When Mwile Simbeye began work as a pharmacist at Andara District Hospital in Namibia, there was no one to orient him to his new post. The previous pharmacy staff left a few months before he started and, consequently, Simbeye did not have the training to take advantage of the facility electronic stock card (FESC) system to help him manage the more than 600 essential medicines and supplies at the hospital. Instead, Simbeye had to use manual, paper stock cards, which are less accurate and more labor intensive than the FESC system.
Simbeye’s dilemma is common among staff in settlements like Andara, where rural settings make attracting and retaining qualified workers a challenge. Moreover, many rural areas in Namibia face significant health challenges. Andara, for example, suffers from a high rate of HIV/AIDS — 21 percent of pregnant women that visit antenatal care clinics test positive.
With these difficulties in mind, the USAID Global Health Supply Chain Program-Procurement and Supply Management (GHSC-PSM) project recently worked with the Ministry of Health and Social Services’ Division of Pharmaceutical Services and other partners to provide on-the-job training and supervision to pharmacists in remote locations in Namibia.
The training and supervision — provided through supervisory support visits — aims to monitor and evaluate interventions and improve regional and site-level pharmacy staff’s delivery of health services. Recent visits involved seven teams of two to three staff drawn from the Division of Pharmaceutical Services and GHSC-PSM. To guide their visits, the teams used a standard checklist which covered topics such as storage infrastructure, inventory managements, antiretroviral therapy services and data quality, quality of dispensing practices, and use of electronic dispensing and stock management tools.
In December 2017, GHSC-PSM staff visited Simbeye and two other health workers at Andara District Hospital to provide them with training on the FESC and other aspects of pharmacy store management. By February 2018, the facility had stopped relying on inefficient paper stock cards and fully adopted the use of the FESC for inventory management. This resulted in achieving 100 percent accuracy in the hospital’s resupply requests to the central medical store, helping staff ensure a reliable supply of medicine — like lifesaving antiretroviral therapy for Andara’s HIV-positive community.
“I was not comfortable with the FESC because I did not know how to use it well until I got the training from GHSC-PSM staff. Now I have stopped using the paper-based stock cards and am fully using FESC in our pharmacy,” said Simbeye.
In all, the Andara District Hospital’s staff was able to resolve almost two-thirds of the issues identified in previous supervisory support visits, including updating the maximum and minimum inventory control parameters in the FESC to help avoid overstocking as well as stockouts.
Despite these improvements, however, the pharmacy at Andara District Hospital — like many of the 44 other facilities in Namibia that receive supervisory support visits — still faces challenges, especially related to inadequate storage space and temperature control. In response, the supervisory support visit team recently held a debriefing session with the hospital management and regional management team to share findings and recommendations for improvement.
In collaboration with the Ministry of Health and Social Services, GHSC-PSM will continue to provide site-level supervision and support throughout Namibia to strengthen the pharmacy workforce and HIV/AIDS commodity supply chain.