................................................................................ 1 2.0 Vision, Mission and Principles for the Supply Chain ............................................................... 3 2.1. Vision Statement ......................................................................................................... 3 2.2. Mission ....................................................................................................................... 3 2.3. Principles .................................................................................................................... 3 3.0 Thematic Areas: Problems and Challenges, Objectives, and Strategic Interventions ............. 5 3.1 Organization (Institutional Capacity and Roles) and Coordination, Human Resources, and Supervision .......................................................................... 5 3.2 Financing, Resource Mobilization, and Commodity Pricing ......................................... 8 3.3 Procurement ............................................................................................................... 9 3.4 Distribution—Storage, Inventory Management, Transport, and Waste Management ............................................................................................................. 11 3.5 Information Systems and Processes (including Logistics Management Information Systems) ................................................................................................ 13 3.6 Quantification and Product Selection ........................................................................ 15 3.7 Policy, Legal, and Regulatory Environment .............................................................. 16 4.0 Organizational Roles [Primary Responsibility for the Implementation of the SCMP’s Strategic Interventions] ........................................................................................... 18 4.1 Proposed Areas of Responsibility for the New National Health Commodity Supply Agency .......................................................................................................... 18 4.2 Roles and Responsibilities for Other MOH Agencies and/or Mechanisms ................ 24 5.0 Implementation Plan ............................................................................................................ 32 5.1 Organization (Institutional Capacity and Roles) and Coordination; Human Resources and Supervision ...................................................................................... 32 5.2 Financing, Resource Mobilization, and Commodity Pricing ....................................... 34 5.3 Procurement ............................................................................................................. 35 5.4 Distribution—Storage, Transport, Inventory Management, and Waste Management ............................................................................................................. 35 5.5 Information Systems and Processes (Including Logistics Management Information Systems) ................................................................................................ 37 5.6 Policy, Legal, and Regulatory Environment .............................................................. 37 5.7 Quantification and Product Selection ........................................................................ 38 5.8 Capacity Building ...................................................................................................... 39 6.0 Implementation Monitoring and Risk Management .............................................................. 40 7.0 Implementation Plan Costing ............................................................................................... 41 7.1 Recurrent Costs ........................................................................................................ 41 7.2 Capital Costs ............................................................................................................ 42 7.3 Activity Costs ............................................................................................................ 44 7.4 Summary of Cost Estimates ..................................................................................... 45 iii Annexes 1. Master Plan - Key Activities and Timeline ....................................................................................... 47 2. Terms of Reference for Technical Working Group .......................................................................... 49 3. Terms of Reference for the Interim Management Team (IMT) ........................................................ 55 4. Implementation Plan with Detailed Activity Cost ............................................................................. 61 5. The Monitoring and Evaluation Plan .............................................................................................. 63 6. Implementation Plan Budget, By Intervention Area, By Year and by Activity Cost Category by Intervention Area ........................................................................................................................... 65 7. Stakeholders Current and Proposed Responsibility ........................................................................ 67 Tables 1. Minimum Staffing Requirements in Total Number of Full Time Equivalent (FTE) for Each Area of Responsibility ............................................................................................ 22 2. Recurrent Costs (in USD) from 2013-2017 ..................................................................................... 42 3. Details of the Capital Cost Estimates (in USD) ............................................................................... 43 4. Activity Costs by Category (in USD) ............................................................................................... 45 5. Summary of Costs for Implementing Five Year Master Plan (in USD) ............................................ 45 iv Acronyms ARV antiretroviral (medicines) CHAG Christian Health Association of Ghana CHIM Centre for Health Information Management CHPS Community- Based Health Planning Services CMS Central Medical Stores EML essential medicines list EPI Expanded Programme on Immunization FDB Food and Drugs Board of Ghana FHD Family Health Department FP family planning GHS Ghana Health Service GMP good management practice GOG Government of Ghana HMIS Health Management Information System HR human resources ICC Interagency Coordinating Committee ICT information and communication technology IMT interim management team IP Implementation Plan IT information technology LMIS Logistics Management Information System MOFEP Ministry of Finance & Economic Planning MOH Ministry of Health MOU memorandum of understanding NACP National AIDS Control Programme NCDP Non-communicable Disease Programme NHCSA National Health Commodity Supply Agency NHIA National Health Insurance Authority NHIS National Health Insurance Scheme NMCP National Malaria Control Programme NTP National Tuberculosis Programme OCP Office of the Chief Pharmacist P&S Procurement and Supply Directorate, MOH PBF performance-based financing PPA Public Procurement Authority RHA Regional Health Administration RHD Regional Health Directorate RMS Regional Medical Store SCCC Supply Chain Coordinating Committee SCMP Supply Chain Master Plan SCMU Supply Chain Management Unit SCMA Supply Chain Management Agency SOP standard operating procedure v SSDM Stores, Supplies and Drug Management STGs standard treatment guidelines TB tuberculosis TH teaching hospital TOR terms of reference TOT training of trainers TWG technical working group USG United States Government vi Executive Summary Background The Ministry of Health (MOH) of Ghana seeks to improve the health status of all people living in Ghana through the provision of universal access to affordable, quality health services and the development of guiding policies and effective systems. Health services and the people they serve depend on getting the right medicines and medical supplies in good condition when they are needed. In most developing countries, a visit to a health facility is not viewed as acceptable unless one or more prescriptions have been received. The supply chain that supports these facilities and providers has, as one of its primary goals, the goal of “commodity security - when people are able to choose,