Click here to listen to Health Uninterrupted Episode 1: The EUV Survey In Nigeria!
The USAID Global Health Supply Chain Program-Procurement and Supply Management project (GHSC-PSM) is happy to announce the release of our new podcast, Health Uninterrupted. In this podcast, we will bring you stories from our country offices worldwide, showcasing how we're strengthening supply chains and ensuring the uninterrupted supply of essential commodities to the countries we serve.
We're kicking this series off with a look at how we're using our End-Use Verification Survey to increase data visibility and support our government partners in Nigeria with their decision-making for maternal, newborn, and child health commodities. Hosted by Digital Engagement Specialist Seunfunmi Tinubu, this episode features a wealth of insight into the role of the survey and its impact on the health supply chain from Olukemi Sofa, GHSC-PSM's Maternal, Newborn, and Child Health Manager in Nigeria.
Listen to the first episode of Health Uninterrupted here! We hope you enjoy it and learn something new! The transcript for this episode can be read below. For more info on the End-Use Verification (EUV) survey, visit www.ghsupplychain.org/euvsurvey.
Transcript
Olukemi Sofa (OS): So, the EUV is kind of a spot check activity that supports other key interventions already institutionalized by the program in Nigeria and also by the project. So, the data for the EUV when collected is mostly used to validate the stockout rates and then also looking at trends and also be able to provide information, that the LMIS data does not cover.
Things like storage management, case management, which are mainly for treatment partners, reasons behind stockout rates, you know, which the LMIS data won't pick during the report collection process.
Seunfunmi Tinubu (ST): Hi, my name is Seunfunmi Tinubu and you're listening to Health Uninterrupted, a health supply chain podcast brought to you by the USAID Global Health Supply Chain Program-Procurement and Supply Management project, also known as GHSC-PSM.
At GHSC-PSM, we help countries get reliable data to improve their health logistics so that Nigerians can have medical supplies whenever they go to the hospital or clinic anywhere in the country, whether urban or rural. We pride ourselves on getting health commodities down to the last mile. In this podcast, we will be diving into 1 of our tools for capacity building, knowledge sharing, and strengthening of the supply chain. The end-use verification survey, also known as the EUV survey.
OS: My name is Olukemi Sofa. I'm the Maternal, Newborn and Child Health (MNCH) Manager for the GHSC-PSM project in Nigeria. I coordinate the EUV activities for the MNCH program. I also participate as a trainer during the orientations for data collectors. And most importantly, also the lead in interpreting the output of the data analysis.
ST: The EUV survey is a health facility survey used in 17 countries to determine the availability of family planning, and maternal, newborn, and child health commodities, like essential medicines that serve patients in the countries where we operate.
The information pulled from this survey gives in-country stakeholders, like Ministries of Health and health clinics, more information to make better policy and supply planning choices over time.
OS: So, some of the data that we collect, for the EUV includes the facility management data. We also collect stock management data, storage data, and then just to also add that when the when the EUV started in Nigeria earlier on, we also started for the MNCH program.
ST: The EUV survey paints a clearer picture of how key MNCH meds are being managed at the facility level. Kemi goes into further detail to explain how exactly we're collecting this data and how it's being used.
OS: We take information on inventory management, how the inventory control cards are being managed, how stock is being replenished, some of the reasons why maybe there may be availability and reasons why they are being used. Probably stockouts based on observations. So those are some of the data we collect on stock management. On storage management, we collect information on how the commodities are being stored based on the requirement by manufacturers.
Should they be stored in cold chain? Should they be stored in ambient temperature? What are the kind of storage conditions in terms of the storage facilities that are available, the designated areas for storage available? Are they under lock and key? Do they have, a personnel managing those commodities and being able to manage the storage conditions?
Are they kept within the required temperature requirements? So those are some of the information we collect for stock and also for storage management.
ST: EUV helps us to answer many different questions, ensuring that we have the relevant information for proper storage of vital medicines. It also allows us opportunities for critical site visits that provide training and learning opportunities for facility staff.
OS: The EUV process is actually facility-based, more or less like a key informant interview and observation of, some of the practices and some of the tools that are being utilized at the health facility. We have the routine data collection, and then for logistics management information system, that's the LMIS, which you collect on a bimonthly basis is mostly transmitted directly from the facility onto the data repository, which is the National Health Logistics Management Information System.
And most cases you may not find or gets people go to the facility to pick up this data is usually done directly by the facility or the data is transmitted in hard copy to the logistics management information units office where it's now keyed directly onto the National Health Logistics Management Information System. The EUV provides the opportunity for facility visits in addition to other interventions like MSVs, the EUV also.
Since the data collectors go directly to the facility, they're able to interact with the facility staff and be able to provide some hands on, even that might not be the key drive, but they're able to provide hands on looking at the data and the gaps that are being identified. So they ask questions around why you stock out?
Do you understand how to fill the logistics management information tools? You have cases where you have people Who have been recently transferred to the new facility, and then they don't have the skill to be able to do some of the functions of a logistic staff within that facility. The EUV provides that avenue to be able to provide quick, corrective measures and be able to provide hands on training to some of the stuff, because it's actually facility based visits and interaction with the facility staff who manage these commodities.
1 key area is being able to provide corrected measures that were identified for immediate action to improve the inventory management practices. And then it's also able to provide some hands-on training in terms of like supportive visit, supportive supervision and mentoring on key areas.
