The Summary of Terminal Evaluation
1. Outline of the ProjectCountry ： The Lao People’s Democratic Project Title ： The Project for Strengthening
Republic
Issue/Sector：Health

Medical Logistics in the Lao PDR
Cooperation scheme：Technical Cooperation

Division in charge：JICA Laos OfficeTotal cost (at the time of evaluation study)：

Period of
Cooperation

May 1, 2005 –April 30, 2008
(3 years)

246,862,000 yen
Partner Country’s Implementing Organization ：Medical Product Supply Center (MPSC)
Supporting Organization in Japan：−
Related Cooperation：Grant Aid for Grassroots
Human Security Project on MES, Dispatch of
Senior Volunteers

1-1

Background of the ProjectIn the Lao PDR, there were few technicians who can maintain and repair med ical equip ments.

Moreover, the budget for maintaining and repairing them was not enough. Therefore, there were a lot of
broken med ical equip ments in Lao PDR. Under the circu mstances, the MOH established Medical
Equip ment Serv ice Center (M ES) with roles of maintaining and repairing medical equip ments as a
Medical Product Supply Center (MPSC)-affiliated organizat ion in 1998. Since then, the MES has given
technical support to technical staff. However, in o rder to solve the above-mentioned problems
drastically, there was still necessity not only to teach technical staff but also to establish the frameworkfor Medical Equip ment Maintenance system in the Lao PDR.
In addition to the problems concerning the med ical equip ment maintenance, because thesystem of the inventory control also was limited in function, most of med icines and medical products
provided by various projects and donors were stocked at the central warehouse for a long time. In case of
the necessity, they would not be distributed to hospitals and medical institutions properly.
Under the circu mstances, in May 2005, MOH and JICA started the project with the objectivethat “The mechanism is established at the central and provincial levels for managing and utilizing
med icines, medical products and equipments efficiently and properly” for 3 years duration until April
2008.

1-2 Project Overview(1) Overall Goal
Medicines, med ical products and equipment come to be managed and utilized efficiently andproperly.

(2)

Project Purpose
The mechanis m is established at the central and provincial levels for managing and utilizing
med icines, medical products and equipment efficiently and properly.

(3)1)

Outputs
The system is established for supporting central and provincial levels through MES and Logistics
Center i .

2)

The capacity of management, maintenance and repair for technical staff is imp roved at MES,
central and provincial hospitals.

3)

The management capacity for central and provincial hospital managers is improved.

4)

The capacity of storage, handling and inventory control for staff in charge of inventory control of
med icines and medical products is enhanced at the Logistics Center and warehouses in 4 target
provinces.

1

(4)

InputsJapanese side:・ Long-term Japanese expert (Project coordinator/Pro ject management: 1 person: 36.0 MM)
・ Short-term Japanese experts (Medical equip ment maintenance, Inventory control, Several
persons: total 18 persons: 36.2 MM)・ Training courses (In Japan, Thailand, and the Lao PDR)
・ Facility construction (Logistics Center: 2,480m2 , US$398,500.)・ Equip ment (Co mputer set, fo rklift, data logger, tool kits, battery powered lift stacker,
calibrat ion tools, etc., US$126,430.)
・ Operational expenses (Official trips, in-country and third country trainings, etc., US$176,205.)
Lao side:・ Personnel assignment (Pro ject Director, Project Manager, the M ES staff, the staff working for
the Logistics Center, trainers fro m the central hospitals, etc.)
・ Provision of the project office and facilit ies
・ Others (Local cost, site and fences of the Logistics Center, running costs for electricity, water,
etc.)

2.

Evaluation TeamMr. Koich i Takei (Leader: Deputy Resident Representative, JICA Laos Office)Dr. Yoichi Ho rikoshi (Health Sector Management: Health and Medical Cooperation andMembersof
Evaluation
Team

Planning, Adviser to the Ministry of Health)
Mr. Kazuyuki Kakuda (Evaluation Planning I: Program Officer, JICA Laos Office)Ms. Kaori Osone (Evaluation Planning II: Assistant Resident Representative, JICA Laos
Office)Mr. Takaaki HIRAKAWA (Evaluation Analysis: Consultant on Participatory
Planning/Evaluation, INTEM Consulting, Inc.)

