The University of Zambia

UNIT 6

SUPPLY CHAIN MANAGEMENT

OF THE NATIONAL ART
LABORATORY COMMODITY & HIV
TEST LOGISTICS SYSTEMS

Student’s Manual

February 2012 Edition

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About SCMS

The Supply Chain Management System (SCMS) was established to enable the
unprecedented scale-up of HIV/AIDS prevention, care and treatment programs in the
developing world. SCMS procures and distributes essential medicines and health
supplies, works to strengthen existing supply chains in the field, and facilitates
collaboration and the exchange of information among key donors and other service
providers. SCMS is an international team of 16 organizations funded by the US
President’s Emergency Plan for AIDS Relief (PEPFAR). The project is managed by
the US Agency for International Development.

This guide was made possible through support provided by the US Agency for
International Development, under the terms of contract number GPO-I-00-05-00032-
00. The opinions expressed herein are those of the author(s) and do not necessarily
reflect the views of the US Agency for International Development or the US
government.

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Contents
COURSE OBJECTIVES ............................................................................................................................. 10
Acronyms .............................................................................................................................................. 12
6.1. Elements and Principles of Supply Chain Management ................................................................ 14
6.2.Introduction to the Zambia Supply Chain and Pipeline .................................................................. 18
6.3 .Roles and Responsibilities in the National ART Laboratory Commodity Logistics System ............ 23
6.4. Introduction to the Logistic Management Information System (LMIS) ......................................... 25
6.5. Inventory Control System or Management ................................................................................... 36
6.6. Recording Usage of Laboratory Commodities ............................................................................... 40
6.7. Reporting Usage of Laboratory Commodities................................................................................ 48
6.8. Completing HIV Test DAR ............................................................................................................... 69
6.9. Completing the Internal Monthly Summary Report (IMSR) ........................................................... 73
6.10. Completing the Report and Requisition for HIV Tests.................................................................. 82
6.11. Receiving Laboratory Commodities ............................................................................................. 95
6.12. Storage of Laboratory Commodities ............................................................................................ 99
6.13. Monitoring, Supervision, and Feedback Reports ....................................................................... 103
7.0. How orders are calculated on the Computer-generated R&R..................................................... 105

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Introduction
The current Ministry of Health and partner supported logistics systems within Zambia
(including the ARV, HIV Tests, Laboratory Commodities, PMTCT, and the Essential
Medicines Logistics Improvement Programs) have greatly improved the availability of
commodities at the facility level as well as client satisfaction. But how sustainable are
these interventions?

The Ministry of Health, in collaboration with the University of Zambia (UNZA), has
instituted logistics and supply chain management within the training curriculum at
UNZA, Evelyn Hone College (EHC), Ndola School of Biomedical Sciences (NSBS),
and Chikankata College of Biomedical Sciences (CCBS) to address this concern.
Following a letter of agreement signed between UNZA (on behalf of the other
institutions) and the USG-funded project Supply Chain Management System
(SCMS), technical assistance in supply chain management has been provided in the
form of training of trainers (TOT) or lectures; followed by the design and
development of a supply chain training curriculum that has been incorporated into
the main syllabus for biomedical sciences trainings both at diploma and degree
levels.

In December 2009 and April 2010, a group of final year students from the above-
named institutions were trained at the pre-service level in the MoH's ART Laboratory
Logistics System prior to graduation. Since then, 80% of the students have been
employed in MoH facilities and were able to implement the system on the first day of
work.

The introduction of supply chain management during pre-service training is showing

a significant reduction in the need for in-service trainings, as new professionals are
coming out already equipped with the skills to run the various logistics systems. This
also reduces the high cost of in-service training compared to the cost of institutional
training, making pre-service supply chain management training a sustainable
alternative to in-country supply chain interventions.

Supply Chain Management Student’s Manual Overview

This manual content has been prepared as a workbook for students for learning
supply chain management as part of the Laboratory management course. It was
developed to assist you (students) to learn effectively and acts as a reference
document during and after the session. There are exercises and evaluation
questions to assess your understanding of the content on supply chain management.

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Who is the Manual For?

This manual is intended for use primarily by biomedical students. The manual’s
sessions give guidance on the time and provide information to be learnt by the
students. The sessions has different activities suggested which focus on increasing
students’ knowledge, skills and attitudes in supply chain management.

How is the Manual Organized?

The manual is divided into 7 sessions; each session is divided into several sections.
The following are the sections of each session:

Session Title: The name of the session.

Total Session Time: The estimated time for teaching the session, indicated in
minutes.

Session Aim: A module or session which needs to be covered before teaching the
session.

Learning Objectives – Statements which indicate what the student is expected to

learn at the end of the session.

Session Content – All the session contents are divided into sub-topics of
discussion.

Content/Activities/Key Points – Each session is divided into key content areas to

be learnt by each student. This part gives a summary of the main points and ideas
from the session.

Exercises – Exercise to practices skill and knowledge given are suggested but not
in every session. STUDENTS ARE ENCOURGED TO DO ALL THE EXERCISES.

Evaluation – The last section of the session consists of short questions based on
the learning objectives to check your understanding of the taught content.

References – These are the sources of information that can be referenced when
learning this topic.

How should the module be used?

Students are expected to use the manual as a workbook in the classroom and
outside classroom settings. Therefore, students should have it all the time supply
chain sessions are being taught. Students are encouraged to share the manual
should there be no enough copies for each student.
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What should the Student do?

 Bring it to the class at all times

 Use the session contents as a workbook.
 Complete all exercises as instructed by the lecturer.
 Make use of other appropriate reference materials as suggested.
 Use the evaluation questions (where applicable) at the end of the session to
measure your understanding of the content.

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COURSE OBJECTIVES
By the end of this Unit the students should be able to:

1. Describe the purpose of the Health Supply Chain Management System,

and the relationships among the major components of the system.
2. Describe the purpose and elements of a Logistics Management
Information System (LMIS).
3. Analyze the LMIS as currently in use in Zambia.
4. Describe the guidelines for proper storage of health commodities.
5. Assess health commodity stock status at all levels of the Supply Chain.
6. Determine appropriate order quantities for all levels of the Supply Chain
using Max-Min Inventory Control procedures.
7. Determine appropriate Maximum-Minimum Inventory Control Systems for
a variety of situations.
8. Describe the concept of Commodity Security (CS).
9. Identify policy level interventions to address the issues related to
Commodity Security (CS).
10. Describe specific roles and responsibilities of the Laboratory personnel in
the Supply Chain Management for Health Commodity Security.

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Acronyms
AIDS Acquired Immunodeficiency Syndrome
AMC Average Monthly Consumption
ART Antiretroviral Therapy
ARV Antiretroviral (drug)
DHO District Health Office
FEFO First Expiry, First Out
GRZ Government of the Republic of Zambia
HIV Human Immunodeficiency Virus
LMIS Logistics Management Information System
LMU Logistics Management Unit
MOH Ministry of Health
MOS Months of Stock
MSL Medical Stores Limited
NAC National AIDS STI/TB Council
NGO Non-governmental Organization
OJT On-the-Job Training
PHO Provincial Health Office
PMTCT Prevention of Mother to Child Transmission of HIV
SDP Service Delivery Point
SOH Stock on Hand
USAID United States Agency for International Development
UR Usage Report for laboratory commodities
SCMS Supply Chain Management System

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6.1: Elements and Principles of Supply Chain Management

Time Allocation: 2 hours

Session Aim:
To equip the students with basic knowledge and terminology in the study of supply
chain management for laboratory commodities.

Session Objectives:

By the end of this session the students should be able to:

1. Describe the concept of commodity security and the role of logistics in

ensuring commodity security.
2. Describe the purpose of a logistics system.
3. Define basic logistics terms, including push/pull, lead time, dispensed vs.
issues and pipeline.
4. Describe the in-country pipeline for HIV Test and Laboratory Logistics
systems.

Session Content:

6.1.1. The Logistics System

6.1.1.1. Key points for the HIV test and laboratory logistics system
6.1.1.2. Commodity Security
6.1.1.3. Purpose of a Logistics System
6.1.1.4. The Six Rights

6.1.2. Key Logistics Terms

6.1.2.1. Push versus Pull

6.1.2.2. Lead Time
6.1.2.3. Dispensed versus Issued
6.1.2.4. Pipeline
6.1.2.5. Describe the pipeline for HIV Tests and Labs

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Session Key Points:

A. The Logistics System

These key points help explain the National ART Laboratory Commodity Logistics
System and what it can offer to the people of Zambia.

1. Laboratory commodities should be available to perform the necessary

diagnostic and monitoring tests when and where they are needed.. This
is called Commodity Security. It is like food security Commodity Security‖ (CS)
is somewhat like ―Food Security.‖ It means having enough to supply
everybody. C.S. in our case means that in Zambia, all laboratory facilities are
always supplied with the commodities required to conduct essential laboratory
tests for HIV and AIDS.

2. The Zambia National ART Laboratory Commodity Logistics System will

help this happen. The enhanced Zambia National ART Laboratory
Commodity Logistics System that you will learn about in this course will help
make laboratory supplies available to provide tests to patients, when and
where they need them.

3. “No Report, No Product, No Programme.” People in logistics say ―No

Product, No Programme,‖ and in order to get the Product you have to have the
Report. This means that if you don’t submit your Usage Report each month,
you won’t have supplies, and you are not in business. If you don’t have
laboratory commodities available, you won’t be able to do the tests required to
have a successful HIV and AIDS program.

4. The Final Kilometre; It is your responsibility to get the laboratory commodities

the ―final kilometre‖ to your health facility by using the system so that you have
no stock outs and can always serve your clients. It does not matter if
laboratory commodities get all the way to the District if they don’t reach you.
Your job is to know when and how to submit your report so that adequate
quantities of product come to the ―final kilometre‖ to you and your clients.

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B. The purpose of a Logistics System:
For a logistics system to work well, it must be able to ensure the Six Rights.

The Six Rights Of Logistics

The Right Laboratory Commodities

In the Right Quantities
In the Right Condition
Are delivered to the Right Facility
At the Right Time
For the Right Cost

*Notice that ―The Right Cost‖ applies even when there is no charge for a service or
products. It means the programme is run efficiently and costs are controlled.

C. Key Logistics Terms:

1. PULL (REQUISITION) SYSTEM: In a pull system, quantities to be issued are

determined by personnel who receive the supplies.

2. PUSH (ALLOCATION) SYSTEM: In a push system, quantities to be issued

are determined by personnel who issue the supplies.

3. LEAD TIME is the time interval between when new stock is ordered and when
it is received and available for use.

4. DISPENSED-TO-USER DATA: Information about the quantity of goods

actually put in the hands of the clients (often shortened to ―dispensed data.‖)

5. ISSUES DATA: Information about the quantity of goods shipped from one
level of the system to another.

6. PIPELINE: The entire chain of storage and transportation links through which
supplies move from the manufacturer to the consumer, including port facilities,
central warehouse, regional warehouses, district warehouses, all service
delivery points and transport vehicles.

Evaluation

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 1. What is Commodity Security?
2. What is the right cost of donated goods?
3. What is a pipeline in logistics?
4. Give the difference between Push and Pull systems.
5. What does ―The final Kilometer‖ refer to?

References:

 USAID | DELIVER PROJECT. 2007. The Logistics Handbook: A Practical

Guide for Supply Chain Managers in Family Planning and Health Programs.
Arlington, Va.: USAID | DELIVER PROJECT, Chapter 1.

 Republic of Zambia, Ministry of Health, Standard Operating Procedures

Manual for Management of the National ART Laboratory Commodity
Logistics System, September, 2009. Chapter 3

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 6.2. Introduction to the Zambia Supply Chain and Pipeline

Time Allocation: 2 hours

Session Aim:
To equip the students with basic knowledge and terminology in the study of supply
chain management for laboratory commodities.

Session Objectives:
By the end of this session students should be able to:
1. Describe the purpose of the Standard operating Procedure Manual
2. Explain the purpose of the National ART Laboratory Commodity Logistics
System
3. Identify the key components of the National ART Laboratory Commodity
Logistics System
4. Define Pipeline.
5. Explain the flow of commodities and information in the logistics system.
6. Draw the national in-country supply pipeline diagram of laboratory commodities
in Zambia.

