Institutionalizing Robust Quantification Processes and Tools within Guinea’s National Malaria Control Program

By Claude Bahati, Deputy Country Project Director, SIAPS, Guinea

Accurate quantification for malaria programs, which involves forecasting the quantities needed and planning for the procurement of appropriate pharmaceuticals and supplies, is essential to ensuring that patients receive a continuous supply of commodities. The US Agency for International Development (USAID)-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program helps the Programme Nationale de Lutte contre le Paludisme (PNLP) and in-country stakeholders in Guinea build their capacity to conduct efficient quantification exercises. The result is increased availability of commodities through effective procurement, delivery, and use of the available financial resources for procurement.

The Challenge

Guinea is a high malaria endemic country with a population of approximately 12.1 million, all of whom are at risk for an episode of malaria each year. Like many African countries, Guinea lacks a clear picture of the medicines and supplies required to support the scale-up of malaria prevention, care, and treatment programs. Until recently, the PNLP had been generating inaccurate forecasts of malaria commodity requirements and it faced numerous challenges, including:

  • Limited use of available data for forecasting, including consumption
    and service-statistics data
  • Little consensus in establishing forecast assumptions
  • Weak methodologies and inappropriate tools for quantification

The resulting forecast estimates were of poor quality and left the PNLP with supply imbalances (i.e., medicine shortages) and costly emergency shipments in cases of underestimation, while overestimation resulted in overstock and an increased risk of product expiry.

Meeting the Need

Faced with the twin challenges of increasing access to malaria diagnosis and treatment and ensuring consistent availability of malaria commodities, the PNLP, with support from the USAID-funded SIAPS Program, made a first significant step toward establishing the Procurement and Supply Management Technical Working Group (PSM-TWG) to help maintain a focus on coordinated forecasting and supply planning of malaria commodities, product availability, strengthening coordination among stakeholders, and reducing duplication and inefficiencies. The PSM-TWG comprises representatives from the PNLP, the Pharmacie Centrale de la Guinée, the Direction Nationale de la Pharmacie et du Médicament, Catholic Relief Services (the Global Fund’s Principal Recipient), and SIAPS.

Participants at the training workshop. Photo credit: Claude Bahati, SIAPS

Recognizing the need to equip PSM-TWG members with the knowledge and skills to efficiently manage the quantification process, the PNLP requested technical support from SIAPS for a training on quantification techniques and tools. In July 2016, SIAPS organized a five-day training workshop. This training, the first of its kind in Guinea, attracted 12 participants who were introduced to quantification methodologies and participated in hands-on training on best practice tools, such as Quantimed (a forecasting tool) and PipeLine (a supply planning tool). The training helped equip PSM-TWG members with the skills to quantify malaria commodities.

Building on the training outcomes, SIAPS/Guinea supported the PNLP to carry out a multiyear (2016–2021) quantification of antimalarial commodities that went beyond demographic data (as done in previous years) to include both consumption and morbidity/service-statistics data.

To ensure effective forecasting and supply planning, SIAPS took the following approach while engaging all in-country partners:

  • Determine the scope of the quantification (What to quantify?
    Who to quantify for? What period to quantify for?)
  • Identify data elements to be collected
  • Reach consensus with all stakeholders on required assumptions
  • Validate assumptions
  • Create and analyze forecast scenarios using both consumption and morbidity/service-statistics data
  • Generate and validate supply plans
  • Share the quantification results (including the technical report)

Results

Embedding robust processes and tools within national-level quantification efforts improves the quality of forecasts while increasing donors’ confidence in the country quantifications”

The quantification process led to the establishment of a multiyear forecast (2016–2021) and a three-year procurement plan of malaria commodities (2016–2018). The PNLP leveraged the quantification results and the supply plan, which was developed using SIAPS’s recommended approach, as an advocacy tool to secure more than 98% of the funding required for the procurement of malaria commodities between 2016 and 2018 from major donors (the President’s Malaria Initiative and the Global Fund to Fight AIDS, Tuberculosis and Malaria). Boosted by these achievements, the PNLP is currently reviewing its strategic plan (2012–2017), extending it on a five-year rolling scope, and developing the projected diagnostic and treatment needs and financial requirements using the quantification results. Using the new strategic plan, the PNLP hopes to attract more donors to cover the commodity gap through 2021.

Sustained Benefits

  • Embedding robust processes and tools within national-level quantification efforts improves the quality of forecasts while increasing donors’ confidence in the country quantifications.
  • The use of a systematic approach to quantification contributes to the knowledge base of malaria epidemiological trends and program metrics. This approach also helps to identify any gaps in essential data. Where gaps are found, recommendations are made to assist the PNLP and in-country partners identify suitable systems that collect the most significant information for quantification decision making.
  • Regularly monitored and updated supply plans offer the PNLP several benefits, including availability of malaria products when they are needed, reduced incidences of costly emergency orders, and reduced risk of product expiry.

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