Period of
Evaluation

November 2, 2007 –November 29, 2007

3.

Results of Evaluation

3-1

Project Performance

Type of Evaluation：
Terminal Evaluation

Overall Goal:

・ The average yearly wo rking ratios of medical equip ment at the central hospitals are 97.7% at
Mahosot hospital, 73.0% at Friendship hospital, 95.5% at Setthathirath hospital, and 75.0% at
Mother and Child hospital. Most importantly, the average yearly working ratios generally tend toincrease at the central and provincial hospitals. Also, the working ratios of most hospitals exceed
more than 80%.

・ The average yearly ratios of dead stockii were 0.0% at the Logistics Center and warehouses in threetarget provinces except the warehouse in Champasak province (2.2%).
Project Purpose:・ The number of repair of medical equip ment was increased at the beginning of the Pro ject because
the technical staff at the hospitals became ab le to repair bro ken med ical equip ment. However, thenumber of repair of medical equip ment has decreased at the central and provincial hospitals fro m
2006 to 2007 because of the adoption of the daily maintenance by users (medical doctors andnurses). It could be said that this is the effect of the Project.

・ The longest average stock periods at the Logistics Center and warehouses in four target provinces
have been improved fro m 12 months in 2006 to 6 months in 2007.

・ The temperature is maintained less than the maximu m standard temperature (25℃) at this mo ment
after installing the air-conditioner inside the Logistics Center and three provincial warehouses.

・ In the past, it took for an hour or several hours (unable to find in some case) to find the target2med icines or medical p roducts inside the warehouses. At present, however, the staff working for the
Logistics Center and four warehouses became able to find the target objects immediately because
the layouts inside the Logistics Center and four warehouses were well-organized with the reference
numbers of all medicines and medical products corresponding to the information of the database.
Output 1:

・ Outreach activities are favorably carried out by the MES at the central and provincial hospitals, aswell as by the Logistics Center at the warehouses in four target provinces. Particularly, the M ES
spontaneously conducted outreach activities five times in 2006 and seven times in 2007 (as of 29th
November).

・ Regular meetings were separately held for the central and provincial hospitals in the area of the
med ical equip ment maintenance. In the area of the inventory control, on the other hand, regularmeet ings were held once a year with the representatives of each Department of the MOH, theLogistics Center, and warehouses in four target provinces all together.

・ The number of references fro m the central and provincial hospitals to the MES tends to be increased,
especially fro m the central hospitals (the number of references has changed to 25 times in 2007 fro mzero in 2006).
Output 2:

・ The number of technical staff in the technical training courses on medical equip ment maintenance isplanned to increase from 24 part icipants in 2006 to 38 in 2007 (under the plan).

・ The trainers have taken the technical train ing courses on medical equip ment maintenance once a
year in Japan (2005) and Thailand (2006 and 2007).

・ More than five (5) types of training materials were prepared by the Project and have been utilized in
the in-country training courses. Also, the train ing materials translated in the Lao language werehighly appreciated by the participants.
Output 3:

・ The total number of hospital managers (directors or deputy directors) was increased in the
management train ing courses fro m 21 participants in 2005 to 24 in 2006.

・ The hospitals in the country have strived to secure the budget for the medical equip ment
maintenance. The specific amounts of the budget for the medical equip ment maintenance at eachhospital are not clarified at this mo ment. Through the Project, however, the hospital managers
recognized the importance of the medical equip ment maintenance and came to secure the budget forthe medical equip ment maintenance even if it is small amounts of the budget.
Output 4:

・ The staff working for the Logistics Center and the warehouses in the four target provinces constantly
participated in the training courses for the inventory control (6 part icipants in 2005, 12 participantsin 2006, and 11 participants in 2007).

・ The Logistics Center and warehouses in four target provinces have prepared the quarterly report ofinventory control. Sign ificantly, after the adoption of the database at four provincial warehouses(Savannakhet: October 2006; Other three provinces: June-July 2007), the four provincial
warehouses have submitted the monthly reports to the Logistics Center.