Session content:
6.2.1. Background of the National ART Laboratory Commodity Logistics System for
Zambia
6.2.2. Purpose of the Standard Operating Procedures Manual
6.2.3. Purpose of the National ART Laboratory Commodity Logistics System
6.2.4. Key Components of the National ART Laboratory Commodity Logistics System
6.2.5 Commodity and Information flow in the system

Key points of the session

A. SOP:
The Standard Operating Procedures (SOP) manual is intended to simplify and
standardize the work required for managing the national ART laboratory commodity
logistics system to allow health care providers more time for patient-focused activities. It
serves as a reference for laboratory staff in facilities operated by the Zambian Ministry
of Health and other cooperating partners. This manual guides laboratory personnel in
the completion of the following tasks:

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  Maintaining adequate supplies of laboratory commodities
 Reporting logistics data of laboratory commodities to the MOH Logistics
Management Unit
 Receiving and storing laboratory supplies
 Recording and reporting consumption
 Monitoring logistics activities and supervising staff throughout the system

B. Purpose of the National ART Laboratory Commodity Logistics System

The purpose of the logistics system described in this manual is to ensure that
reagents and other laboratory supplies are continuously available to support
laboratory services. In order to be successful, the system must fulfill the Six Rights
of logistics

C. Key Components of the National ART Laboratory Commodity Logistics

System
 Ministry of Health (MOH) – Logistics Management Unit (LMU)
 Medical Stores Limited
 Hospitals (Level 1, and Level 2 and 3)
 Provincial Chief Biomedical Scientist (PCBM)
 District Chief Biomedical Scientist (DCBS)
 Health Centres

D. Commodity and information flow in the system

 Commodities flow down from MSL to level 1, 2 and 3 hospitals, and to District
Health Office, where the DCBS sits, as a pass through to health centres.
Commodities are used to test patients at service delivery points. Service delivery
points include all health centres, level 1, level 2 and level 3 hospital laboratories.

 The information that is collected on the forms used in the Logistics Management
Information System (LMIS) flows up from the hospitals to MSL directly, and from
health centres to the DHOs who in turn send the information to MSL. MSL then
passes on all information on laboratory commodities to the MOH LMU for processing.

 Feedback reports from the Laboratory Supply Chain Manager software1 are
generated within the MOH LMU and sent to MSL and to MOH Deputy Director
Laboratory Services, including the Director of Clinical Care and Diagnostic Services,
the provincial health offices, hospitals, DHOs, health centres, and cooperating

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The Laboratory Commodity Supply Chain Manager software is Supply Chain Manager Software that has
been adapted for Zambia to collects data from facilities and calculates orders quantities and provides
feedback reports on facility and program level consumption and stock status of laboratory commodities.
Reports generated from the database are used for program management, procurement, monitoring of the
in-country supply pipeline, and supervision of testing laboratories.
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partners . Feedback reports are used by central level, provincial and district MOH
staff, and NGO and private partners for supervision and feedback action.

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E. Drawing Zambia Pipeline

Instructions: This is a simplified version of the pipeline diagram than in your SOP
manual for Laboratory commodities logistics system. Add information to this diagram
and indicate the flow of commodities and information.

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Evaluation
1. What is the purpose of an SOP manual in the National ART Laboratory
Commodity Logistics System?
2. Name six key components of the National ART Laboratory Commodity Logistics
System?
3. What are the Six Rights?
4. Briefly describe how commodities and information move from one level to the
other.

References:

 Republic of Zambia, Ministry of Health, Standard Operating Procedures Manual for

Management of the National ART Laboratory Commodity Logistics System, September,
2009. Chapter 3

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6.3 .Roles and Responsibilities in the National ART
Laboratory Commodity Logistics System

Time Allocation: 60 minutes

Session Aim:
To equip students with basic knowledge of pipeline, how commodities and information
flow in the national in-country supply pipeline.

Session Objectives:
By the end of the session students will be able to:
1. Identify the positions and roles of personnel who manage the National ART
Laboratory Commodity Logistics System
2. Discuss the relationship between their role and the role of others in their
facility and with others in the system.

Session Content
6.3.1. Roles and responsibilities
6.3.2. Who’s Who in the National ART Laboratory Commodity Logistics
System

Key points of the session:

A. Roles and Responsibilities

 Many health staff play key roles in the operation of the national ART laboratory
commodity logistics system. The roles and responsibilities for personnel involved in
this system are listed below. If no one has been assigned one of the following
personnel designations at a facility, one must be assigned the responsibility to ensure
that the logistics system operates and that adequate products are available for
patients.

 NGOs or other cooperating partners, their specific roles and responsibilities in

the logistics system may vary depending on their agreements with the MOH and the
level(s) at which the organization works.

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B. Who is who in the National ART Commodity logistics System?

MOH

 Deputy Director Laboratory Services

MOH LMU

 LMU Laboratory Technical Officers

 Data Entry Clerk
MSL Central Warehouse

 Assistant Warehouse Manager & Laboratory Quality Assurance Manager

Provincial Health Office

 Provincial Chief Biomedical Scientist

District Health Office (FOR HEALTH CENTRES)

 District Chief Biomedical Scientist

Hospitals: Level 1, Level 2 and 3

 Chief Biomedical Scientist

 Biomedical Scientist
 Laboratory Technologist
 Laboratory Technician
 Storekeeper (where applicable)

Health Centre

 Biomedical Scientist
 Laboratory Technologist
Laboratory Technician
Evaluation:
1. What are the roles and responsibilities of NGO or cooperating partners in the
logistics system?
2. What is the role of the provincial health Office in this system?
3. Who approves the Hospitals orders before sending them to MSL?
4. Give at least two roles of the Assistant Warehouse Manager and Laboratory
Quality Assurance Manager.

Reference:

 Republic of Zambia, Ministry of Health, Standard Operating Procedures Manual

for Management of the National ART Laboratory Commodity Logistics System,
September, 2009. Chapter 3

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6.4. Introduction to the Logistic Management Information
System (LMIS)

Time Allocation: 6 hours

Session aim
To equip the students with knowledge and skills on the importance and functions of the
LMIS for health commodities in Zambia.

Session Objectives

By the end of this session, students should be able to:

1. Describe the purpose of the LMIS and the Key elements (data, records, and
reports)of a well-functioning LMIS
2. List essential data for health logistics management
3. Describe the three types of logistics records
4. Distinguish between the LMIS forms used in the systems
5. Accurately complete the LMIS forms used in both systems

Session Content
6.4.1. Logistic Management Information System
6.4.2. Types of Records
6.4.3. Transaction Records
6.4.4. Consumption Records
6.4.5. Other Types of Reports

Key points of the session:

A. Purpose of LMIS

 The purpose of a logistics management information system (LMIS) is to collect,

organize, and report information to other levels in the system in order to make
decisions that govern the logistics system and ensure that all Six Rights are fulfilled.\

B. Three Essential Data Items

 Stock on Hand: Quantities of usable stock (laboratory commodities) available at

a particular point in time.

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 Consumption Data: The quantity of laboratory commodities used during the
reporting period (one month).

 Losses/Adjustments: Losses are the quantities of reagents removed from your

stock for anything other than for performing tests or issuing to a facility (e.g., expiry,
loss, damage or theft). Adjustments are quantities of a product received from any
source other than the scheduled delivery from MSL or the district, or quantities
transferred between facilities (borrowed/returned).

C. Main Activities that happen to laboratory reagents and other supplies within
a logistics system:

1. Stored in inventory,
2. Moved between facilities, and
3. Used to conduct tests

D. Types of Records

1. Stock keeping records

2. Transaction records
3. Consumption records

E. Stock Keeping Record:

1. There are three types of stock keeping records i.e. Bin Card, Inventory control
card/Stock control Card and Stores Ledger.
2. Logistics data that should be found on any well-designed stock keeping
record are: SOH and losses/Adjustments

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Figure 1: Sample Stock Keeping Record: Stock Control Card

MINISTRY OF HEALTH
LABORATORY COMMODITY STOCK CONTROL CARD
Name of facility: ……………………………….
District: ………………………….. MSL Code: …………..
Item Description: ……….……...………..…….. Unit: …………………..
(Must be in the specified
units)
Maximum Level: 3.0 Months Minimum Level (Emergency Order Point): 0.5 Months

Issued to OR Quantity Quantity Losses and

Received Received Issued Adjustments Name &
Date Ref. No. from (+) (-) (+/-) Balance Remarks Signature

*Physical count must be conducted at the end of each month

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F. Summary discussion points related to Stock keeping Records

Stock keeping records are generally of two kinds:

1. Bin cards or stock cards which generally have one per lot; and the cards are
kept with the products on the storeroom shelves/pallets, and
2. Inventory control cards, which generally have one per commodity, are
sometimes kept in ledger or book form, and may be kept in the product
manager’s office

Stock keeping records must contain at least the following data.

1. the balance of stock on hand at any time

2. losses and adjustments
3. quantity on order
4. quantity to order

G. Transaction Records:

1. The types of transaction records include: the requisition and issue vouchers,
issue vouchers, packing slips, delivery notes.
2. The type of data that is collected on transaction records include: quantity of
product being ordered/shipped/received; authorization to issue, etc.;
other signatures, proof of receipt, dates

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 3. Figure 2: Sample Transaction Record: Internal Requisition Form

No. 12345

MINISTRY OF HEALTH

LABORATORY INTERNAL REQUISITION FORM

Name of facility: ………………………………… District: ...……………………...…………

From: …………………...……..………………… To: .………………………………………

Date: …………………….………………………….

Commodity Quantity Quantity Quantity

Description Unit Size Requested Issued Received Remarks

Requested by: Date:

Authorized by: Date:
Issued by: Date:
Received by: Date:

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 H. Consumption Records:

1. The type of data that is collected on the Consumption record include:

product used or dispensed to the end user or used at the SDP when
service is provided.
2. The types of consumption records include: Daily Activity Register or log,
tick sheets, test register

ADDITIONAL INFORMATION

Reports and Records Used in Managing Laboratory Commodities

A detailed description of each type of form, its purpose, and its related activity are
listed in the table below. Copies of these forms can be found in the Annex of the
SOP Manual.

Form Name Purpose Activity

Laboratory  To account for the quantity  Issuing

Commodity of laboratory commodities  Storing
Stock Control in a storeroom, including  Receiving
Card transactions such as  Reporting
issuing, receiving, noting  Physical Inventory
losses/adjustments and
physical count
Laboratory  To track the quantity of  Issuing
Internal commodities issued from  Receiving
Requisition Form store room to laboratory  Reporting
departments, in the case of
large hospitals (Level 2
and 3)
Usage Report for  To report essential logistics  Reporting
Laboratory data to the MOH LMU
Commodities

MSL Despatch  To record the quantities  Receiving

Note issued by MSL and  Issuing
delivered to the districts and
health facilities
 To capture any
discrepancies between the
amount issued and
received

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Computer-  To record the order  Receiving
generated Report quantities of each  Issuing to Health Centres from
and Requisition laboratory commodity as the district
for Laboratory calculated by the computer
at the LMU for each facility
Supplies

Report for  To track the quantities of  Issuing

Returning expired, damaged or  Receiving
Products surplus products returned to
the district, then MSL, from
health centres, or returned
directly to MSL from level 1,
2 and 3 hospitals
MSL Returns  To report on unusable  Reporting
Authorisation commodities and request
Form authorization to return
commodities to MSL (using
the Report for Returning
Products)

Other Types of Reports

Report Name Purpose Primary User

Computer-generated Bolded entries indicate errors in MOH LMU staff

Report and Requisition the facility Usage Report for
for Laboratory Laboratory Commodities that has Provincial Chief
Commodities, bolded been corrected in the Supply Chain Biomedical Scientist;
entries Manager software at MOH LMU. District Chief
Biomedical Scientist,
health facility staff

Non-Reporting List of health facilities that have not MOH LMU staff
Facilities submitted a Usage Report for
Laboratory Commodities for the Provincial Chief
most recent reporting period. Biomedical Scientist;
District Chief
Biomedical Scientist,
and NGO managers

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Report Name Purpose Primary User

Discrepancy between Discrepancies between the MOH LMU staff

Quantity Supplied and quantities of product issued by
Quantity Received MSL and the quantities received at Provincial Chief
health facilities. Biomedical Scientist;
District Chief
Biomedical Scientist,
health facility staff

Stock Imbalance Report Stock outs, below the emergency MOH LMU staff
order point and/or overstocked by
facility and by product. Provincial Chief
Biomedical Scientist;
District Chief
Biomedical Scientist,
and NGO managers

Adjustment Summary Computer-generated or user- MOH LMU staff

By Facility reported adjustments of products
at individual health facilities. Provincial Chief
Biomedical Scientist;
District Chief
Biomedical Scientist,
health facility staff

Facilities Stocked Percentage of health facilities that MOH LMU staff

According to Plan are stocked between the
established maximum stock level Provincial Chief
and emergency order point. Biomedical Scientist;
District Chief
Biomedical Scientist,
and NGO managers

Facilities Stocked Out The number and percentage of MOH LMU staff
health facilities that have
experienced a stock out (by Provincial Chief
product). Biomedical Scientist;
District Chief
Biomedical Scientist,
and NGO managers

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Report Name Purpose Primary User

Summary Consumption Comparison of the absolute and MOH LMU staff

Comparison By percentage consumption by
Product product by level (Health Facility, Provincial Chief
District or Province) Biomedical Scientist;
District Chief
Biomedical Scientist,
and NGO managers

Dispensed to User To monitor monthly consumption of MOH LMU staff

Graph products over time, by product, by
facility or by level. Provincial Chief
Biomedical Scientist;
District Chief
Biomedical Scientist,
and NGO managers

Stocked According to To monitor the number of health MOH LMU staff

Plan Graph facilities stocked according to plan,
i.e., between their minimum and Provincial Chief
maximum stock levels over time. Biomedical Scientist;
District Chief
Biomedical Scientist,
and NGO managers

Overstock Graph To monitor the number of health MOH LMU staff

facilities with Physical Count of
more than one month above the Provincial Chief
maximum stock level, by product or Biomedical Scientist;
by facility, over time. District Chief
Biomedical Scientist,
and NGO managers

Stock out Graph To monitor the number of health MOH LMU staff
facilities stocked out, (by product,
by product type or for indicator Provincial Chief
products) over time. Biomedical Scientist;
District Chief
Biomedical Scientist,
and NGO managers

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Summary Logistics Records and Reports: Types and Data

1. Stock-keeping Records
Types of Stock-keeping Records: Stock-keeping Data:

 Bin Cards  Stock on Hand

 Inventory Control Cards  Losses and Adjustments

 Stores Ledgers  Quantity to Order

 Quantity on Order

2. Transaction Records
Types of Transaction Records: Transaction Data:

 Requisition and Issue Vouchers  Quantity of product being

ordered/shipped/received
 Issue Vouchers  Authorization, usually by signature, to issue

 Packing Slips  Proof of receipt, usually by signature

 Dates for all parts of the transaction

3. Consumption Records
Types of Consumption Records: Consumption Data:

 Daily activity registers  Quantity dispensed to user

 Tick sheets  Time period

Summary Reports 4.ESSENTIAL DATA ITEMS

For a specified time period:
 Stock on hand
 Quantity dispensed to user
 Losses and adjustments
 Stock on Hand
 Consumption
 Losses and Adjustments
Note: Each brand and formulation of
each product must be reported
separately.

