# Presentation: 508207

## BOTSWANA CENTRAL MEDICAL STORES - PROCUREMENT AND INVENTORY

- LABORATORY REAGENTS AND CONSUMABLES.
- Dr. I. M. Mtoni
- Consultant Microbiologist and Head of National Health Laboratory
- LABORATORY EQUIPMENT AND MAINTENANCE
- 			Mr. R. Mhiti
- Superintendent Biomedical Engineer Division

## INTRODUCTION

- CENTRAL MEDICAL STORES (CMS)
- Modern Word-Class Facility currently situated in Gaborone
- Plans of having a similar facility for Francistown are underway.
- CMS has high Quality infrastructure for both:
- Receiving;
- Storage;
- Dispatch;
- of laboratory reagents, consumables, drugs and equipment.
- CMS has other supportive facilities which includes:
- Laboratory – DRU Quality Unit.
- Administration infrastructures
- Transport infrastructures

## CMS is a centralized system which caters for the following health facilities.
Central and other Institutions:	   
National Health Laboratory
National Blood Transfusion Services
Public Health Laboratory – supports epidemiology unit programmes.
Institute of Health Sciences – Lab Technician Training Programme
Laboratory Services for private (mines) and missionary hospitals.
Botswana-Harvard HIV Reference Laboratory.

- Central and other Institutions:
- National Health Laboratory
- National Blood Transfusion Services
- Public Health Laboratory – supports epidemiology unit programmes.
- Institute of Health Sciences – Lab Technician Training Programme
- Laboratory Services for private (mines) and missionary hospitals.
- Botswana-Harvard HIV Reference Laboratory.

**CMS centralized system for Lab Services:**

## Referral and District Laboratories:

- Princess Marina Hospital
- Nyangabgwe Hospital
- Selibe Phikwe Hospital
- Sekgoma Memorial Hospital
- Mahalapye Hospital
- Maun Hospital
- Scottish Livingstone Hospital
- Athlone Hospital
- Mental Hospital

## Primary Hospital Laboratories:

- Kasane			∎  Gweta
- Palapye			∎ Bobonong
- Rakops			∎ Thamaga
- Gumare			∎ Mmadinare
- Tsabong			∎ Sefhare
- Hukuntsi
- Ghanzi
- Tutume
- Masunga
- Letlhakane
- Goodhope

## AIMS OF CMS

- Overall aims is to ensure that the correct supplies are delivered:
- To the Right Place,
- At the Right Time,
- At an Appropriate Cost and Quality

## AIMS OF CMS ........ Cont.

- To do this, one needs control of the total supply chain:
- Placing orders with manufacturers
- Receipt of orders
- Quality control checks
- Correct storage methodology
- Proper order picking and dispensing
- Dispatch to hospitals and clinics
- Controls expiry periods of drugs.
- CMS acts as **Central logistic coordinator **of a total government strategy.

## EVALUATION OF LABORATORY REGEANTS AND CONSUMABLES

- Evaluation of Lab reagents and consumables is a responsibility of the National Health Laboratory.
- Occasionally, few items are sent to Nyangabgwe reference Laboratory for evaluation.
- New Laboratory reagents and consumables are collected from suppliers by CMS and given to NHL for evaluation on Annual basis.
- Evaluation reports are sent to the EVALUATION AND PURCHASE COMMITTEE based at NHL.
- The committee reviews different evaluation reports from different laboratory disciplines and awards offers to successful suppliers.

## EVALUATION OF LABORATORY REGEANTS AND CONSUMABLES...... Cont.

- Issues of consideration during evaluation are
- Quality of the product – According to the user’s specifications
- Cost
- Credibility of the supplier
- The recommendations of the committee are sent to the Central Tender Board (CTB) for Approval.
- After approval by CTB, the CMS is then authorized to start purchasing the required items.

## PURCHASING AND DISTRIBUTION

- Solely the responsibility of CMS.
- Purchases are strictly from those suppliers approved by CTB.
- Distributions are done by CMS to individual health facilities.
- Items confined to the two referral laboratories are distributed through NHL.