3-2 Summary of Evaluation Results(1) RelevanceFor the following reasons, the Project is judged to be of high relevance.
Consistency with the Develop ment Strategies on the Health Sector in the Lao PDR
The direction of the Project is in line with the contents and concepts of the “Health Strategy

3

2020”, “Medical Equip ment Management (M EM) Policy”, and “Rev ised National Medicine Policy.”
The “Health Strategy 2020” puts emphasis on six priority programs, and the fo llo wing fourpriority programs are consistent with the directions of the Project : (1) Curative and Rehabilitation
Strategies; (2) Consumer Protection St rategies; (3) Hu man Resource Develop ment for Health Strategies;and (4) Health Administration Strategies.
The goal of the Medical Equip ment Management (M EM ) Po licy is set up “to improve theutilizat ion and management of med ical equip ment in all health facilities throughout the country.”
The “Rev ised National Medicine Policy” is related to parts of the inventory control. One ofchapters in the Nat ional Medicine Policy is the “Medicine Supply : Procurement, Distribution, andStorage” described as follows: Fo r the public sector, the government will endeavor to provide adequate
storage facilities, basic equipment and sufficient number of staff for medicine supply management at alllevels of the healthcare system. A lso, the MOH will provide training o f staff working for med icine
supply management at all levels and sectors to improve the services provided by them.
Consistency with Japan’s foreign aid policy
The project concept is consistent with the content of the “Japan’s Country Assistance Program
for the Lao PDR” by the Ministry of Foreign Affairs of Japan. The Program places “improving
healthcare services” as one of six priority areas, and human resources development related to the healthand medical care field (assistance for better maintenance and management of medical equip ment) is
described in the assistance policy by the priority areas.
The long-term goal of the Project is consistent with the Program on Capacity Development for
Hu man Resources in the Health Sector described in the JICA’s country imp lementation plan of the Lao
PDR. There are two healthcare-related programs in the JICA’s plan, and this Project is positioned in the
Program on Capacity Development for Hu man Resources in the Health Sector.
Needs of the target group
According to the result of the preparatory study and interviewing in the terminal evaluation
study, the followings are confirmed.
<Medical Equip ment Maintenance>
When the hospitals received medical equip ment through the government and donor agencies,
they did not know how to maintain and repair medical equip ment because of a lack of knowledge on
med ical equip ment maintenance and difficulties for the hospitals to obtain the spare parts in the Lao
PDR. Also, the users (med ical doctors and nurses) utilized the equip ment without conducting thepreventive maintenance because they did not know the importance of the medical equipment
maintenance. Thus, it was highly necessary for technical staff to upgrade their skills and knowledge aswell as for the managers (directors or deputy directors) and users to change their awareness on the
med ical equip ment maintenance. Regard ing the spare parts of the equip ment, the hospitals needed theadvice and supports on types and procurement of the spare parts.
<Inventory Control>
Before starting the Project, it was quite hard to find target objects fro m the warehouses. Thus,
it was extremely necessary to effectively utilize the spaces inside new warehouses through theconstruction/renovation of the warehouses and to improve the knowledge and skills of the staff working
for the warehouses.

(2)

EffectivenessFor the following reasons, the effectiveness of the Project is judged to be high to a certain4

degree.
Achievement of the Pro ject Purpose<Medical Equip ment Maintenance>
The mechanism has gradually been established at the central and provincial levels for
managing and utilizing medical equip ment efficiently and properly. There are several reasons to support
the conclusions. Firstly, the daily maintenance system for med ical equip ment has steadily become partsof the routine works. Secondly, the hospitals intended to secure the budget for the medical equip ment
maintenance even if it was small amounts of the budget.
<Inventory Control>
The mechanism has steadily been established at the central and provincial levels fo r managing
and utilizing medicines and medical products efficiently and properly. The reasons are exp lained in thefollowings. In the first place, the layouts inside the warehouses have been improved, so the stocks areclassified and well-sorted inside the warehouses right now. Secondly, it became much easier for the staff
to manage the stocks inside the warehouses through the adoption of the database. As a result, the staff
became ab le to find a certain med icine within several minutes. Thirdly, the temperature properly came tobe controlled in specific areas of the warehouses.
Relationship between the Outputs and the Project Purpose
Through implement ing outreach and trainings/seminars by MES and Logistics Center, thesupporting mechanism in central and rural areas has been established. By imp roving technical skills of
med ical equip ment technicians, management skills of hospital managers and capacity for the staff incharge of inventory control have been improved. The high-quality healthcare services will eventually beprovided for the patients even in rural and remote areas.
Important Assumptions from the Outputs to the Project Purpose
Technical staff and trained trainers for med ical equip ment maintenance and staff in charge of
inventory control have continued working for M ES, central/provincial hospitals, Logistics Center andwarehouses in four target provinces. Therefore the Important Assumptions from the Outputs to theProject Purpose are fulfilled.