34
Evaluation
1. List three main activities that happen to a Laboratory commodity.
2. What is the difference between LMIS and HMIS?
3. How many LMIS form are there in the National ART Laboratory Commodities
Logistics system?
4. What transactions are recorded on a store keeping record?
5. What would be an example of a Transaction record?

References

 USAID | DELIVER PROJECT. 2011. The Logistics Handbook: A Practical Guide

for Supply Chain management of Health Commodities. Arlington, Va.: USAID |
DELIVER PROJECT. Chapter 2

 Republic of Zambia, Ministry of Health, Standard Operating Procedures Manual

for Management of the National ART Laboratory Commodity Logistics System,
September, 2009. Chapter 3

35
6.5. Inventory Control System or Management

TIME: 3 hours + 1 hour field visit

Session Aim

To provide the students with knowledge and skills on the proper storage for health
commodities.

Session Objectives:

By the end of this session the students should be able to:

1. Describe the purpose of an inventory control system

2. Assess stock status and determine what actions should be taken based on the
outcome.
3. Place emergency orders, when required.
4. Receive laboratory supplies, including HIV tests, including completing, reviewing, and
signing the appropriate forms.
5. Store laboratory supplies, including HIV tests according to proper guidelines.
6. Describe the process for returning unusable products, including completing the
proper forms
7. Explain the procedures related to disposal of expired and damaged products

Session Content

6.5.1 Purpose of inventory control System

6.5.2. Concept of Assessing Stock Status

6.5.3. Calculating months of stock

6.5.4 What decisions to make
6.5.5. Placing emergency orders

Key points of the session:

A. The Laboratory Inventory Control System

 The purpose of an inventory control system is to inform personnel when and

how much of a commodity to order and to maintain an appropriate stock level to
meet the needs of patients. A well designed and well operated inventory control
system helps prevent shortages, oversupply, and expiry of products

B. Determining Months of Stock

 By calculating the months of stock, a facility can determine if the quantities of

laboratory commodities in stock are adequate. To determine how long stock will
last, the following simple formula can be used:

36
 Months of Stock
Stock on Hand
= on Hand

Average Monthly Consumption

 Before calculating Months of Stock on Hand, you need to know two pieces of
information: Stock on Hand and Average Monthly Consumption. To detemine
Average Monthly Consumption (AMC), add the last three months’ consumption of
a particular product, then divide by three.

Use the following formula to determine AMC:

Current month + previous two months’

consumption = Average Monthly
3 Consumption

Note: When calculating Average Monthly Consumption, always round up to the

nearest whole number!!!

ADDITIONAL INFORMATION

To help facilities maintain adequate stocks, the maximum months of stock and an
emergency order point have been established.

 The maximum months of stock is the maximum number of months of stock of

a product a facility should have in stock at any one time. If a facility has more than
the maximum number of months of stock of a product, it is overstocked and risks
having stocks expire before they can be used.

 The emergency order point is the number of months of stock of a product at

which the risk of stocking out is likely, and an emergency order should be placed
immediately.

37
The maximum months of stock and emergency order point for the different levels of
the National ART Laboratory Commodity Logistics System are shown in the following
table:

Maximum Emergency
Level
Months of Stock Order Point
Hospitals
2 weeks
(Level 1, Level 2 3 months
(= 0.5 months)
and 3)
2 weeks
Health Centres 3 months
(= 0.5 months)

A. Deciding What Actions to Take after Stock Status Has Been Determined
Months of
Interpretation Decisions
Stock
A. At or above Stock status is adequate. No action required unless it is the
2 months and at end of the month and time to
or below 3 complete the Usage Report for
months Laboratory Commodities.
B. Greater than The facility is overstocked Discuss the stock status of the
3 months with this product. product with your specified contact.

If a hospital or health centre is

significantly overstocked, the MOH
LMU will notify the hospital or the
DCBS of any quantities of surplus
stock to be returned to MSL for
redistribution.
C. Below 2 The facility is Continue to monitor stock levels until
months and understocked with that the next delivery arrives, or until they
above product, but stock levels reach the emergency order point.
2 weeks (0.5 have not yet reached the
months) emergency order point.

38
D. At or below The facility is Discuss the stock status of the
2 weeks (0.5 understocked with this product with your specified contact.
months) product. The stock level is An emergency order should be
at or below the emergency placed!
order point of 2 weeks (0.5
months). Note: In order to assist staff in
identifying products that are at or
below the emergency order point,
the “New EOP” expressed in
quantity of products will be listed
on the monthly Computer-generated
Report and Requisition for
Laboratory Commodities that the
facility receives from MSL.

Evaluation:
1. What are the maximum and minimum stock level levels in the National ART
Laboratory commodity logistics System in Zambia?
2. What type of max/Min Inventory control system?
3. What is safety stock and how is it calculated?
4. How do you determine months of stock on hand in this system?
5. Are emergence orders allowed in this system?

References:
 Republic of Zambia, Ministry of Health, Standard Operating Procedures Manual for
Management of the National ART Laboratory Commodity Logistics System,
September, 2009. Chapter

 USAID | DELIVER PROJECT. 2011. The Logistics Handbook: A Practical Guide for
Supply Chain Management of Health Commodities. Arlington, Va.: USAID | DELIVER
PROJECT. Chapter 4

39
6.6. Recording Usage of Laboratory Commodities

Time allocation: 170 Minutes

Session aim:
To equip the students with knowledge and skills to correctly and accurately record
the usage of laboratory commodities.

Session Objectives:
By the end of the session students will be able to:
1. Use a Job Aid to complete the Laboratory Commodity Stock Control Card
2. Open a Laboratory Commodity Stock Control Card
3. Update a Laboratory Commodity Stock Control Card
4. Describe the purpose of a physical count

Session Content
6.6.1. Introduction to the stock Control Card
6.6.2. Unit of Recording in the Stock Control Card
6.6.3. Recording Transactions in the Stock Control card
6.6.4. Conducting a physical count
6.6.5. Practice using the Stock Control Card

Key points of the session:

A. Introduction to Stock Control Card.

 A new Laboratory Commodity Stock Control Card should be started for each
laboratory commodity. At the end of the month, the data on the Laboratory
Commodity Stock Control Card will be aggregated to complete the Usage Report
for Laboratory Commodities

 Stock control card is used to track supplies received, issued and held in
storage; Importantly, in this system we will be using the ―issues‖ information from
the stock card as consumption)

 Receipts from MSL, issues to the bench, losses and adjustments, the results
of a physical count, information about adjustments in stocks – like loans or
returns) are transactions that are recorded on a stock control card.

 The stick control card is generally kept in the store room where commodities
are.

B. Unit of Recording in the Stock Control Card

 Use the annex of the SOP, where a list of 185 commodities is located
40
C. Recording Transactions in the Stock Control card

 Use your SOP and refer to a Job Aid: Recording Transactions in the Stock
Control card

D. Using Stock Control Card Demonstration and practice

Instructions: Use the following information and the blank Laboratory Commodity
Stock Control Card to complete this demonstration in class.

1. Example information for starting a New Laboratory Commodity Stock

Control Card.
Today is January 3, 2010 and you are opening new Laboratory Commodity Stock
Control Card at Ndola Central Hospital, in Ndola District, Copperbelt Province.

You are opening a Laboratory Commodity Stock Control Card for Commercial
Reagent Kit (syphilis RPR). The MSL # is LAB0127. The product unit should be
gotten from the list of 185 commodities.

2. Information for Demonstration

3 January 2010 Balance brought forward (from previous stock

control card) per physical count is 2 kits of 100 tests
each

6 January 2010 1 kit of 500 tests, and 4 kits of 100 tests were
received from MSL with MSL Issue Voucher number
797

10 January 2010 4 kits of 100 tests were issued to Main Laboratory

27 January 2010 2 kits of 100 tests were loaned to St. Anne’s

Hospital Laboratory using Issue Voucher

31 January 2010 Physical count, 1 kit of 500 tests counted

41
 MINISTRY OF HEALTH

LABORATORY COMMODITY STOCK CONTROL CARD

Name of facility: ……………………………….

District: ………………………….. MSL Code: …………..

Item Description: ……….……...………..…….. Unit: …………………..

Maximum Level: 3.0 Months Minimum Level (Emergency Order Point): 0.5 Months

Quantity Quantity Losses and

Issued to OR Received Issued Adjustments
Received Name &
Date Ref. No. from (+) (-) (+/-) Balance Remarks Signature

*Physical count must be conducted at the end of each month

42
E. Stock Control Card – Practice Exercise

Instructions: You are Mary Tembo, a storekeeper in the Kitwe Central Hospital
Laboratory (Kitwe District, Copperbelt Province). You use the following information
to update the Stock Control Cards on the following pages.

1. Tritest with Trucount Tubes CD4/CD8/CD45 Reagent Kit (MSL Code:

LAB0017)

1 Januar10 Mary opens a new stock control card, bringing a

balance forward of 4 kits of 50 tests
6 Januar10 Mary receives a shipment from MSL of 3 kits of 50
tests (the Reference Number is: 798)
10 Januar10 Mary Issues 2 kits of 50 tests to the main laboratory
27 Januar10 Mary Loans 1 kit of 50 tests to St. Anne’s Hospital
31 Januar10 When conducting a physical count, Mary finds 4 kits
of 50 tests but 1 of those kits is discovered to be
damaged.

2. Applicator Sticks, Orange (MSL Code: LAB0200)

1 January10 Mary opens a new stock control card, bringing a

balance forward of 700 applicator sticks.
4 January10 Mary Issues 200 sticks to the main laboratory
6 January10 Mary receives a shipment from MSL of 200 applicator
sticks (the Reference Number is: 799)
27 January10 Mary receives a loan that is returned from St. Anne’s
Hospital (of 50 applicator sticks)
31 January10 During a physical Count, Mary counts 750 applicator
sticks in the storeroom.

3. Plastic Transfer Pasteur Pipette, 3 ml (MSL Code: LAB0079)

1 January10 Mary opens a new stock control card, bringing a

balance forward of 5000 pipettes.
6 January10 Mary receives a shipment from MSL of 3500 pipettes
(the Reference Number is: 800)
10 January10 Mary Issues 3000 pipettes to the main laboratory
27 January 10 Mary Loans 2000 pipettes to St. Anne’s Hospital
31 January 10 During a physical count, Mary finds that 1000 pipettes
were missing, since she only counted 2500 pipettes
during a physical count.

43
 MINISTRY OF HEALTH
LABORATORY COMMODITY STOCK CONTROL CARD

Name of facility: ……………………………….

District: ………………………….. MSL Code: …………..

Item Description: ……….……...………..…….. Unit: …………………..

(Must be in the specified
units)

Maximum Level: 3.0 Months Minimum Level (Emergency Order Point): 0.5 Months

Issued to OR Quantity Quantity Losses and

Received Received Issued Adjustments Name &
Date Ref. No. from (+) (-) (+/-) Balance Remarks Signature

*Physical count must be conducted at the end of each month

44
 MINISTRY OF HEALTH
LABORATORY COMMODITY STOCK CONTROL CARD

Name of facility: ……………………………….

District: ………………………….. MSL Code: …………..

Item Description: ……….……...………..…….. Unit: …………………..

(Must be in the specified
units)

Maximum Level: 3.0 Months Minimum Level (Emergency Order Point): 0.5 Months

Issued to OR Quantity Quantity Losses and

Received Received Issued Adjustments Name &
Date Ref. No. from (+) (-) (+/-) Balance Remarks Signature

*Physical count must be conducted at the end of each month

45
 MINISTRY OF HEALTH
LABORATORY COMMODITY STOCK CONTROL CARD

Name of facility: ……………………………….

