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Consultant: CMS Standard Operating Procedures Development

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Consultant: CMS Standard Operating Procedures Development Request for Proposals Capacity Building and Access to Medicines (CBAM) Afghanistan

Technical Activity: Developing standard operating procedures for the Afghan Ministry of Public Health Central Pharmaceutical Storage Warehouse – Central Medical Stores (CMS)

Timeframe: February - July 2012 Location: Kabul, Afghanistan Amount of Contract: Negotiable DEADLINE FOR COMPLETE PROPOSALS (Including workplan and budget): DECEMBER 20, 2011 to Julia Wight atjwight@hpicafghanistan.ca

A.Introduction

Health Partners International of Canada (HPIC) is a humanitarian not-for-profit relief and development organization dedicated to improving access to medicine and enhancing health in the developing world. Currently HPIC is conducting a project to build the capacity of the national health sector in Afghanistan through the Capacity Building and Access to Medicine (CBAM) project. The goal of the CBAM project is to support the Ministry of Public Health (MoPH) in Afghanistan to effectively ensure greater and more equitable access to priority pharmaceuticals and medical supplies for all Afghans with a specific emphasis on women and children. HPIC is the implementing partner in the CBAM project, and as part of the project, has agreed to develop and implement standard operating procedures (SOPs) for the Central Medical Stores (CMS).

The CMS, operating under the MoPH General Directorate of Administrative Affairs (GDAA), is the national warehouse storing and managing pharmaceuticals and medical supplies for public health facilities, and is an integral part of the pharmaceutical distribution system in Afghanistan. It is a complex storage and distribution facility that requires a pharmaceutical stock management system that meets international best practice standards in-order to effectively and efficiently coordinate the supply of pharmaceuticals and medical supplies throughout Afghanistan. Such a system requires the development and implementation of SOPs to support existing systems and to determine and direct the operations and processes of the CMS. Currently, such written formal SOPs do not exist.

Without existing SOPs, HPIC recognizes that the development of SOPs at the CMS that are both logical, complete, and meet international best practice standards, will be a process that may take several years and several stages of development to achieve. As part of this long term approach to facilitating incremental development of SOPs at the CMS, this consultancy aims to develop a minimum of 700 to 1000 SOPs that follow international best practice standards. As the CMS moves forward in adopting international best practice standards for SOPs, the SOPs that are developed from this consultancy will create a foundation for the CMS management and staff to continuously review and revise, and to create further SOPs in the future. HPIC has begun the SOP development process by producing written procedures documenting the stock management process in the CMS; these were completed over the past year and a half. From these written procedures, thematic categories have been identified to be used as organizational and logical guides when developing SOPs. The 10 SOP thematic categories are as follows:

  1. Control
  2. Donation
  3. Inspection
  4. Maintenance
  5. Registration
  6. Reporting
  7. Returns and Damages
  8. Safety
  9. Stock Security
  10. Storage Registration

Please note that HPIC recognizes that SOPs for the thematic categories of database, environment and human resources will need to be developed, however these are currently outside of the scope of this RFP, as they will require highly specialized expertise in their specific fields.

Each of the 10 SOP thematic categories listed above will be developed based on the following defined thematic sub-categories of SOPs; thus ensuring that all the levels of administration, management and integration of SOPs are considered during the development process:

  1. Administrative – SOPs that are concerned with the clerical, documentation and management activities of the CMS.
  2. Physical – SOPs that are concerned with the labour-intensive activities of the CMS.
  3. Technical or Political (ToP) – Any SOP that requires a specific specialization or expertise in its design or implementation, most notably in stock/warehouse management, and/or any SOP that is of a sensitive nature and/or that requires advocacy to policy/decision makers for revision.

This consultancy will develop the Administrative, Physical and ToP SOPs based on international best practices for pharmaceutical stock management in all 10 thematic categories of SOPs; the minimum number of total SOPs expected by HPIC to be developed is between 700 and 1000 SOPs.

The SOP development process will require close collaboration with the CMS management and staff, and HPIC staff in Kabul. The CMS standard operating procedures development process for this contract is to begin February 1, 2012 and be concluded by the end of July 31, 2012. This includes reviewing the written procedures and pre-existing SOPs, conducting supplementary research, writing the Administrative, Physical and ToP SOPs, and presenting the completed SOPs to HPIC and the MoPH. Please note, that there is a potential for another contract around the provision of training in the SOPs that are developed following this RFP.