(3)

Efficiency
The Inputs of the Project were efficiently transferred to the Activit ies and the Outputs.

Assignment of the Japanese experts
Overall, Japanese experts were appropriately assigned in the Pro ject. In part icular, only one
long-term expert has managed and coordinated the entire project activit ies in charge of the “ProjectManagement/Coordinator.” Even though only one long-term expert has been assigned for this Pro ject, it
could be said that the activ ities have favorably been pro moted. Fro m the perspective of the personnel
expense, i.e., the Input of the Pro ject, it seems that the adoption of the one long-term expert was
efficient. In addition, all the short-term experts were repeatedly dispatched in each field. Speaking of thedispatch of the same experts in a short period, it could be said that the way of the assignment wassignificantly efficient.
Training courses in Japan and Thailand
Training courses in Japan and Thailand were very useful for the participants because they5

were able to learn the concepts and advanced skills of the med ical equip ment maintenance and theinventory control. As most participants were the trainers fo r the technical staff and the staff in charge ofthe inventory control in the country, the train ing courses were so meaningfu l fo r not only the participants
but also the above staff so as to establish the mechanism for d isseminating the concepts and replicableskills obtained by the participants to them.
The Logistics Center
The Logistics Center is a focal point of warehouses in the country. Importantly, it could besaid that the construction of the Logistics Center as the Input of the Project is considerably mean ingful
so as to show the model o f the logistics system to the other warehouses. Also, the mechanism and layoutof the Center are well-organized, so the Center became able to take in and out the stocks rapidly.
Important Assumptions for the achievement of the Outputs
The perosonnel assignment for medical equip ment maintenance and inventory control has
been promoted favorably. It is necessary for the Lao side to continuously strive for the allocation of thetechnical staff and the staff in charge of inventory control, specifically the assignment of the permanent
staff in these areas, for the achievement of the Output.

(4)

Impact

The following impact is recognizable fro m the imp lementation of the Project.
Prospects for the achievement of the Overall Goal
As mentioned in “3-1 Project Perfo rmance” above, since the indicators have favorably been
improved, there are prospects that the Overall Goal will be achieved if the Lao side makes further efforts
to continue the routine procedures even after the termination of the Pro ject.
Medical equip ment beyond repair should be decommissioned. While the necessity ofdecommissioning of medical equip ment is mentioned in “Medical Equip ment Management Po licy,” theconcrete procedure for decommissioning medical equip ment has not been established. If the guideline
for deco mmission procedure is developed and the medical equip ment that is beyond repair and not in use
are decommissioned, working rat io of med ical equip ment will increase, and then the Overall Goal will
be achieved, which med ical equip ment will co me to be managed and utilized efficiently and properly.
Positive impacts beside the Overall Goal・ At the beginning of the Project, even if the exp irat ion date of medicines and medical products
exceeded, the staff working for the o ld central warehouse (the Logistics Center at present) was notable to deal with them. However, they are easily able to check the expiration date of the medicinesand medical products through the database right now. For examp le, before exceed ing the exp iration
date of medical products stored by donors, the Center has become able to request the donors to copewith the medical products by showing the evidence prepared by the database to them.
・ The introduction of the database and the arrangement of the stocks at the four warehouses improved
the reporting system. Those warehouses became able to prepare the reports to the Provincial Health
Offices (PHO) mo re easily and efficiently through the database.

(5)

Sustainability
The prospects of the project sustainability will be good if hu man and financial resources areproperly secured by the MPSC under the MOH.