District: ………………………….. MSL Code: …………..

Item Description: ……….……...………..…….. Unit: …………………..

(Must be in the specified
units)

Maximum Level: 3.0 Months Minimum Level (Emergency Order Point): 0.5 Months

Issued to OR Quantity Quantity Losses and

Received Received Issued Adjustments Name &
Date Ref. No. from (+) (-) (+/-) Balance Remarks Signature

*Physical count must be conducted at the end of each month

46
Evaluation:
1. What do you think the Stock Control Card is used for?
2. What kinds of transactions would be recorded?
3. Where are generally Stock Control Cards kept?
4. What is the unit of measure used in the Laboratory Commodity Logistics
System?
5. What colour is used to record physical count and why?

References

 USAID | DELIVER PROJECT. 2011. The Logistics Handbook: A Practical

Guide for Supply Chain management of Health Commodities. Arlington, Va.:
USAID | DELIVER PROJECT. Chapter 2

 Republic of Zambia, Ministry of Health, Standard Operating Procedures

Manual for Management of the National ART Laboratory Commodity Logistics
System, September, 2009. Chapter 3

47
6.7. Reporting Usage of Laboratory Commodities

Time Allocation: 220 minutes

Session Aim
To equip students with knowledge and skills report usage of laboratory commodities
correctly and accurately

Session Objectives:

By the end of this session, students will be able to:

1. Identify the role of the Health Facility in reporting usage of laboratory

commodities, and process of completing and submitting the Usage Report for
Laboratory Commodities.
2. Understand where the information comes from to complete this report.
3. Use the job aid to complete the Usage Report for Laboratory Commodities
4. Understand the role of the DHO in reviewing Health Centre Usage Reports
5. Identify the role of the MOH LMU in processing reports and orders

Session Content

6.7.1. Introduction to the usage report

6.7.2. Sections of the usage report
6.7.3. Where does the information come from to complete the Usage Report?
6.6.4. The Role of Health facilities in Reporting
6.7.5. Usage Report Practical exercise

Key points of the session:

A. Sections of the Usage Report

Section Information Collected Notes to discuss

1. Facility/Report Identifying information on the

Identifier facility, reporting period,
emergency order

2. Monthly Report Pre-printed commodity names Also note that there are blank
for Laboratory and units, beginning balance, lines at the end of this section
Commodities quantity received/issues, for any commodities that are
Losses and Adjustments, and among this list but are not pre-

48
 physical count (ending printed
balance)

3. Special Orders Commodity name, unit, date

of last receipt, amount
received, SOH, quantity
needed.

4. Explanation for Comments to describe loss These are required to justify

Losses/Adjustments and adjustment losses/adjustments in the
and Remarks system.

5. Monthly Test By test offered at a facility,

Numbers and collects the machine test
Equipment count (if applicable), total tests
Information per month, and information on
whether equipment is
functioning.

6. Signatures Signatures and dates of

completing and authorizing
officers.

B. The Role of Health Facilities in reporting

At the end of every month…

Health centres Report usage, losses and

adjustments, and physical count to the
district by the 4th day of the following
month.

Districts with health After receiving and reviewing the Districts submit the
centres Usage Report for Laboratory orders for their health
Commodities from health centres in centres to the MOH LMU
the district, if there are no errors or by the dates published in
discrepancies, the district faxes all the the MSL delivery
Usage Report for Laboratory schedule.
Commodities to MSL according to the
MSL delivery schedule.

49
Hospitals: Level 1, Report usage, losses and Hospitals submit their
Level 2 and 3 adjustments, and physical count to the orders to the MOH LMU
MOH LMU according to the MSL by the dates published in
delivery schedule; all orders will be the MSL delivery
calculated at the LMU schedule.

*If stock levels ever fall below 2 weeks (0.5 months of stock) before the end of the month,
an emergency order should be placed.

50
 C. Completing the Usage Report – Exercise

Note: The following Exercise may be used to assess the comprehension of the
Usage report by the students.

Instructions: Use the information provided in the attached LMIS forms (including
last month’s Usage Report), and the solid reagents and equipment notes below to
complete the Usage Report found at the end of this exercise.

Background Information: On 2 August 2010, after completing a physical count of

all of products in the store room (on 31 July), Mary Chizuka, a laboratory technician
at Lubuto Clinic (Ndola District, Copperbelt Province), sits down to complete her
monthly Usage Report for 1 – 31 July, 2010.

Mary collects all of the relevant Stock Control Cards the Usage Report from last
month to complete the report. Mary is eager to have the Usage Report completed,
so she has already entered information for the following products on the Usage
Report, including the Acetone, Microscope Cover Slips, Microscope Slide, vacutainer
4ml EDTA, and vacutainer Needles.

Note on Solid Reagents:

Mary also needs to determine whether to order Giemsa Stain and Crystal Violet
Powder for her laboratory. Since these were not pre-printed on her form, she looked
in the annex of the SOPs to find out whether they were included in the list of 185
laboratory commodities to be supplied by MSL. There was only Crystal Violet on the
list, but she had enough instructions from the training and her SOPs to be able to
report and order these products. Mary uses her Stock Control Card to complete the
Usage Report for these commodities. Based on her consumption of Giemsa Stain,
she estimated should would need an additional 25 g (1 bottle). Based on her
consumption of Crystal violet, she determined that she would need an addition 25 g
(1 bottle).

Note on Equipment at Lubuto Clinic:

In early July, the Humalyzer 2000 machine was repaired after not working for nearly
6 months. During this time, all of the commodities required to run the machine either
expired, or were redistributed to a nearby facility whose machine was working.
Therefore, Mary did not run any tests on the Humalyzer this month. Now that that the
machine is working, Mary would like to receive the reagents and other supplies
necessary to run tests.
Mary has just looked in her CD4 Count Log, and noticed that she has run 37 counts
in total during the month of July.

51
 MINISTRY OF HEALTH
LABORATORY COMMODITY STOCK CONTROL CARD

Name of facility: ……Lubuto Clinic……..….

District: …Ndola….…………….. MSL Code: LAB0018
Item Description: BDFACSCount CD4/CD8
Reagent Kit Unit: …Kit of 50 tests
(Must be in the specified
units)
Maximum Level: 3.0 Months Minimum Level (Emergency Order Point): 0.5 Months

Issued to OR Quantity Quantity Losses and

Received Received Issued Adjustments Name &
Date Ref. No. from (+) (-) (+/-) Balance Remarks Signature
Balance MC
Brought
1/6/10 Forward 3
MC
25/6/10 Bench 1 2
MC
31/6/10 Physical Count 2
MC
2/7/10 Bench 1 1
MC
21/7/10 MSL 1 2
MC
31/7/10 Physical Count 2

*Physical count must be conducted at the end of each month

52
 MINISTRY OF HEALTH
LABORATORY COMMODITY STOCK CONTROL CARD

Name of facility: ……Lubuto Clinic……..….

District: …Ndola….…………….. MSL Code: LAB022.
Item Description: ……Thermal Paper..…….. Unit: ……Roll……..
(Must be in the specified
units)
Maximum Level: 3.0 Months Minimum Level (Emergency Order Point): 0.5 Months

Issued to OR Quantity Quantity Losses and

Received Received Issued Adjustments Name &
Date Ref. No. from (+) (-) (+/-) Balance Remarks Signature
Balance MC
Brought
1/6/10 Forward 3
MC
30/6/10 Physical Count 3

*Physical count must be conducted at the end of each month

53
 MINISTRY OF HEALTH
LABORATORY COMMODITY STOCK CONTROL CARD

Name of facility: ……Lubuto Clinic……..….

District: …Ndola….…………….. MSL Code: LAB0019
Item Description: ……FACSFlow….. Unit: ……5L…..
(Must be in the specified
units)
Maximum Level: 3.0 Months Minimum Level (Emergency Order Point): 0.5 Months

Issued to OR Quantity Quantity Losses and

Received Received Issued Adjustments Name &
Date Ref. No. from (+) (-) (+/-) Balance Remarks Signature
Balance
Brought
1/6/10 Forward 4 MC
MC
7/6/10 Bench 1 3
MC
23/6/10 Bench 1 2
MC
30/6/10 Physical Count 2
MC
13/7/10 Bench 1 1
MC
21/7/10 MSL 2 3
MC
22/7/10 Bench 1 2
MC
31/7/10 Physical Count 2
*Physical count must be conducted at the end of each month

54
 MINISTRY OF HEALTH
LABORATORY COMMODITY STOCK CONTROL CARD

Name of facility: ……Lubuto Clinic……..….

District: …Ndola….…………….. MSL Code: LAB0020
Item Description: ……BDFACSClean..…….. Unit: …5L………..
(Must be in the specified
units)
Maximum Level: 3.0 Months Minimum Level (Emergency Order Point): 0.5 Months

Issued to OR Quantity Quantity Losses and

Received Received Issued Adjustments Name &
Date Ref. No. from (+) (-) (+/-) Balance Remarks Signature
Balance
Brought
1/6/10 Forward 3 MC

30/6/10 Physical Count 3 MC

7/7/10 Bench 1 2 MC

31/7/10 Physical Count 2 MC

*Physical count must be conducted at the end of each month

55
 MINISTRY OF HEALTH
LABORATORY COMMODITY STOCK CONTROL CARD

Name of facility: ……Lubuto Clinic……..….

District: …Ndola….…………….. MSL Code: LAB0018

Item Description: ……FACSControl Kit….. Unit: Kit of 25 Tests

(Must be in the specified
units)
Maximum Level: 3.0 Months Minimum Level (Emergency Order Point): 0.5 Months

Issued to OR Quantity Quantity Losses and

Received Received Issued Adjustments Name &
Date Ref. No. from (+) (-) (+/-) Balance Remarks Signature
Balance MC
Brought
1/6/10 Forward 2
MC
21/6/10 MSL 1 3
MC
30/6/10 Physical Count 3
MC
15/7/10 Bench 1 2
MC
21/7/10 MSL 1 3
MC
31/7/10 Physical Count 3

*Physical count must be conducted at the end of each month

56
 MINISTRY OF HEALTH
LABORATORY COMMODITY STOCK CONTROL CARD

Name of facility: ……Lubuto Clinic……..….

District: …Ndola….…… MSL Code: …LAB02
Item Description: ………FACSRinse….. Unit: ……5L……..
(Must be in the specified
units)
Maximum Level: 3.0 Months Minimum Level (Emergency Order Point): 0.5 Months

Issued to OR Quantity Quantity Losses and

Received Received Issued Adjustments Name &
Date Ref. No. from (+) (-) (+/-) Balance Remarks Signature
MC
1/6/10 BBF 4
Lent to MC
Chipokota
16/6/10 Mayamba HC -1 3
MC
21/6/10 Bench 1 2
MC
30/6/10 Physical Count 2
Returned from MC
Chpokota
4/7/10 Mayamba HC +1 3
MC
16/7/10 Bench 1 2
MC
21/7/10 MSL 1 3
MC
31/7/10 Physical Count 3

57
 MINISTRY OF HEALTH
LABORATORY COMMODITY STOCK CONTROL CARD

Name of facility: ……Lubuto Clinic…….

District: ………Ndola………….. MSL Code: …LAB0206.

Item Description: ………Microcapillary tubes, non-

heparinized..…….. Unit: …pack of 100 tubes….
(Must be in the specified units)
Maximum Level: 3.0 Months Minimum Level (Emergency Order Point): 0.5 Months

Quantity Quantity Losses and

Received Issued Adjustments
Issued to OR Name &
Date Ref. No. Received from (+) (-) (+/-) Balance Remarks Signature
1/6/10 Balance 5 MC
Brought
Forward
4/6/10 Bench 1 4 MC

20/6/10 Bench 1 3 MC

21/6/10 MSL 1 4 MC

30/6/10 Physical Count 4 MC

1/7/10 Bench 1 3 MC

21/7/10 MSL 2 5 MC

31/7/10 Physical Count 5 MC

*Physical count must be conducted at the end of each month

58
 MINISTRY OF HEALTH
LABORATORY COMMODITY STOCK CONTROL CARD
Name of facility: ………Lubuto Clinic….
District: …………Ndola…….. MSL Code: …LAB0259.
Item Description: …Microcapillary Tubes Heparinized..…….. Unit: pack of 100 tubes
(Must be in the specified units)
Maximum Level: 3.0 Months Minimum Level (Emergency Order Point): 0.5 Months

Quantity Quantity Losses and

Issued to OR Received Issued Adjustments Name &
Date Ref. No. Received from (+) (-) (+/-) Balance Remarks Signature
1/5/10 BBF 3 MC
16/5/10 Bench 1 2 MC
21/5/10 MSL 1 3 MC
30/5/10 Physical Count 3 MC
12/6/10 Bench 1 2 MC
20/6/10 Bench 1 1 MC
21/6/10 MSL 1 2 MC
31/6/10 Physical Count -1 1 1 pack missing during MC
physical count
7/7/10 Bench 1 0 Below EOP, shipment within MC
2 weeks
21/7/10 MSL 4 4 MC
31/7/10 Physical Count -2 2 2 packs missing during MC
physical count
*Physical count must be conducted at the end of each month
59
 MINISTRY OF HEALTH
LABORATORY COMMODITY STOCK CONTROL CARD