## ORDERING SYTEMS

- All Laboratory items are coded.
- The request forms are expected to be faxed to CMS with Code number of the requested items.
- Deliveries are by vehicles from CMS or individual facilities once they are in Gaborone
- Special orders are processed through NHL.

## PROBLEMS EXPERIENCED AT CMS

- Difficulties in adapting to high technology, modern systems.
- Difficulties in adapting to a totally new business culture.
- The COMPUTER SYSTEM was developed in isolation to the operational activities.
- The computer system was generally inappropriate to the needs of CMS.

## PROBLEMS BETWEEN CMS AND USERS

- Facilities were:
- Not coding items when ordering .
- Not doing their Average Monthly Consumption
- Not having proper inventory procedures
- Not communicating problems to CMS (instead to NHL and MOH)

## CONCLUSION

- CMS is our major tool for procurement and distribution of our Laboratory reagents and consumables.
- New computer soft-ware has been installed to address the previously encountered problems.
- Training on this soft-ware has been conducted.
- Installation of labels, new coding and stock-taking will be done on the month of August 2003.

## CONCLUSION....... Cont.

- The CMS facility will be closed for the whole month of August.
- The new system is expected to go live on 1st September 2003.
- Efforts are being made to improve inventory procedures at facility level.
- Hope is to ensure the best quality and provide high level of services to our customers.

## Medical Laboratory Equipment Procurement and Maintenance

**Richard Mhiti**

## Departments responsible for equipping and purchasing of medical equipment

- Department of Hospital Services.
- Department of Primary Health Care
- Department of Technical Support Services
- Department of Health Manpower
- Department of Supplies
- Planning Unit

## Submission of Requests

**Users requests and specifications of equipment shall be approved by heads of facilities/local MSIEC**
**List of needs to be forwarded to secretariat**
**MSIEC, together with the users, to standardize equipment for  all primary and district hospitals**
**All health facilities have standard equipment and instruments list**

## Procedures for the Secretariat at MoH

- Requests for write-offs
- Supply of medical equipment
- User and maintenance/technical training of BES staff.
- Accessories and consumables for new equipment.
- Procurement planning according to allocation of funds by various departments

## Activities of MSIEC and PPADB

- Preparation of technical specifications
- Preparation of tender documents
- Preparation of computer spreadsheets
- Tender evaluation and adjudication
- Recommendation to PPADB
- Respond to queries from PPADB
- Letters of award

## Activities of Secretariat

- Follow up of deliveries.
- Acceptance (inspection and testing of incoming equipment)
- Deliveries to facilities/notification
- Installation, training and commissioning
- Sanction payment by Supplies Unit
- Assist Police, BDF, Mission, Local Govt.

## Biomedical Engineering Services (BES) is a division within Department of Technical Support Services (TSS) in the MOH
Solely responsible for servicing medical equipment in the country
There are five centres in the country:
Gaborone (Major)
Francistown (Major)
Maun
Molepolole
Selebi Phikwe

- Biomedical Engineering Services (BES) is a division within Department of Technical Support Services (TSS) in the MOH
- Solely responsible for servicing medical equipment in the country
- There are five centres in the country:
- Gaborone (Major)
- Francistown (Major)
- Maun
- Molepolole
- Selebi Phikwe

## Major equipment (highly sophisticated electronics).
Gaborone / Francistown
Service contracts
All other equipment are referred to the service centres.
Standard Operating Procedures (SOPs) for maintenance are in place.
To maintain quality and efficiency of services

- Major equipment (highly sophisticated electronics).
- Gaborone / Francistown
- Service contracts
- All other equipment are referred to the service centres.
- Standard Operating Procedures (SOPs) for maintenance are in place.
- To maintain quality and efficiency of services

## BES advises the MOH, Local Government, and other stakeholders on the following:
Control of purchase
Utilization, maintenance and right-off of medical equipment and instruments.

- BES advises the MOH, Local Government, and other stakeholders on the following:
- Control of purchase
- Utilization, maintenance and right-off of medical equipment and instruments.