6

Align ment with the Policy of the Lao PDR
According to the “MEM Po licy” and the “Revised Nat ional Medicine Policy” as mentioned in
the “Relevance”, the project activities on the medical equip ment maintenance and the inventory control
would be supported by those governmental policies in the Lao PDR even after the termination of the
Project.
Regarding med ical logistics system, there is not the guideline which clarifies the standard of
behavior. In order to strengthen the support system in central and provincial level, developing theconcrete guideline for med ical logistics system under the Revised National Medicine Policy isrecommended. With regard to medical equip ment management, M EM Co mmittee in central andprovincial level does not function properly, for examp le, regular co mmittee meeting has not conducted.
The more efficient functioning of M EM co mmittee as a center of activit ies of medical equip ment
management is expected.
Organizational sustainability
The most crucial point is that the project activities are incorporated into the routine works at
the hospitals and warehouses, so they would be able to continue the activities as their routine works. The
improvement of the medical equip ment maintenance and the inventory control greatly contributes
toward providing h igh-quality healthcare services for the people through the medicines, medical
products and equipment toward the same object ive.
Although it is prospective that the technical staff of medical equip ment maintenance and staff
for inventory control will be continuously allocated from the view point of past trend of personnel
assignment, Laos side should strive to staff the personnel in both positions of medical equip ment
maintenance and inventory control for continuing the future activities.
<Medical Equip ment Maintenance>
The managers and the technical staff would like to continue the maintenance activities
because they recognize that the medical equip ment greatly contributes toward saving the patient’s life aswell as supporting the medical services provided by the med ical doctors and nurses. As the users
recognized the importance of medical equipment maintenance through the instructions of the preventive
maintenance repeatedly conducted by the MES and technical staff, their attitudes towards themaintenance have gradually been changed so as to be able to maintain medical equip ment by their own
hands according to the checklist of the daily maintenance.
<Inventory Control>
The staff working for the warehouses intends to improve the conditions of the warehouses
more appropriately according to the code of conduct set up by the Project, i.e., “5S: Seiri(Distinguishing);

Seiton(Sorting);

Seisou(Cleaning);

Seiketsu(Maintaining);andShitsuke(Disciplining).” A lso, the staff of the warehouse considers that they would like to make efforts in orderto improve their warehouse management skills. This is because the improvement contributes toward
providing high-quality healthcare services and medicines for the patients.
Financial sustainability
As shown in the Table below, the MPSC tries to secure the budget for their routine activities.
The total revenues have been decreased since the fiscal year of 2006. However, most revenues were
disbursed for the construction expenses to prepare fences, electricity, water supply, etc. for the Logistics
Center. In consideration of the operating expenses without the construction expenses, the specific budget
tends to be increased. Therefore, the MPSC intends to continue the project activities fro m the perspective