ST: Collaboration is a big part of our work at GHSC-PSM and the EUV survey is no different. Kemi shed some light on the key partners who we work with for the survey, including the government of Nigeria.
OS: So, in Nigeria, we work. Mainly with three USAID partners, we work with Integrated Health Project, which is the IHP, they support their, they support all the five states where the MNCH program, the Maternal, Newborn, and Child Health Program, also supports, which is Bauchi, Kebe, Sokoto, FCT, and Ebonyi. We work directly with them. They also support, in some cases, the trainings and also they support at the data collection in the field.
They also work with breakthrough action at the attention of the orientations, and we're able to use the output of EUV to be able to engage them for service improvement, and also to be able to create demand and also provide awareness on some of the activities that the project is undertaking from the findings of the EUV.
Most importantly, we also work with the government of Nigeria in all the states, so we still have data collectors representing the government of Nigeria.
ST: EUV has had a positive impact in a Nigerian context. By providing increased data visibility, which helps the country's states to address their unique issues in their health supply chain.
OS: 1 of the innovations we've been able to do as a program is to have some level of state level data, such that we're able to have the EUV rather than integrated in terms of the data analysis for all the states where we support.
And we've been able to have a breakdown. For each state so that the data is more useful and specific to their own challenges and gaps that are being observed. So that's 1 key area intervention that happened in the last 2 EUVs when we commenced that and we're hoping that you will be able to gain some traction with the state being able to identify their own state specific challenges because the challenges that are observed are different in each of the states and some are peculiar to some states and not to the others.
ST: By collecting data not captured by other existing systems and communicating that data to the relevant actors, EUV helps to address bottlenecks that can occur. Monitoring and supervision visits also known as MSVs are very important in addressing knowledge gaps within the supply chain quickly and effectively.
OS: So you find gaps within the facility based on what has been observed, and because we have worked really collaboratively with the Government of Nigeria staff, we're able to address some of the bottlenecks that have been observed, and then it also helps to foster collaboration between implementing partners and then the Government of Nigeria.
And then secondly, it also helps to improve generally knowledge and then gaps that we find in storage conditions, specifically using like the oxytocin. So we wouldn't know what consumption or what information system data that we collect on a bimonthly basis. We wouldn't know what kind of storage condition these commodities are being kept if we don't go for MSPs, if we don't have the spot checks from the EUV. The intervention that especially oxytocin like I mentioned that concerns the climate condition within Nigeria. We've been able to observe that in some of the facilities you find oxytocin that are not properly labeled for Nigeria, saying that can be stored in room temperature at 25 degrees centigrade. And then the notion that people think, oh, room temperature. I can store it outside the cold chain, knowing fully well that the climate conditions in Nigeria are way beyond 25 degrees centigrade. So those kind of knowledge gaps that we find in terms of people saying, “Oh, I didn't know oxytocin was meant to be stored in cold temperature”, you know, so it was kept in ambient temperature on shelves.
We're able to address some of those gaps. So for me, those are kind of the key lessons and then we're able to use them. To our advantage to be able to address or to be able to include them in some of our interventions at the national level and at programmatic level as well.
ST: Seeing specific instances of the EUV fulfilling its purpose is highly encouraging. Knowledge is power and addressing knowledge gaps within the supply chain empowers actors like pharmacists and health facility staff members to make decisions that will benefit their patients the most in the short and long term.
OS: I think it's in Bauchi State. Some of the facilities that were visited did not have the inventory control cards, the ICC cards that is used to record influx of commodities in and out of the facilities using the inventory control cards to manage. That was taken up directly to the directorate of Pharmaceutical Services and the Logistics Management Coordinating Unit, and I know for a few of those facilities were able to address those gaps immediately to be able to send inventory control cards to those facilities were used.
If documentation is not done, it could probably lead to some of the stock being overstocked so that it could lead to expiries or in some cases understocked so that it can lead to stock out as well. So it's important that health facility staff update their inventory control cards, and that essentially helps to be able to ascertain the quantities that will be available for the end users in the long run knowing fully well that they need to calculate the amount of stock based on their, average monthly consumption and what they have available as their stock on hand.
ST: The future of the EUV survey in Nigeria sees gaps in the supply chain diminished greatly through the collection of data and sharing of knowledge and information. Actors along the supply chain will be able to make decisions faster and more strategically. By working with these actors hands-on, we're helping to build a more resilient and sustainable supply chain that gets patients the medicines they need when they need them.
OS: So you see areas in wrong practices in documentation on inventory management tools. So those are kind of areas where each of the data collectors are able to put supports and give them hands on training immediately. So it's able to address key areas that have been identified within the EUV data collection process.
ST: And that brings us to the end of our discussion on the End-Use Verification Survey in Nigeria with Olukemi Sofa. The survey is playing a major role in Nigeria by helping to address gaps in knowledge, ensuring consistent commodity storage, and giving stakeholders like the government necessary information for public health decision-making. Thank you for taking the time to listen. We hope you've been able to learn something new.
Stay tuned for our next episode where we examine the role of the EUV survey in Ghana. Until next time, I'm Seunfunmi Tinubu, and you've been listening to Health Uninterrupted, a health supply chain podcast. Brought to you by the USAID Global Health Supply Chain Program-Procurement and Supply Management project.
