In this three part series, Jay Heavner, Director of Knowledge Sharing and Communication at Supply Chain Management System (SCMS), highlights his experiences visiting three countries in Africa to observe SCMS project sites.
The Fital Health Center is located about 135 kilometers north of Ethiopia’s capital, Addis Ababa, in a beautiful agricultural region of small villages of thatched roof huts and fields of dark, rich soil. HIV prevalence is low here. Although the center tests about 1,000 people a month, the center has only 37 patients on treatment, three of whom are children.
The health center has a small but well organized store room filled with medical supplies, including adult anti-retroviral medicines and HIV test kits provided by the Global Fund and pediatric antiretroviral drugs (ARVs) and laboratory supplies procured by SCMS with funding from the President’s Emergency Plan for AIDS Relief (PEPFAR) through USAID. The store room also serves as a distribution point for nine other smaller health centers in the area.
As recently as 2009, the health center struggled to manage its relatively small number of medicines and other supplies. Staff here told me they faced challenges with drugs expiring and experienced stockouts of drugs and other supplies as well.
As part of a national capacity building program, SCMS has provided training and ongoing supportive supervision visits with key staff here and at 198 sites like it to strengthen the health center’s processes, including reporting and ordering to the regional warehouse hub, management of its medical supplies and distribution to other sites. Staff here showed me examples of the forms they fill out and use to report data—including consumption of commodities and current stock on hand—to the regional warehouse staff, who then enter the information in a national internet-based system developed by SCMS to support Ethiopia’s Pharmaceutical Fund and Supply Agency (PFSA) and international donors plan their funding and procurement of HIV/AIDS commodities. They also showed me a number of other forms, including ones they use to manage their inventory and others used to process and track orders from the other sites they serve. SCMS prints and distributes many of the forms sites like this use to manage their HIV/AIDS medicines and supplies.
The health center’s store room is small, and has shelves and refrigerator that are a bit old. However, good management overcomes these limitations. The staff enthusiastically participated in training and has completely owned the systems and processes they learned. They now have a reliable supply of quality medicines and supplies, and rarely experience stockouts or expiry of medicines.
The impact on their community can be measured in the attitudes of their patients. Just a few years ago, people diagnosed with HIV would usually hide their status. They would most often seek treatment from a traditional healer, or have to travel as far as Addis Ababa for medical care. Once their illness became obvious, they would hide in their homes and wait to die.
Now, people who test positive for HIV just as likely tell others their status and try to teach them how to avoid getting the disease. They now seek AIDS care from the health center rather than a traditional healer. And mostly importantly, people who were bed-ridden are recuperating and able to return to their work and care for their families.
The health center operates on a very limited budget, and the staff say that PEPFAR and USAID’s support help them fill in the gaps. Asked about their hope for the future, they didn’t think about themselves. Instead they expressed their hope that even more health facilities can be equipped with the medicines and training to provide treatment for HIV/AIDS, because only 1,000 of 3,500 health centers nationwide are now trained and equipped to care for those living with the disease.