7

of the operating expenses.
Table

Budget of the MPSC fro m FY 2005 to FY 2008
2 005

Items

Plan

Un it: Kip
20 06

Realization

Plan

2007
Realization

Plan

20 08
Realizatio n

Plan

Revenues
Government

282,300,000

282,300,000

1,106,314,000

1,106,314,000

470,937,000

470,937,000

283,176,000

130,000,000

130,000,000

141,590,000

141,590,000

130,737,000

130,737,000

187,900,000

Expendit ures
Operating exp en ses
SalaryWater

3,000,000

3,000,000

3,000,000

3,000,000

3,000,000

3,000,000

3,500,000

Electricity

15,000,000

15,000,000

15,000,000

15,000,000

15,000,000

15,000,000

20,000,000

T elep hone

6,000,000

6,000,000

6,000,000

6,000,000

6,000,000

6,000,000

8,000,000

Facility maintenance

14,000,000

14,000,000

15,000,000

15,000,000

15,000,000

15,000,000

12,000,000
10,000,000

Eq uipmen t maintenance

2,000,000

2,000,000

4,000,000

4,000,000

4,000,000

4,000,000

Others37,300,000

37,300,000

40,724,000

40,724,000

37,200,000

37,200,000

41,776,000

207,300,000

207,300,000

225,314,000

225,314,000

210,937,000

210,937,000

283,176,000

Su b Total (Operating expenses)
Capital expenses
Consturctio n

Total

75,000,000

75,000,000

881,000,000

881,000,000

260,000,000

260,000,000

282,300,000

282,300,000

1,106,314,000

1,106,314,000

470,937,000

470,937,000

283,176,000

Source: Budgetary Sheet prepared by the MPSC
Note: The Fiscal Year for the Lao government has started from 1st October to 30th September.
(FY 2005: October 2004 – September 2005)<Medical Equip ment Maintenance>
Through the Project, hospital managers recognized the importance of the medical equip ment
maintenance. Also, they were able to understand the importance of the preventive maintenance becauseof the limitation of the budget in co mparison with the procurement of new medical equip ment and therepair of existing equip ment. As a result of their changes in awareness, the budgetary allocation for the
med ical equip ment maintenance came to be secured even if it is small amounts of the budget.
The hospitals charge patients for the medical services provided by the hospitals, such as
hospital fees, bed fees, X-ray examinat ion, drugs, etc. Parts of those user fees came to be allocated forthe medical equip ment maintenance by the discretion of the hospitals.
Since the budget for the medical equip ment maintenance was not allocated at the hospitals
until recently, it was the enormous progress to be able to secure the budget for the medical equip ment
maintenance at this mo ment. However, the amounts of revenues fro m the MOH are still not sufficient forthe medical equip ment maintenance.
<Inventory Control>
The staff working for the Logistics Center had the opportunities to train the people of theprivate co mpanies on how to manage the stocks and keep the temperature inside the warehouse. In
addition, since the stock management at the Log istics Center was highly appreciated, a private co mpany
requested to keep the containers and materials inside the Logistics Center. These services might be asource of revenues for the Logistics Center.

3-3 Factors promoting project progress(1) Factors concerning to Planning・ It is considerably significant to conduct the medical equip ment maintenance as their routine works at
the hospitals by involving not only the technical staff but also the managers and users along with the
project plan. As a result, the medical equip ment maintenance at the hospitals was smoothly
promoted in collaboration with the technical staff, managers, and users.

8

(2) Factors concerning to the Implementation Process
・ New concepts were introduced into the routine works of the staff at the M ES and the Logistics
Center, the managers and technical staff at the hospitals, and the staff in charge o f inventory control
in four target provinces, such as daily maintenance of medical equip ment, adoption of the database,etc. As the project activit ies made their routine works more effective and efficient, they were able toaccept the activities more easily than as expected.

・ The staff of warehouses was able to imp rove their routine activities along with the code of conduct
set up by the Project, i.e., “5S: Seiri (Distinguishing); Seiton (Sorting); Seisou (Clean ing); Seiketsu(Maintaining); and Shitsuke (Disciplin ing).”・ In order to prepare the operational guide of medical equip ment (the procedure of how to utilize themed ical equip ment) in the Lao language at the provincial hospital in Savannakhet, the technical staff
discussed with the responsible users of the medical equip ment who had the knowledge on how to
use the equipment. The hospital staff became able to share the directions for use of each medical
equipment in their language.

3-4 Factors inhibiting project progress(1) Factors concerning to Planning・ At the beginning of the Project, it was not planned to assign a short-term expert in charge of theestablishment of the Logistics Center, the preparation of the tender documents, and the construction
management. A lthough the dispatch of the expert in charge was decided after the co mmencement of
the Project, the sufficient period was not secured for the construction of the Logistics Center becauseof the unplanned budget of the Project. Also, since the preparat ion survey on the construction of the
Logistics Center was not sufficient, only a half of the actual budget was estimated for theconstruction. According to the insufficient budget, the scale of the Logistics Center was downscaled,
and the construction standard was changed from the Japanese standard to the local standard.

・ The Lao side was not able to prepare the budget for the relocation to the Logistics Center fro m theold central warehouse after the co mpletion of the Logistics Center. The delay in securing the budget
prolonged the process of the relocation (Co mpletion of the Logistics Center in October 2006;
Relocation to the Logistics Center in February 2007).

(2) Factors concerning to the Implementation Process
・ In case of Oudomxai p rovince, it might be necessary to improve the communication between theprovincial hospital and the PHO/technical staff. Although the users are supposed to report the
problems on med ical equip ment to the technical staff through the formal channel, the users directly
report the problems to the director/deputy director at the hospital because it is often d ifficult tocommunicate with the technical staff assigned for the PHO who has a lot of maintenance and repair
works within the province.

