In Namibia, hospital pharmacies play an essential role in ensuring HIV-positive patients have continuous access to lifesaving antiretroviral (ARV) therapy. In addition to providing medicines to patients, many hospital pharmacies store ARVs for smaller neighboring clinics.
However, some hospital pharmacies struggle to effectively manage and stock antiretrovirals and other essential medicines. As part of its support to 15 health facilities in high-burden HIV/AIDS regions, the USAID Global Health Supply Chain Program-Procurement and Supply Management (GHSC-PSM) project, identified the Onandjokwe Intermediate Hospital as a facility in urgent need of support in managing its pharmaceutical stocks. Serving as a referral hospital for nearby regions, Onandjokwe is one of the busiest facilities in the country, with about 9,000 patients seeking antiretroviral therapy. It also supplies medicines to seven nearby clinics.
The hospital’s pharmacy was not fully using inventory management tools and systems — such as manual and electronic stock cards — or properly tracking maximum and minimum stock levels. The pharmacy had no lock and lacked a designated staff member dedicated to managing inventory. As a result, the pharmacy and the clinics it supplies experienced frequent stockouts, under-supply, overstock, and wastage due to expiry, which contributed to patients’ not getting medicines they needed.
As a first step in gaining control of its pharmaceutical supply, the hospital prioritized and repaired the door locks, ensuring only qualified staff could access it. GHSC-PSM then supported the hospital pharmacist, Ms. Hewan Gebremichael, to evaluate all stock levels, update stock cards, and calculate the maximum and minimum stock levels. ARVs worth about $2,400 at risk of expiry were returned to Oshakati medical stores, while ARVs at risk of stockout were ordered and delivered. Armed with reliable maximum and minimum stock levels, pharmacists can spend less time ordering new medications and managing stock, and more time caring for patients.
“Now I can manage the store without worrying about the security of the medicines and stock cards being messed up”, said Gebremichael.
Since the exercise took place, the project has trained a second pharmacist, Mr. Alemseged Gulma. Together, the two pharmacists have been trained in and now use the Facility Electronic Stock Card (FESC) software to efficiently manage the pharmacy’s medicine. The software is more effective than the manual stock card system it replaced. FESC simplifies inventory control tasks, automates the calculation of average monthly consumption, helps generate orders to resupply and maintain adequate stock levels, and provides an auditable trail of transactions to improve accountability. By automating tasks once done manually, the tool also saves pharmacists valuable time. FESC had been installed in the ARV therapy pharmacy but was not in use due to lack of training. GHSC-PSM’s training covered all modules of FESC, including how to capture different types of stock transactions and how to generate reports enabling them to make better, data-driven decisions about orders and inventory management.
Six months after the FESC training, the pharmacy staff are managing all ARVs using the tool and maintaining stock levels according to plan for more than 90 percent of the ARVs. In addition to Onandjokwe Intermediate Hospital, GHSC-PSM is supporting 20 other health facilities in the region to strengthen supply chain management skills, ensuring that medicines are there when patients need them.