B. Background / Rationale for Assignment

During current efforts to rebuild Afghanistan it has been vital to address the provision of quality healthcare, especially for women and children. Crucial to this has been ensuring that Afghan health facilities are supplied with sufficient quality pharmaceuticals and medical supplies. The CMS acts as the direct link between health facilities and the rest of the national pharmaceutical and medical supply chain. However after decades of war, it’s capacity to act as this link has degraded through neglect and the daily realities of limited resources and complex management systems. In a 2008 report, the European Commission commented that the CMS is “highly disorganized, unprofessionally managed and far removed from exhibiting good storage practice.” In addition, in February 2010, HPIC conducted an assessment study of the CMS to identify the infrastructure and capacity needs of the CMS and found that stock management procedures at the CMS were undocumented and failed to reflect internationally approved standards. The CMS management system is lacking, and current procedures are done on a somewhat ad hoc basis, with little standardization or documentation. The lack of SOPs leaves the CMS unable to exhibit good stock management practices, thereby raising questions of accountability and effectiveness in the eyes of international donors, as well as the MoPH. This also causes disruption in the supply of pharmaceuticals and medical supplies to Afghan health facilities. To address this concern, HPIC is working to improve the CMS’ management system, with special attention to developing CMS SOPs.
To date, HPIC has begun the initial stages of SOP development within the CMS through producing written procedures describing current CMS procedures, which began in 2010 and was completed in early 2011. The CMS written procedures documented by HPIC cover the following areas of activities in the CMS: control, donation, inspection, registration, reporting, returned and damaged, and storage registration. Additional procedures that are relevant to the CBAM project and will need to be developed and documented as procedures are: maintenance, safety, and stock security. Beginning in May 2011, HPIC staff began to develop the initial versions of Administrative and Physical SOPs of the CMS; 14 Registration SOPs, 4 Reporting SOPs and 1 Returns and Damaged SOP, for a total of 19 SOPs, have been developed. These 19 SOPs have been reviewed and refined to provide the preferred language, content, style, and logical sequencing that HPIC has determined will be used as the model for all CMS SOPs.

To meet the demands of the SOP development process, it has been determined that a consultant experienced in the development of pharmaceutical warehouse SOPs that require a high level of detail and logical sequencing, will be required. As cross-cutting themes of the CBAM project, all of the SOPs will have gender sensitive and environmentally sound practices and conduct integrated into them where applicable.

Goal and Objectives

The GOAL of the CMS Standard Operating Procedures Development consultancy is to develop SOPs for the CMS based on international best practices for pharmaceutical stock management, in order to increase the capacity of the CMS management and staff to operate the CMS in an organized, effective, and efficient manner.

Objectives 1. The consultant will spend time at the CMS to observe the pre-existing procedures and processes for the purpose of gaining a complete understanding of the CMS system a. The consultant will review the HPIC written procedures to further understand the existing CMS procedures; b. The consultant will review the 19 prepared SOPs by HPIC and will provide feedback, to ensure the format and content are suitable as a model for all CMS SOPs; c. The consultant will facilitate regular meetings in partnership with HPIC with select CMS staff and management and GDAA representatives to discuss the SOP development process and begin a discussion regarding potential changes or improvements to pre-existing procedures and processes at the CMS, with particular attention given to the processes contained in the written procedures. (This committee will reconvene regularly during the consultant’s in-Kabul work to discuss and agree upon potential changes or improvements when necessary.)

For this objective, the consultant will work closely with HPIC’s Logistics Manager, whom will act as facilitator, translator and intermediary between the CMS/GDAA and the consultant.

  1. Develop and author Administrative, Physical and ToP SOPs based on the following thematic categor a. Control b. Donation c. Inspection d. Maintenance e. Registration f. Reporting g. Returns and Damages h. Safety i. Stock Security j. Storage Registration

a. A minimum number of total SOPs expected by HPIC to be developed is between 700 and 1000 SOPs.

b. All SOPs will follow the applicable international best practices and standards, with particular attention given to those by the WHO and guidelines provided by Management Sciences for Health (MSH) in Managing Drug Supply 2nd Edition.

c. As the ToP SOPs are developed, special attention should be given to the following factors:

a. Improving their efficiency; b. Implementing international best practices and standards, with particular attention given to those of the WHO. It should also be noted that the CMS follows the guidelines provided by MSH in Managing Drug Supply, 2nd Edition; these should also be followed; c. Ensuring buy-in and participation from CMS management; d. Reducing redundancies; and e. Streamlining content with the MoPH’s system.

Please note, given the potential to include sensitive content and recommendations for changes to existing procedures, HPIC anticipates that the ToP SOPS will require special attention. Therefore, these procedures will likely take more time to develop and will require many discussions with HPIC and the CMS management before implementation will begin. HPIC’s Logistics Manager will work alongside the consultant as facilitator, translator and intermediary.

  1. Provide HPIC a complete set of the CMS SOPs for review and feedback. The consultant should use the SOP format provided by HPIC if deemed suitable.

C. Methodology/Approach

  1. Parties Involved: During the assignment, work and collaboration will occur between the following actors:

a. SOP Development Consultant: HPIC anticipates engaging an individual that should have expertise in the following areas: i. Pharmaceutical stock management ii. Pharmaceutical stock warehousing iii. Standard operating procedure development iv. Adult education/training v. Warehouse safety vi. Fluency in English and Dari (both spoken and written) preferred

It would be preferable if the consultant is knowledgeable in any of the following: i. Risk mitigation ii. Gender equity iii. Environmental best practices

b. Stakeholders and Participants i. The CMS Management will have a participatory role and will be involved in providing insight, access to necessary documents, employees and facilities. They will hold a particularly important role when potential changes or improvements to existing processes are being determined.
ii. The CMS Staff will participate by providing insight into daily operations. iii. GDAA management will be kept informed throughout the SOP development process. Their comments and feedback regarding the content and format of the SOPs will be sought on a regular basis, and they will provide final approval of all SOPs prior to implementation at the CMS. iv. HPIC staff will provide guidance, clarification and support. v. Other stakeholders and participants as identified and required.