・ Although each hospital is supposed to submit the report about working ratio of medical equip ment to
MES every six months, some hospitals have not submitted it. Regarding this matter, M ES is trying
to promote the hospitals to submit the report through the outreach activity and explanation of thenecessity and importance of the report in the collaboration meeting.

・ In the area of the inventory control, although the provincial government is supposed to transport the
med icines and med ical products to the district level, it is somet imes unable to allocate the sufficientbudget for the transportation to the district level. This may affect the number of dead stock of
med ical products in provincial warehouses.

3-5

Conclusion
The evaluation study team concluded that the Project Purpose would be ach ieved and the9expected efficient wou ld be had by the end of the cooperation period. In terms of the medical equip ment
maintenance, the adoption of the follo wing act ivities greatly contributed towards achieving the Project
Purpose. Firstly, the importance of the med ical equip ment maintenance was recognized by the managers,
technical staff, and users through the instructions by the MES. Secondly, the users have gradually cometo conduct the daily maintenance as their routine works. The managers recognized the medical
equipment maintenance as necessary for providing h igh-quality healthcare services for the people.
Thirdly, it became easier fo r the M ES to monitor the working condition of the medical equip ment at thehospitals through the database of the medical equip ment.
With reference to the inventory control, the adoption of the following activit ies greatly
contributed towards achieving the Project Purpose. Firstly, the newly-established central warehouse,
named as the Logistics Center, has been functioning as a center of the logistics system in the country.
The monthly reports to the Logistics Center have come to be firmly submitted by the four provincial
warehouses. Secondly, the layouts inside the warehouses have been improved, so the stocks areclassified and well-sorted with the reference nu mber corresponding to the informat ion in the
newly-established database. As a result, the staff became ab le to find a certain medicine or medical
product within several minutes. Thirdly, the staff became easily able to monitor the exp irat ion date of
med icines and medical products through the database. Fourthly, medicines can be stored at specific areasof warehouses in an appropriate condition because the room temperatures are properly managed with
air-conditioning by the trained staff.
Fro m the result of the evaluation based on five evaluation criteria, there is no big problem in the
project design, activities and the imp lementation process. At the same time, since the achievement of theOverall Goal has potential, it is convenient to think that the Pro ject will be finished as scheduled. MPSC
should continuously try to secure the finances for routine activities.

3-6

Recommendations(1)

The Project should continue to share the outcomes, experiences and lessons learnt of project
activities much more widely among each Department of the MOH, each Provincial Health Office,concerning donors and organizations.

(2)

The MOH should develop and finalize the guideline as the p rinciple for the logistics system underthe “Revised National Medicine Po licy” in the Lao PDR with technical support of the Project.

(3)

All of the hospitals should submit the report to the M ES every six months, so that the MES canmonitor and manage the working condition of medical equip ment.

(4)

The MOH should facilitate the M EM Co mmittee to function as the focal point of the medical
equipment management in the Lao PDR(5)The MOH should continuously promote the hospitals to decommission med ical equip ment.

(6)

The MOH should establish the financial system for continuing the outcomes and activities
achieved by the Project in terms of the medical equip ment maintenance as well as the inventory
control.

(7)

Donors and other organizations should consider the soft component in case of providing medical
equipment for hospitals.

10

3-7

Lessons Learned(1)

The Laotian textbooks for the managers and technical staff provided by the Pro ject have beenhighly appreciated and used widely in the Lao PDR.

(2)

The newly-introduced concepts and activities that were extensions of the routine work pro moted
the changes in the consciousness easily and made the routine work more effect ive and efficient.

(3)

The hospital intended to establish the system for the medical equip ment maintenance in a body
because of involving not only the technical staff but also the managers and users at hospitals in theactivities of the medical equip ment maintenance.

(4)

Donors and other organizations should consider the soft component in case of providing medical
equipment for hospitals.

i

Logistics Center is settled under Medical Products Supply Center (M PSC) and functions both ofwarehousing and managing regional warehouses as a central warehouse.
ii

The ratio of dead stock is defined as the ratio of the nu mber of the pallets stored more than five years to
the total number of the pallets in the warehouse.

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