Name of facility: Lubuto Clinic

District: …Ndola….… MSL Code: …LAB0143
Item Description: Giemsa Unit: ……g…………..
(Must be in the specified units)
Maximum Level: 3.0 Months Minimum Level (Emergency Order Point): 0.5 Months

Issued to
OR Quantity Quantity Losses and
Received Received Issued Adjustments Name &
Date Ref. No. from (+) (-) (+/-) Balance Remarks Signature
MC
1/7/10 Balance Brought Forward 50
MC
15/7/10 Bench 25 25
MC
21/7/10 MSL 50 75
MC
23/7/10 Bench 25 50
Physical MC
31/7/10 Count 50
*Physical count must be conducted at the end of each month

60
 MINISTRY OF HEALTH
LABORATORY COMMODITY STOCK CONTROL CARD

Name of facility: ……Lubutu Clinic………. District: ……Ndola………….. MSL Code: LAB0132

Item Description: ……Crystal Violet Stain Powder. Unit: ……g………..
(Must be in the specified units)
Maximum Level: 3.0 Months Minimum Level (Emergency Order Point): 0.5 Months

Quantity Quantity Losses and

Issued to OR Received Issued Adjustments Name &
Date Ref. No. Received from (+) (-) (+/-) Balance Remarks Signature
1/6/10 Balance 75g MC
Brought
Forward
15/6/10 MSL 25g 100g MC

25/6/10 Bench 25g 75g MC

31/6/10 Physical Count 75g MC

21/7/10 MSL 25g 100g MC

22/7/10 Bench 25g 75g MC

31/7/10 Physical Count -25g 50g Dropped 25g MC

bottle during
physical count
*Physical count must be conducted at the end of each month

61
 MINISTRY OF HEALTH
Emergency Order
USAGE REPORT FOR LABORATORY COMMODITIES
HEALTH CENTRE-LEVEL
Reporting Period: From __01/06/10_ to __30/06/10__ Province:_____Copperbelt____
Max Stock 3.0 Months
Level:
dd/mm/yyyy dd/mm/yyyy

Facility: _____Lubuto Health Clinic________ District:________Ndola______ Emergency 0.5 Months

Order Point:
Part I: Monthly Report for Laboratory commodities:
Laboratory Commodity Unit Beginning Total Quantity Total Quantity Losses and Physical Count
Balance Received During Used/Issued for Adjustments
the Month the Month
BD FACSCount
BD FACS CD4/ CD8 Reagent Kit Kit of 50 tests 3 1 2 0 2
BD FACS Controls Kit of 25 Tests 2 1 0 0 3
BD FACS Rinse 5L 3 1 2 0 2
BD FACS Clean 5L 3 1 1 0 3
BD FACS Flow 20 L 2 1 1 0 2
BD FACSCount Thermal Paper Roll 3 1 1 0 3
ABX Micros 60
ABX Miniclean 1L N/A N/A N/A N/A N/A
ABX Minilyse 1L N/A N/A N/A N/A N/A
ABX Minoton LMG 20 L N/A N/A N/A N/A N/A
Humalyzer 2000
Human ALT(GPT) Liquicolor UV 10 X 10ml 10 x 10 ml 0 0 0 0 0
Human AST(GOT) Liquicolor UV 10 X 10ml 10 x 10 ml 0 0 0 0 0
Human Creatinine Liquicolor 200 ml 0 0 0 0 0
Human Glucose Liquicolor 1L 0 0 0 0 0
Facility Name: ______ Lubuto Health Clinic ____________
62
Human Urea Liquicolor 2x 100 ml 0 0 0 0 0

Human Bilirubin Direct 100 ml 0 0 0 0 0

Human Bilirubin Total 100 ml 0 0 0 0 0
Humatrol Normal (N19) 6 x 5 ml 0 0 0 0 0
Humatrol Pathological (P17) 6 x 5 ml 0 0 0 0 0
Humalyzer 2000 Thermal Printing Paper Roll 0 0 0 0 0
Humalyzer 2000 Cuvettes Pcs. 0 0 0 0 0
General Reagents
Acetone 2L N/A N/A N/A N/A N/A
Commercial Reagent Kit (Syphilis RPR) Tests N/A N/A N/A N/A N/A
General Consumables
Microcapillary Tubes, Non-heparinized Pack of 100 4 1 1 0 4
Microcapillary Tubes, Heparinized Pack of 100 1 2 2 0 1
Microscope Cover Slips Pack of 100 3 1 1 0 3
slips
Microscope Slide, Frosted End Slides 200 100 200 0 100
Vacutainer, 4 ml, EDTA Tube 300 0 100 0 200
Vacutainer Needles, 21G X 1 Each 400 100 100 0 400

Note: Indicate Not Applicable (N/A) for those commodities that you are NOT using at your facility

Explanation for
Losses/Adjustments:

Remarks:

Facility Name: ______ Lubuto Health Clinic ____________

63
Part II: Special Orders
Laboratory Commodity Unit Date of Last Amount Received Usage Since Stock on Hand Quantity
Receipt Last Receipt Needed

Part III: Monthly Test and Equipment Information

MONTHLY TEST NUMBERS AND EQUIPMENT INFORMATION
Test Machine Test Total for Month Equipment
Count Functioning (Y/N)
BD FACSCount 53 Y
ABX Micros 60
Humalyzer ALT/GPT
Humalyzer AST/GOT
Humalyzer Creatinine
Humalyzer Glucose
Humalyzer Urea
Humalyzer Direct Bilirubin
Humalyzer Total Bilirubin

Completed By: Mary Chizuka Authorized By:

Signature: Mary Chizuka Signature:
Date: 2 July 2010 Date:
Phone No. 966162325 Phone No.

Facility Name: ______ Lubuto Health Clinic ____________

64
 MINISTRY OF HEALTH
USAGE REPORT FOR LABORATORY Emergency Order
COMMODITIES
HEALTH CENTRE-LEVEL
Reporting Period: From __________ to __________ Province:__________________
Max Stock Level: 3.0 Months
dd/mm/yyyy dd/mm/yyyy

Facility: ____________________________ District:___________________ Emergency Order 0.5 Months

Point:
Part I: Monthly Report for Laboratory commodities:
Laboratory Commodity Unit Beginning Total Quantity Total Quantity Losses and Physical
Balance Received During Used/Issued for Adjustments Count
the Month the Month
BD FACSCount
BD FACS CD4/ CD8 Reagent Kit Kit of 50 Tests
BD FACS Controls Kit of 25 Tests
BD FACS Rinse 5L
BD FACS Clean 5L
BD FACS Flow 20 L
BD FACSCount Thermal Paper Roll
ABX Micros 60
ABX Miniclean 1L
ABX Minilyse 1L
ABX Minoton LMG 20 L
Humalyzer 2000
Human ALT(GPT) Liquicolor UV 10 X 10ml 10 x 10 ml
Human AST(GOT) Liquicolor UV 10 X 10ml 10 x 10 ml
Human Creatinine Liquicolor 200 ml
Human Glucose Liquicolor 1L
Facility Name: ______________________________________

65
Human Urea Liquicolor 2x 100 ml

Human Bilirubin Direct 100 ml

Human Bilirubin Total 100 ml
Humatrol Normal (N19) 6 x 5 ml
Humatrol Pathological (P17) 6 x 5 ml
Humalyzer 2000 Thermal Printing Paper Roll
Humalyzer 2000 Cuvettes Each.
General Reagents
Acetone 2L
Commercial Reagent Kit (Syphilis RPR) Tests
General Consumables
Microcapillary Tubes, Non-heparinized Pack of 100
Tubes
Microcapillary Tubes, Heparinized Pack of 100
Tubes
Microscope Cover Slips Pack of 100 3 2 1 0 4
Slips
Microscope Slide, Frosted End Slide 100 50 50 0 100
Vacutainer, 4 ml, EDTA Tube 200 100 50 0 250
Vacutainer Needles, 21G X 1 Each 400 100 200 0 300

Note: Indicate Not Applicable (N/A) for those commodities that you are NOT using at your facility

Explanation for
Losses/Adjustments:

Remarks:

Facility Name: ______________________________________

66
Part II: Special Orders
Laboratory Commodity Unit Date of Last Amount Received Usage Since Stock on Hand Quantity
Receipt Last Receipt Needed

Part III: Monthly Test and Equipment Information

MONTHLY TEST NUMBERS AND EQUIPMENT INFORMATION
Test Machine Test Total for Month Equipment
Count Functioning (Y/N)
BD FACSCount
ABX Micros 60
Humalyzer ALT/GPT
Humalyzer AST/GOT
Humalyzer Creatinine
Humalyzer Glucose
Humalyzer Urea
Humalyzer Direct Bilirubin
Humalyzer Total Bilirubin

Completed By: Authorized By:

Signature: Signature:
Date: Date:
Phone No. Phone No.

Facility Name: ______________________________________

67
Evaluation
1. When are Health Centre Labs expected to send their reports to the District?
2. Where does the information to complete the Usage Report come from (which
form(s)?
3. Number of tests done can be obtained from two sources; what are they?
4. How are solid reagents different for the liquid reagents when reporting?

Reference:
 Republic of Zambia, Ministry of Health, Standard Operating Procedures
Manual for Management of the National ART Laboratory Commodity Logistics
System, September, 2009. Chapter 3

68
6.8. Completing HIV Test DAR

Total Time: 60 minutes

Session Objectives:
By the end of this session, participants will be able to:
1. Describe the recording forms in the system from which the essential data
items come
2. Explain the purpose and use of a Job Aid
3. Use a Job Aid appropriately
4. Describe the purpose and use of the Daily Activity Register (DAR)
5. Complete a DAR in an exercise

Session Content
6.8.1 Recording HIV Test used and process of testing clients
6.8.2 Follow the Job Aid to complete the DAR

69
6.8.1 Completing the Daily Activity Register (DAR) using the Job Aid- Exercise

You are the Medical Laboratory Technologist authorized to perform HIV testing at
the Main Laboratory of Lubuto Health Centre in Ndola District, Copperbelt Province.
It is 5 June, 2010. Complete the Daily Activity Register for HIV Tests with the
following information (a blank DAR is on the next page).

1. On the morning of 5 June, 2010, the beginning balances of each test are:
Determine: 15 tests, Unigold: 5 tests, SD Bioline: 8 tests

2. You request and receive 100 Determine tests and 20 Unigold tests from the main
store room.

3. Following appropriate quality control procedures, you run a known positive sample
using Determine and Unigold. Then, you run a known negative sample on Determine
and Unigold.

4. A sample for patient # 144 arrives at the laboratory in the morning with a request
for clinical diagnosis for HIV. The sample is screened for HIV using a Determine
rapid test. The result is positive, so it is retested to confirm using Unigold. The
second test is also positive.

5. Shortly afterwards, patient # 156 arrives at the clinic looking severely wasted and
has a history of recurrent diarrhoea. The doctor sends a blood sample to the
laboratory to test for HIV. The sample is screened using Determine. The result is
positive so a confirmatory test is done using Unigold. This result is negative. A tie-
breaker test is conducted using SD Bioline and the sample is negative.

6. A patient arrives at the clinic and is assigned # 308. The doctor requests a test for
HIV and sends a sample to the main laboratory. The sample is first tested using
Determine, but the results are invalid. The sample is retested using Determine again
and the result is negative.

7. Another patient, # 122, comes to the clinic for prenatal care. The PMTCT doctor
sends her sample to the main laboratory for an HIV test. The sample is tested using
Determine and her test results are negative.

8. In the afternoon, a new laboratory technician begins working at the main

laboratory and is trained how to conduct HIV testing by using a known positive
sample on Determine, Unigold and SD Bioline. This is repeated using a known
negative sample on Determine, Unigold and SD Bioline.

9. Patient # 139 has come to the clinic in the afternoon and the doctor determines
that he should be tested for HIV. The sample is sent to the laboratory and tested
using Determine and the results were positive. The sample is tested using Unigold
and the test results are also positive.

10. It is now the close of business. Complete the DAR for the day, including the
Summary of HIV Tests Used by Purpose. Your Physical Count for each product is:
Determine: 105 tests, Unigold: 18 tests, SD Bioline: 5 tests

70
 Daily Activity Register for HIV Tests
Date: _______________________________
day/month/year

Type of Test
Confirmator
Screening Tiebreaker
y
Determine Unigold SD Bioline
Beginning Balance
Final Test Results
Quantity Received
Indeter-
Client No. Purpose* Result Result Result Positive Negative
minate

Quantity Used Page

Total
Daily Total TOTAL Final Test Results
Losses/Adjustments Page
Total
Daily Total
Physical Count

Remarks:

* Purpose of the Test: VCT, PMTCT, Clinical Diagnosis (CD), Quality Control (QC), Other (explain)

Summary of HIV Tests Used by Purpose

Type of Test Product Clinical Quality
VCT PMTCT Other TOTAL
Diagnosis Control
Screening Determine
Confirmatory Unigold
Tiebreaker SD Bioline
TOTAL

71
Evaluation
.

1. How many pages of the DAR would be needed if you tested 16 clients in a
day? If you tested 30? If you tested 2?
2. Which of these abbreviations is likely to be used the least on the DAR: R,
NR, or I? Why?
3. If you start a brand new ledger of the DAR, where does the beginning balance
come from?
4. How many purposes can participants think of to write in the Purpose Column?
What would be examples of "Other" purposes?
5. What are examples of losses and adjustments?
6. Why would you ever write a ―0‖ on the DAR?
7. Would you ever write a line completely down a column or across a row to
show that there was no activity there?
8. Who uses the DAR? What is done with the information on it?