  1. Meetings: Before, during and after the assignment, the following meetings and contact between the commissioning organization and the consultant are planned: a. The consultant will confer with HPIC Canada staff to discuss and review the SOP development process.

b. The consultant will meet with HPIC Kabul staff to discuss and review the developed SOP written procedures and SOP models.

c. The consultant will meet with HPIC Kabul staff to present and agree upon a research strategy at the CMS to: 1) obtain information not contained within the written procedures; 2) determine SOP best practices; and 3) gather otherwise needed information for SOP development.

d. During in-Kabul SOP development, the consultant will meet with HPIC Kabul staff regularly, at minimum twice a week, to facilitate communication and to assess SOP development progress. These meetings will be supplemented by email and telephone calls when necessary; HPIC Canada staff will be included in all email communications.

e. During SOP development, the consultant will provide weekly update reports to HPIC Canada staff regarding SOP development progress.

f. The consultant will meet with HPIC Kabul staff to present the completed SOPs, and to ensure that all SOP gaps are filled and properly documented and that best practices have been followed.

  1. Methods

a. A variety of methods can be used for gathering information at the CMS for SOP development. These include, but are not limited to. i. Review of relevant CBAM and CMS Documents ii. Key Informant Interviews iii. Observation iv. Group discussions

b. Utilizing the SOP format provided by HPIC, the consultant will develop the SOPs.

  1. Resources Available: During the assignment, the consultant will have access to the following resources: a. The consultant will have access to an office space at HPIC Kabul, as necessary. b. HPIC Kabul will arrange necessary research aids (CMS meetings/tours, interviews, etc.). c. HPIC Kabul will provide printed documents as necessary.

D. Specific Tasks and Deliverables

  1. Task: The tasks for this consultancy will include the following: a. Preparation i. Review the SOP written procedures, the 19 prepared SOPs, Managing Drug Supply 2nd Edition, and relevant WHO documents ii. Prepare necessary research strategy at the CMS for gathering additional information needed for SOP development b. SOP development i. Implement research strategy at the CMS to gather additional information needed for SOP development ii. Using SOP format write Administrative, Physical and ToP SOPs

  2. Deliverables: The outputs of the assignment shall include: a. Completed Administrative, Physical and ToP SOPs for: i. Control ii. Donation iii. Inspection iv. Maintenance v. Registration vi. Reporting vii. Returned and Damaged viii. Safety ix. Stock Security x. Storage Registration

The minimum number of total SOPs expected by HPIC to be developed is between 700 and 1000 SOPs.

  1. Timeframes/Level of effort a. Preparation is to take 1 week beginning in early-February, 2012 b. Research at the CMS to take 3 weeks beginning in mid-February, 2012 c. Administrative and Physical SOP writing and formatting to take 2.5 months beginning in early-March 2012 d. TOP SOP writing and formatting to take 2.5 months beginning in mid-May 2012

  2. Deadlines: Due dates for various activity components a. Preparation to begin on February 1, 2012 and to be finished by February 9, 2012 b. In-Kabul work at CMS to begin on February 12, 2012 and to be finished by March 1, 2012 c. Administrative and Physical SOP development to begin on March 4, 2012 and to be presented to HPIC by May 17, 2012 d. TOP SOP development to begin on May 20, 2012 and to be presented to HPIC by July 31, 2012

  3. Reporting Procedures and Supervision The consultant will be responsible to reporting to the HPIC Senior Director and Program Manager in Canada as well as HPIC Kabul staff at various stages of the consultation. The communications structure may include emails, bi-weekly meetings, and telephone calls; the final structure will be determined once the consultant has been identified and the contract has been finalized. While working in Kabul, the consultant will work closely with HPIC’s Logistics Manager, whom will act as facilitator, translator and intermediary between the consultant and the CMS.

E.Remuneration and Terms of Payment 1.50% of the agreed costs will be paid upon signing of contract, 50% upon production of the completed SOPs. 2.If consultant is from outside of Kabul, HPIC will negotiate accommodations, travel arrangements and other associated costs.

The CBAM project proposes that the SOP development take place from February 1, 2012 to July 31, 2012.

F.Other Other information the consultant may need or other information specific to the assignment. 1. List of Reference Documents a. Managing Drug Supply 2nd Edition by Management Sciences for Health b. WHO Guidelines for Safe Disposal of Unwanted Pharmaceuticals in and around Emergencies

How to apply:

DEADLINE FOR COMPLETE PROPOSALS (Including workplan and budget): DECEMBER 20, 2011 to Julia Wight atjwight@hpicafghanistan.ca

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