Reference:
 Republic of Zambia, Ministry of Health, Standard Operating Procedures Manual for
Management of the National ART Laboratory Commodity Logistics System,
September, 2009. Chapter 4

72
6.9. Completing the Internal Monthly Summary Report (IMSR)

Total Time: 60 minutes

Session Objectives:

By the end of this session, participants will be able to:

6. Explain the purpose of the IMSR in the HIV Test Logistics System and
where the information to complete it comes from.
7. Use the IMSR correctly.

Session Content
6.9.1. Purpose of the IMSR in the HIV Test Logistics System

The following question can be can be used after students have read the Job Aids.

1. What are the three main parts of the IMSR?

2. Where does the data for the top part of the IMSR come from?
3. How often is the IMSR completed?
4. Where does one get the data needed to complete Losses and Adjustments?
5. If a hospital has two testing sites, how many IMSRs should be done each
month?
6. In most cases, will the number for Indeterminate be larger than Positive or
Negative results?
7. What are four possible purposes for using HIV Tests?
8. If you did not use any tests for Quality Control, for example, what should you
record in that column?
9. Where should one document a discrepancy between the physical count and
the calculated closing balance?
10. Who signs the IMSR when it is completed?

73
6.9.2 Completing the IMSR – Homework Exercise

Complete the attached Internal Monthly Summary Report for HIV Tests

Instructions: You are the Head of the VCT Unit at Lubuto Health Centre in Ndola
District. It is 2 February, 2010 and you must submit your January Internal Monthly
Summary Report for HIV Tests to the Laboratory in Charge at the facility. Complete
the Internal Monthly Summary Report for HIV Tests (next page) using the Daily
Activity Register for HIV Tests found on the pages that follows.

74
 INTERNAL MONTHLY SUMMARY REPORT FOR HIV TESTS

Reporting Period: From __________________ to __________________

dd/mm/yyyy dd/mm/yyyy

Facility: ____________________________ Testing Site: _______________________

Summary of HIV Test Stock Balance

Type of Test Product Beginning Quantity Quantity Losses and
Physical Count
Balance Received Used Adjustments
Screening Determi
Confirmatoy ne
Unigold
SD
Tiebreaker
Bioline

Remarks:

Summary of HIV Tests Used by Purpose

Type of Test Product Clinical Quality
VCT PMTCT Other TOTAL
Diagnosis Control
Determi
Screening
ne
Confirmatoy Unigold
SD
Tiebreaker
Bioline
TOTAL

Summary of Final Test Results

Positive Negative Indeterminate

Final Test Result

Completed by: _____________________________

Signed : _____________________________

Date: _____________________________

75
 Daily Activity Register for HIV Tests
Date: ________7/January/2010_______________________
day/month/year

Type of Test
Screening Confirmatory Tiebreaker
Determine Unigold SD Bioline
Beginning Balance 130 30 4
Final Test Results
Quantity Received
Indeter-
Client No. Purpose* Result Result Result Positive Negative
minate
QC R R
503 VCT R R POS
122 VCT NR NEG
399 VCT R NR NR NEG
964 VCT NR NEG
548 VCT R R POS
639 VCT NR NEG
45 VCT NR NEG
106 VCT R NR R POS
450 VCT NR NEG

Quantity Used Page

10 5 2 3 6
Total
Daily Total 10 5 2 TOTAL Final Test Results
Losses/Adjustments Page 0 0 0
Total
Daily Total 0 0 0
Physical Count 120 25 2
Remarks:

* Purpose of the Test: VCT, PMTCT, Clinical Diagnosis (CD), Quality Control (QC), Other (explain)

Summary of HIV Tests Used by Purpose

Type of Test Product Clinical Quality
VCT PMTCT Other TOTAL
Diagnosis Control
Screening Determine 9 0 0 1 0 10
Confirmatory Unigold 4 0 0 1 0 5
Tiebreaker SD Bioline 2 0 0 0 0 2
TOTAL 15 0 0 2 0 17

76
 Daily Activity Register for HIV Tests

Date: __________10/January/2010____________________
day/month/year

Type of Test
Screening Confirmatory Tiebreaker
Determine Unigold SD Bioline
Beginning Balance 120 25 2
Final Test Results
Quantity Received
Indeter-
Client No. Purpose* Result Result Result Positive Negative
minate
876 VCT R R POS
453 VCT NR NEG
834 VCT R NR NR NEG
922 VCT NR NEG
230 VCT R NR R POS
734 VCT NR P NEG
76 VCT R NR I
490 VCT Invalid
490 VCT R R POS
33 VCT NR NEG
87 VCT NR NEG
507 VCT R NR I

Quantity Used Page Total 12 6 2 3 6 2

Daily Total 12 6 2 TOTAL Final Test Results
Losses/Adjustments Page Total 0 0 0
Daily Total 0 0 0
Physical Count 108 19 0
Remarks: Was unable to read the result from first test for patient 490, so reran the
same test.

* Purpose of the Test: VCT, PMTCT, Clinical Diagnosis (CD), Quality Control (QC), Other (explain)

Summary of HIV Tests Used by Purpose

Type of Test Product Clinical Quality
VCT PMTCT Other TOTAL
Diagnosis Control
Screening Determine 12 0 0 0 0 19
Confirmatory Unigold 6 0 0 0 0 6
Tiebreaker SD Bioline 2 0 0 0 0 2
TOTAL 20 0 0 0 0 20

77
 Daily Activity Register for HIV Tests
Date: _________15/January/2010______________________
day/month/year

Type of Test
Screening Confirmatory Tiebreaker
Determine Unigold SD Bioline
Beginning Balance 108 19 0
Final Test Results
Quantity Received 20
Indeter-
Client No. Purpose* Result Result Result Positive Negative
minate
93 VCT NR NEG
100 VCT R NR NR NEG
82 VCT NR NEG
704 VCT R R POS
23 VCT R R POS
90 VCT NR NEG
110 VCT NR NEG
701 VCT R NR R POS
500 VCT NR NEG

Quantity Used Page Total 9 4 2 3 6

Daily Total 9 4 2 TOTAL Final Test Results
Losses/Adjustments Page Total 0 0 0
Daily Total 0 0 0
Physical Count 99 15 18
Remarks:

* Purpose of the Test: VCT, PMTCT, Clinical Diagnosis (CD), Quality Control (QC), Other (explain)

Summary of HIV Tests Used by Purpose

Type of Test Product Clinical Quality
VCT PMTCT Other TOTAL
Diagnosis Control
Screening Determine 9 0 0 0 0 9
Confirmatory Unigold 4 0 0 0 0 4
Tiebreaker SD Bioline 2 0 0 0 0 2
TOTAL 15 0 0 0 0 15

78
 Daily Activity Register for HIV Tests
Date: _________20/January/2010______________________
day/month/year

Type of Test
Screening Confirmatory Tiebreaker
Determine Unigold SD Bioline
Beginning Balance 99 15 18
Final Test Results
Quantity Received
Indeter-
Client No. Purpose* Result Result Result Positive Negative
minate
444 VCT NR NEG
640 VCT R R POS
920 VCT NR NEG
325 VCT NR NEG
892 VCT R NR NR NEG
23 VCT R N
R POS
22 VCT NR NEG
784 VCT NR NEG
99 VCT R R POS
290 VCT R R POS
77 VCT NR NEG
83 VCT NR NEG

Quantity Used Page Total 12 5 1 4 8

Daily Total 12 5 1 TOTAL Final Test Results
Losses/Adjustments Page Total 0 0 0
Daily Total 0 0 0
Physical Count 87 10 17
Remarks:

* Purpose of the Test: VCT, PMTCT, Clinical Diagnosis (CD), Quality Control (QC), Other (explain)

Summary of HIV Tests Used by Purpose

Type of Test Product Clinical Quality
VCT PMTCT Other TOTAL
Diagnosis Control
Screening Determine 12 0 0 0 0 12
Confirmatory Unigold 5 0 0 0 0 5
Tiebreaker SD Bioline 1 0 0 0 0 1
TOTAL 18 0 0 0 0 18

79
 Daily Activity Register for HIV Tests
Date: __________28/January/2010_____________________
day/month/year

Type of Test
Screening Confirmatory Tiebreaker
Determine Unigold SD Bioline
Beginning Balance 87 10 17
Final Test Results
Quantity Received
Indeter-
Client No. Purpose* Result Result Result Positive Negative
minate
90 VCT NR NEG
333 VCT R R POS
523 VCT NR NEG
16 VCT NR NEG
620 VCT R R POS
95 VCT R NR R POS
20 VCT NR NEG
45 VCT NR NEG
482 VCT R R POS
67 VCT NR NEG
29 VCT R R POS

5
Quantity Used Page Total 11 1 5 6
Daily Total 11 5 1 TOTAL Final Test Results
Losses/Adjustments Page Total -2 0 0
Daily Total -2 0 0
Physical Count 74 5 16
Remarks: 2 Determine tests were damaged during the day.

* Purpose of the Test: VCT, PMTCT, Clinical Diagnosis (CD), Quality Control (QC), Other (explain)

Summary of HIV Tests Used by Purpose

Type of Test Product Clinical Quality
VCT PMTCT Other TOTAL
Diagnosis Control
Screening Determine 11 0 0 0 0 11
Confirmatory Unigold 5 0 0 0 0 5
Tiebreaker SD Bioline 1 0 0 0 0 1
TOTAL 17 0 0 0 0 17

80
Evaluation
.

1. When is the IMSR submitted to the person responsible for managing the HIV
Tests?
2. If the health facility has 4 testing sites, how IMSR for HIV tests should be
received by the person managing the HIV Test?
3. If the Health facility has one testing site does it complete the IMSR for HIV Tests?
4. Do you think IMSR for HIV Tests make it easy to complete the R&R for HIV
Tests?

Reference:
 Republic of Zambia, Ministry of Health, Standard Operating Procedures
Manual for Management of the National ART Laboratory Commodity Logistics
System, September, 2009. Chapter 6

81
 6.10. Completing the Report and Requisition for HIV Tests

Total Time: 60 minutes

Session Objectives:

By the end of this session, students will be able to:

1. Identify parts of the R&R for HIV Tests

2. List sources of data to complete the R&R for HIV Tests
3. Complete the Report and Requisition for HIV Tests

Session Content

6.10.1. Sections of the R&R for HIV Tests and Sources of Data to complete the R&R

6.10.2 R&R short quiz:

Here are the questions/statements. Are these statements TRUE or FALSE?

1. The formula for AMC is used in completing the R&R.

2. The Beginning Balance is only the stock in the store room in the laboratory.
3. The total quantity used comes originally from the DARs.
4. All losses and adjustments should be subtracted.
5. The IMSR makes filling out the R&R faster and more accurate.
6. If you are over stocked with more than three months AMC, you should leave
the column for OQ blank.
7. Column C should usually be larger than Column A plus Column B.
8. You should check your calculations twice on the R&R.

82
6.10.3 Report and Requisition for HIV Test – Practice Exercise:

Instructions: Prepare the attached Report and Requisition for HIV Tests for Ndola
Central Hospital for June 2010 using your SOP, and information from the following
forms:

 The previous months’ R&R

 The data from the two Internal Monthly Summary Reports i.e. from the VCT
unit and Laboratory.
 Updated Stock Control Cards for the 3 products.

83
 INTERNAL MONTHLY SUMMARY REPORT FOR HIV TESTS

Reporting Period: From _01 June 2010 to 30 June 2010

dd/mm/yyyy dd/mm/yyyy

Facility: Ndola Central Hospital Testing Site: Laboratory

Summary of HIV Test Stock Balance

Type of Test Product Beginning Quantity Quantity Losses and
Physical Count
Balance Received Used Adjustments
Screening Determin 100 100 104 -1 95
e
Confirmatory Unigold 16 60 50 -1 25
SD
Tiebreaker 18 20 21 0 17
Bioline

Remarks: One Determine HIV Test was damaged, One Unigold noted lost at the end of the day

Summary of HIV Tests Used by Purpose

Type of Test Product Clinical Quality
VCT PMTCT Other TOTAL
Diagnosis Control
Screening Determine 0 58 45 0 1 104
Confirmatory Unigold 0 31 18 0 1 50
Tiebreaker SD Bioline 0 13 7 0 1 21
TOTAL 0 102 70 0 3 175

Summary of Final Test Results

Positive Negative Indeterminate

Final Test Result
41 59 0

Completed by: _______XYZ_____________________

Signed: _________XYZXYZXYZ____________________
Date: ___02 July 2010________________________

84
 INTERNAL MONTHLY SUMMARY REPORT FOR HIV TESTS

Reporting Period: From __01/June/2010_________ to __30/June/2010________________

dd/mm/yyyy dd/mm/yyyy

Facility: __Ndola Central Hospital________ Testing Site: ____VCT Unit______________

Summary of HIV Test Stock Balance

Type of Test Product Beginning Quantity Quantity Losses and
Physical Count
Balance Received Used Adjustments
Screening Determin 90 300 200 -2 188
e
Confirmatory Unigold 23 200 140 0 83
SD
Tiebreaker 15 20 20 0 15
Bioline

Remarks: 2 Determine tests were damaged.

Summary of HIV Tests Used by Purpose

Type of Test Product Clinical Quality
VCT PMTCT Other TOTAL
Diagnosis Control
Determin
Screening
e 199 0 0 1 0 200
Confirmatory Unigold 139 0 0 1 0 140
SD
Tiebreaker 20 0 0 0 20
Bioline
TOTAL 358 0 0 2 0 360

Summary of Final Test Results

Positive Negative Indeterminate

Final Test Result 124 75 0

Completed by: _____XYZ________________________

Signed : _____XxxYyyZyy________________________

Date: ______2/July/2010_____________________

85
 HIV Test Stock Control Card

CODE: __35243____________

ITEM DESCRIPTION: _DETERMINE HIV TESTS________ STRENGTH: ______________

UNIT: __1 Test__________

MAXIMUM LEVEL: __3 Months of Stock________ MINIMUM LEVEL: _____ E.O.P = 0.5Months ___ (Reorder Level)

ISSUED TO QUANTITY QUANTITY LOSSES

REF. and UNIT NAME/
DATE OR RECEIVED ISSUED BALANCE REMARKS
No. PRICE SIGNATURE
(+) (-) ADJUST-
RECEIVED FROM MENTS

1/5/2010 B/F 230 XYZ

1/5/2010 892 MSL 600 830 XYZ
1/5/2010 Main Laboratory 130 700 XYZ
15/5/2010 VCT Unit 100 600 XYZ

31/5/2010 Physical Count 600 XYZ

3/6/2010 482 MSL 300 900 XYZ
8/6/2010 Main Laboratory 100 800 XYZ
16/6/2010 Loss -20 780 XYZ Expired
16/6/2010 VCT Unit 300 480 XYZ

30/6/2010 Physical Count +20 500 XYZ Found at PC

 HIV Test Stock Control Card

CODE: ___99999___________

ITEM DESCRIPTION: __Unigold HIV Tests_____________ STRENGTH: ______________

UNIT: ___1 Test_________

MAXIMUM LEVEL: _3 months of stock_____ MINIMUM LEVEL: __ E.O.P = 0.5Months ____ (Reorder Level)

ISSUED TO QUANTITY QUANTITY LOSSES

REF. UNIT NAME/
DATE OR RECEIVED ISSUED and BALANCE REMARKS
No. ADJUST- PRICE SIGNATURE
RECEIVED FROM (+) (-)
MENTS

1/5/2010 B/F 50 XYZ

1/5/2010 Main Laboratory 26 24 XYZ
1/5/2010 892 MSL 400 424 XYZ
10/5/2010 VCT Unit 20 404 XYZ
15/5/2010 VCT Unit 4 400 XYZ

31/5/2010 Physical Count 400 XYZ

2/6/2010 Loss -16 384 XYZ Damaged
3/6/2010 482 MSL 200 584 XYZ
8/6/2010 VCT Unit 200 384 XYZ
8/6/2010 Main Laboratory 60 324 XYZ

30/6/2010 Physical Count -20 304 XYZ Found missing at PC

 HIV Test Stock Control Card

CODE: __543___________

ITEM DESCRIPTION: __SD Bioline HIV Test___________ STRENGTH: __________

UNIT: __1 Test__________

MAXIMUM LEVEL: _3 months of stock_____ MINIMUM LEVEL: __ _ E.O.P = 0.5Months ___ (Reorder Level)

ISSUED TO
QUANTITY QUANTITY LOSSES
REF.
RECEIVED ISSUED and NAME/
DATE OR BALANCE UNIT PRICE
SIGNATURE
REMARKS
No. ADJUST-
(+) (-)
RECEIVED FROM MENTS

B/F 7 XYZ
19/4/2010
892 MSL 80 87 XYZ
1/5/2010
Main Laboratory 20 67 XYZ
1/5/2010
VCT Unit 40 27 XYZ
10/5/2010
VCT Unit 20 7 XYZ
15/5/2010
Physical Count 7 XYZ
31/5/2010
482 MSL 80 87 XYZ
3/6/2010
VCT Unit 20 67 XYZ
8/6/2010
Main Laboratory 20 47 XYZ
21/6/2010
Physical Count 47 XYZ
30/6/2010
 MINISTRY OF HEALTH  Emergency Order
REPORT AND REQUISITION FOR HIV TESTS
Reporting Period: From 1/March/ 2010 to 31/March/2010 Province: Copperbelt Maximum Stock Level: 3 Months
dd/mm/yyyy dd/mm/yyyy
Facility: Ndola Central Hospital District: Ndola Emergency Order Point: 0.5 Months

All STOCK INFORMATION SHOULD BE RECORDED IN INDIVIDUAL TESTS, NOT IN KITS.

Beginning
Losses/ Physical Count AMC
Balance Total Total Maximum Order Quantity
Type of Test Product Adjustments (Store Room + (C+2 previous
(Store Room + Quantity Quantity Quantity (G-E)
(- / +) Testing Sites) months) / 3)
Testing Sites) Received Used (F x 3)
A B C D E F G H
Screening Determine 200 400 300 -10 290 250 750 460
Confirmatory Unigold 160 140 200 0 100 150 450 350
Tiebreaker SD Bioline 40 20 20 0 40 20 60 20

Remarks and Explanation of Losses/Adjustments:

Adjustment of -10, one card of 10 Determine tests was damaged

Summary of HIV Tests Used by Purpose

Type of Test Product Clinical
VCT PMTCT Quality Control Other TOTAL
Diagnosis
Screening Determine 270 20 8 1 1 300
Confirmatory Unigold 180 11 7 1 1 200
Tiebreaker SD Bioline 18 1 0 0 1 20
TOTAL 468 32 15 2 3 520

Completed by: _________________________ Authorized by: ____________________________ Approved by: __________________________

Signed: _________________________ Signed: ____________________________ Signed: _________________________
Date: _________________________ Date: ____________________________ Date: __________________________
 MINISTRY OF HEALTH  Emergency Order
REPORT AND REQUISITION FOR HIV TESTS
Reporting Period: From 1/ April /2010 to 30/ April /2010 Province: Copperbelt Maximum Stock Level: 3 Months
dd/mm/yyyy dd/mm/yyyy
Facility: Ndola Central Hospital District: Ndola Emergency Order Point: 0.5 Months
All STOCK INFORMATION SHOULD BE RECORDED IN INDIVIDUAL TESTS, NOT IN KITS.

Beginning
Losses/ Physical Count AMC
Balance Total Total Maximum Order Quantity
Type of Test Product Adjustments (Store Room + (C+2 previous
(Store Room + Quantity Quantity Quantity (G-E)
(- / +) Testing Sites) months) / 3)
Testing Sites) Received Used (F x 3)
A B C D E F G H
Screening Determine 290 500 400 0 390 300 900 510
Confirmatory Unigold 100 360 300 +40 200 200 600 400
Tiebreaker SD Bioline 40 20 50 0 10 30 90 80

Remarks and Explanation of Losses/Adjustments:

Adjustment of +40, 40 unigold tests received from Kitwe Central Hospital

Summary of HIV Tests Used by Purpose

Type of Test Product Clinical
VCT PMTCT Quality Control Other TOTAL
Diagnosis
Screening Determine 370 27 1 1 1 400
Confirmatory Unigold 292 5 1 1 1 300
Tiebreaker SD Bioline 49 1 0 0 0 50
TOTAL 711 33 2 2 2 750

Completed by: _________________________ Authorized by: ____________________________ Approved by: __________________________

Signed: _________________________ Signed: ____________________________ Signed: _________________________
Date: _________________________ Date: ____________________________ Date: __________________________
 MINISTRY OF HEALTH  Emergency Order
REPORT AND REQUISITION FOR HIV TESTS
Reporting Period: From 1/May/ 2010 to 31/May/2010 Province: Copperbelt Maximum Stock Level: 3 Months
dd/mm/yyyy dd/mm/yyyy
Facility: Ndola Central Hospital District: Ndola Emergency Order Point: 0.5 Months
All STOCK INFORMATION SHOULD BE RECORDED IN INDIVIDUAL TESTS, NOT IN KITS.

Beginning
Losses/ Physical Count AMC
Balance Total Total Maximum Order Quantity
Type of Test Product Adjustments (Store Room + (C+2 previous
(Store Room + Quantity Quantity Quantity (G-E)
(- / +) Testing Sites) months) / 3)
Testing Sites) Received Used (F x 3)
A B C D E F G H
Screening Determine 390 600 200 0 790 300 900 110
Confirmatory Unigold 200 400 160 -1 439 220 660 221
Tiebreaker SD Bioline 10 80 50 0 40 40 120 80

Remarks and Explanation of Losses/Adjustments:

Adjustment -1, one Unigold test was lost

Summary of HIV Tests Used by Purpose

Type of Test Product Clinical
VCT PMTCT Quality Control Other TOTAL
Diagnosis
Screening Determine 169 24 4 2 1 200
Confirmatory Unigold 149 6 2 2 1 160
Tiebreaker SD Bioline 48 1 1 0 0 50
TOTAL 366 31 7 4 2 410

Completed by: _________________________ Authorized by: ____________________________ Approved by: __________________________

Signed: _________________________ Signed: ____________________________ Signed: _________________________
Date: _________________________ Date: ____________________________ Date: __________________________
 MINISTRY OF HEALTH  Emergency Order

REPORT AND REQUISITION FOR HIV TESTS

Reporting Period: From __________ to __________ Province: __________________________ Maximum Stock Level: 3 Months
dd/mm/yyyy dd/mm/yyyy
Facility: ________________________________________ District: __________________________ Emergency Order Point: 0.5 Months
All STOCK INFORMATION SHOULD BE RECORDED IN INDIVIDUAL TESTS, NOT IN KITS.

Beginning
Losses/ Physical Count AMC
Balance Total Total Maximum Order Quantity
Type of Test Product Adjustments (Store Room + (C+2 previous
(Store Room + Quantity Quantity Quantity (G-E)
(- / +) Testing Sites) months) / 3)
Testing Sites) Received Used (F x 3)
A B C D E F G H
Screening Determine
Confirmatory Unigold
Tiebreaker SD Bioline

Remarks and Explanation of Losses/Adjustments:

Summary of HIV Tests Used by Purpose

Type of Test Product Clinical
VCT PMTCT Quality Control Other TOTAL
Diagnosis
Screening Determine
Confirmatory Unigold
Tiebreaker SD Bioline
TOTAL

Completed by: ______________________ Authorized by: _______________________ Approved by: __________________________

Signed: _________________________ Signed: ____________________________ Signed: _________________________
Date: _________________________ Date: ____________________________ Date: __________________________
Evaluation
1. What are the sources of data to complete the R&R for HIV Tests?
2. When is the R&R for HIV Tests due to LMU for hospitals and Districts?
3. What are the key sections of the R&R for HIV Tests?
4. Based on this R&R for HIV Tests; is the HIV Tests logistics system a push or
pull system?
5. How do you review the R&R for HIV Tests before submitting it to LMU?

Reference:
 Republic of Zambia, Ministry of Health, Standard Operating Procedures
Manual for Management of the National ART Laboratory Commodity Logistics
System, September, 2009. Chapter 7
6.11. Receiving Laboratory Commodities

Time Allocated: 80 minutes

Session Aim:
To impart knowledge and skills on how to receive laboratory commodities and
procedures to be followed.

Session Objectives:
By the end of this session, students will be able to:
1. Identify the forms that document the issue and receipt of an order
2. Describe the process for receiving supplies at a facility
3. Describe how to document a discrepancy between the documentation
accompanying an order (Despatch note and Computer’ generated Report and
Requisition Form) and the actual order
4. Complete facility portion of the Despatch note
5. Describe the features of the Computer’ generated Report and Requisition Form
and how to review this document

Session Content
6.11.1. Identify the forms that document the issue and receipt of an order
6.11.2. Receiving Laboratory Commodities at a Health Centre

Key points of the session:

B. Steps in receiving Laboratory commodities
1. Form a committee to meet the MSL truck upon arrival (which carries both the
Laboratory Commodities and the Essential Drugs)
2. Conduct a visual inspection of the products, noting any damage or expiry
3. Receive 2 copies of the Despatch Note from the driver and 2 copies of the
computer generated R&R
4. Note any discrepancies on the Despatch Note and sign 2 copies – giving 1 to the
driver, and keeping 1 to be filed at the facility.
5. Complete the stock control cards and store the commodities

C. Forms that accompany the products

1. Computer –generated Report and Requisition
95
2. MSL Despatch Note
3. Requisition and Issue Voucher
4. Delivery Note

96
ADDITIONAL INFORMATION

LABORATORY COMMODITY DISTRIBUTION

Medical Stores Limited:

Laboratory Commodity orders are pre-

packaged for hospitals and
aggregated for districts (for the health
centre-level facilities; orders are
included with essential drugs orders.

Each order travels with the:

 Computer-generated copy of
the Report & Requisition for
Laboratory Commodities (2
copies for HC, 1 copy for
hospitals)
 Computer-generated MSL
Despatch Note (2 copies)

DISTRICT:
HOSPITALS:
Aggregated laboratory supply
Laboratory commodity orders
orders arrive with the aggregated
for the hospitals arrive with the
essential drugs orders for the
essential drugs orders.
districts. Orders are immediately
separated and re- packaged for the
individual health centre.

Each order travels with the:

 Computer-generated copy of the Report

& Requisition for Laboratory
Commodities (2 copies)

HEALTH CENTRE FACILITY:

Individual laboratory commodity

orders for the health centres are
delivered by the district or collected
by the facility. 97
Evaluation
1. What is the purpose of a computer-generated R&R?
2. How many copies of the Computer-generated R&R go with the products from
MSL?
3. What other documents accompany the products?
4. What do you think the bolded number might mean?
5. Where are discrepancies realized when receiving commodities recorded?

References:
 Republic of Zambia, Ministry of Health, Standard Operating Procedures Manual
for Management of the National ART Laboratory Commodity Logistics
System, September, 2009. Chapter

98
6.12. Storage of Laboratory Commodities

Time Allocated: 60 minutes

Session Aim
To provide the students with knowledge and skills on the proper storage for health
commodities.

Session Objectives:
By the end of the session students will be able to:
1. Describe the purpose of storage
2. Explain the importance of shelf life for laboratory commodities
3. Identify good storage practices, including how to store and distribute supplies
according to FEFO and manage products in cold storage
4. Conduct a visual inspection

Session Content
6.12.1. Purpose of Storing
6.12.2. Shelf Life
6.12.3. Basic Storage Guidelines
6.12.4. Visual Inspection
6.12.5. Physical Inventory of Stock on Hand
6.12.6. Disposal

Key points of the session:

A. Purpose of storing commodities

 Protect the quality of laboratory supplies by preserving the packaging

 Make sure that laboratory supplies are available for use

99
B. 13 Storage Guidelines:

1. Clean and disinfect storeroom regularly, and take precautions to discourage

harmful insects and rodents from entering the storage area.
2. Store health commodities in a dry, well lit, and well ventilated storeroom—out of
direct sunlight.
3. Protect storeroom from water penetration.
4. Keep fire safety equipment available, accessible, and functional, and train
employees to use it.
5. Store latex products away from electric motors and fluorescent lights.
6. Maintain cold storage, including a cold chain, as required.
7. Limit storage area access to authorized personnel and lock up controlled
substances.
8. Stack cartons at least 10 cm (4 in.) off the floor, 30 cm (1 ft.) away from the walls
and other stacks, and no more than 2.5m (8ft.) high.
9. Arrange cartons with arrows pointing up (), and with identification labels, expiry
dates, and manufacturing dates clearly visible.
10. Store health commodities to facilitate ―first-to-expire, first- out‖ (FEFO)
procedures and stock management.
11. Store health commodities away from insecticides, chemicals, flammable
products, hazardous materials, old files, office supplies, and equipment; always
take appropriate safety precautions.
12. Separate damaged and expired health commodities from usable commodities,
remove them from inventory immediately, and dispose of them using established
procedures.
13. It is important to ensure that medicines, health commodities and other medical
supplies are safe from theft.

100
 C. When to Conduct Visual Inspection
 every time products are received from the manufacturer (usually at the central
level)
 each time the warehouse or clinic receives supplies
 when conducting a physical inventory
 when investigating complaints
 when supplies are about to expire
 when supplies show signs of damage
We should do visual inspection each time we come in contact with the products
(physical inventory, issuing, receiving) or each time we suspect that there is a
problem with the quality of our products.

D. What to Look for in a Visual Inspection

 Package and product integrity: check for damage to packaging (tears,
perforations, and water or oil leakage, e.g., lubricated condoms) and products
(such as broken or crumbled pills or tablets, torn packets of condoms, etc.)
 Manufacturing defects (such as incomplete supply, missing or illegible
identification information)
 Labeling (make sure that products are labeled with date of manufacture or
expiration, lot number and manufacturer's name)
 Missing contents of e.g., a ―kit‖ (such as a bottle of chase buffer missing from an
HIV test kit; litmus paper missing from a lab kit)

E. Physical Inventory of Stock on Hand

 ―A physical inventory is the process of counting by hand the total number of
units of each commodity in your store or health facility at any given time.‖

 ―The purpose of a physical inventory is to compare actual stock on hand for

each commodity with the amount recorded on the stock card.‖

Physical inventories:
o should be conducted at least once a year
o should be done more frequently than once a year if discrepancies
between actual balance on hand and the balance listed on the stock
records are frequently found
Evaluation:

1. Why do we store products or commodities?

2. Name five (5) storage Guidelines.
3. Define shelf Life.
4. What is the purpose of visual inspection and when is it done?

101
 5. When is Physical inventory done and why?

References

 USAID | DELIVER PROJECT. 2011. The Logistics Handbook: A Practical Guide

for Supply Chain Management of Health Commodities. Arlington, Va.:
USAID | DELIVER PROJECT Chapter 8

 Republic of Zambia, Ministry of Health, Standard Operating Procedures Manual

for Management of the National ART Laboratory Commodity Logistics System,
September, 2009. Chapter 8

 John Snow, Inc. /DELIVER in collaboration with the World Health Organization.
Guidelines for the Storage of Essential Medicines and other

102
6.13. Monitoring, Supervision, and Feedback Reports

Time Allocated: 3 hours

Session Aim:
To impart the students with knowledge and skills necessary to monitor and supervise
the lower level staff.

Session Objectives:
By the end of this session the students should be able to:
1. Define terms in Monitoring and Supervision
2. Discuss the purpose of monitoring logistics activities
3. Discuss the purpose of supervising logistics personnel
4. Discuss the differences between monitoring and supervision
5. Outline the guidelines for Logistics Monitoring and Supervision

Session Content
6.13.1. Introduction to Logistics Monitoring, Supervision and providing Feed back
6.13.2. Define Key terms Logistics Monitoring, Supervision, and On-the-job-
training (OJT)
6.13.3. Reasons for Monitoring
6.13.4. Reasons for Supervision
613.5. Difference between Monitoring and Supervision
6.13.6. Planning for Logistics Monitoring and Supervision

Key points of the session:

A. Key terms in Logistics Monitoring, Supervision and OJT

 Monitoring: is checking on a regular basis to ensure that assigned activities are

being carried out. Monitoring is the regular checking and recording of activities
taking place in a project or program. It is a process of routinely gathering
information on all aspects of the project.

 Supervision: is the process of ensuring that personnel have the knowledge and
skills required to carry out their responsibilities effectively, and to provide
immediate on-the-job training, as needed.

103
 On-the-Job Training: is helping someone improve his or her performance as
soon as a problem is noticed by demonstrating the correct way to do a task. It is
training that takes place on the job, working closely with the worker.

 Effective on-the job training should take place as soon as a performance problem
is identified.

B. Planning for a Logistics Monitoring and Supervision

1. Prepare the visit

2. Establish the rapport
3. Visit the storeroom
4. Assess the condition of the medicine store
5. Count the stock
6. Actions During the visit
7. Actions After the visit

References

 USAID | DELIVER PROJECT. 2011. The Logistics Handbook: A Practical Guide for
Supply Chain management of Health Commodities. Arlington, Va.: USAID | DELIVER
PROJECT. Chapter 9

 Republic of Zambia, Ministry of Health, Standard Operating Procedures Manual for

Management of the National ART Laboratory Commodity Logistics System, September,
2009.
 John Snow, Inc./DELIVER. 2005. Guidelines for Warehousing Health Commodities.
Arlington, Va.: John Snow, Inc./DELIVER, for the U.S. Agency for International
Development.

 John Snow, Inc. /DELIVER in collaboration with the World Health Organization.
Guidelines for the Storage of Essential Medicines and other Health Commodities. 2003.
Arlington, VA; John Snow, Inc. /DELIVER, for the US Agency for International
Development.

104
7.0. How orders are calculated on the Computer-generated
R&R

Session Aim
To enable students understand how order quantities are calculated at LMU and
be able to interpret the Computer-generated R&R
Objective: By the end of this session the participants will be able to:
1. Identify parts on the requisition section of the computer-generated R&R
2. Explain how order quantities are calculated.
3. Calculate maximum and order quantities correctly.
Session Content
7.0.1. Explaining parts of the requisition section of the R&R
7.0.2. Explanation of Maximum and Order Quantity formulae
7.0.3. Special Cases
7.0.4. Short exercise for calculating maximum stock levels and order quantity.
Key Points of the Session

 The computer-generated R&R being one of the forms used to give feedback to
the facilities. The orders are calculated by the computer once the data in
captured in Supply chain Manager Software. Some calculations so that they
appreciate how the calculation is done.

 You expected to do the calculations when ordering lab commodities. This done at
LMU.

 It is important for Health Centers and Hospitals to calculate AMC and determine
MOS.

 Formula for Calculating Order Quantity is Max-SOH(OQ=Max-SOH).

 If calculated order quantity results into a negative value it means the facility may
be overstocked. Hence OQ will be zero on the UR.

105
Exercises with OQ

REGULAR OR
EMERGENCY
TOTAL WHAT IS WHAT IS ORDER?
SOH MOS? OQ?
AMC

Ex. 132 164 1.2 232 Regular

Ex. 64 18 0.3 174 Emergency

1. 24 9

2. 240 321

3. 69 81

4. 110 18

5. 83 467

106
 Instructions: You are the computer at LMU. Using the following information from the two
previous URs; complete the requisition section of the Computer-generated R&R.

April 1-30th 2001

Product Units Beginnin Total Total Adjust- Physica

g Quantit Quality ments l Count
Balance y Dispens
Receive ed
d

LAB0476 Acetone Liquid L 500 300 250 0 550

LAB0051 Olympus ALT, 4x12ml 4X12ml, 10 0 4 -1 5

4x6

Lab0300 Calibrate 3CE 25 test Kit of 25 70 10 25 0 55

tests

LAB0081 Ammonium Axalate g 11 7 3 -2 13

LAB0228 Olympus AST 4x6ml, 4 0 2 0 2

4x4ml

LAB0114 Basic Fuchsin Powder g 0 200 90 -10 100

LAB0403 Olympus Bilirubin Direct 4x25ml 0 3 2 -1 0

LAB0127 Commercial Reagent Kit, Tests 1500 4600 3100 +1000 4000
Syphilis RPR

107
 May 1-31st 2011

Product Units Beginnin Total Total Adjust- Physica

g Quantit Quality ments l Count
Balance y Dispens
Receive ed
d

LAB047 Acetone Liquid L 550 200 300 0 450

6

LAB005 Olympus ALT, 4x12ml 4X12ml, 5 7 3 0 9

1 4x6

Lab030 Calibrate 3CE 25 test Kit of 25 55 20 40 -5 30

0 tests

LAB008 Ammonium Axalate g 13 0 11 0 2

1

LAB022 Olympus AST 4x6ml, 2 4 3 0 3

8 4x4ml

LAB011 Basic Fuchsin Powder g 100 170 78 +12 204

4

LAB040 Olympus Bilirubin Direct 4x25ml 0 6 2 -1 3

3

LAB012 Commercial Reagent Kit, Tests 4000 5300 5600 0 3700

7 Syphilis RPR

108
 Report Requisition for Laboratory Commodities

Report Period: June 1-30 2010

Facility: UTH

Facility Code: 504002

Product Units Beginnin Total Total Adjust- Physical AMC Max Order Quantity
g Quantity Quality ments Count Quantity Supplied
Balance Receive Dispens
d ed

LAB0476 Acetone Liquid L 450 184 150 0 480 234 702 222 222

LAB0051 Olympus ALT, 4x12ml 4X12ml, 9 3 4 0 8 3 9 1 0

4x6

Lab0300 Calibrate 3CE 25 test Kit of 25 30 22 19 0 33

tests

LAB0081 Ammonium Axalate g 2 5 5 -2 0

LAB0228 Olympus AST 4x6ml, 3 2 0 0 5

4x4ml

LAB0114 Basic Fuchsin Powder g 204 56 119 0 141

LAB0403 Olympus Bilirubin Direct 4x25ml 3 2 3 +1 4

LAB0127 Commercial Reagent Kit, Tests 3700 2900 4500 1000 2100
Syphilis RPR

109
Evaluation:

1. Where are order quantities calculated from?

2. What is the formula for calculating Order Quantity?
3. What does a negative(-) calculated Order Quantity mean?

References

Republic of Zambia, Ministry of Health, Standard Operating Procedures Manual for

Management of the National ART Laboratory Commodity Logistics System, September,
2009. Chapters5 & 9

110