Fullscreen

  • Transportation of Supplies under NTEP

    Content

    Timely procurement and an uninterrupted supply of medicines and other consumables are important requirements for the successful implementation and sustainability of the programme. 

    In a vast country like India where >70% of the population resides in rural areas, it is a challenge to transport sputum samples, drugs, consumables and other items on time and subsequently may result in delayed diagnosis and treatment initiation. 

    To combat this, the National TB Elimination Programme (NTEP) developed a multi-sectoral engagement strategy and entered into agreements with various ministries like the railways, road transport, aviation and communications for transportation of NTEP supplies and specimen transport across the countries through one of these modes.

    Various Transportation Modes Utilised under NTEP for the Transport of Drugs and Other Supplies

    Transportation Service

    Activity

    Indian Railway

    The railway network is utilised for the supply of drug consignments from State/ District drug stores to far-flung areas. Ministry of Railways has also extended support to NTEP in terms of supply chain management and technical support for the implementation of TB-related activities across the country through railway medical services.

    Indian Postal Services 

    Provides universal access to the rapid diagnosis of TB by specimen transportation from peripheral health facility to TB diagnostic laboratory, maintaining specimen quality while also respecting the timelines; delivering drugs across the country; and also fulfilling the submission of the TB notification forms to the Nodal Officer.

    Air Transport Services

    NTEP undertakes the transportation of the equipment as well as drug consignments through air cargo from various warehouses to the State Drug Stores on a routine basis as well as during emergencies.

    In some situations, where the sputum specimens are required to be transported to the reference laboratories from various parts of the country, air transport of specimens is carried out to ensure efficient and timely testing.

    Couriers

    Third-party courier services are identified by NTEP in almost every district in the country and are given the responsibility to transport supplies and specimens from one centre to another while strictly adhering to the guidelines. The District TB Officer (DTO) is responsible for ensuring the quality of the transportation process through these courier services.

    Government Vehicles

    Vehicles are provided to the Senior Treatment Supervisor (STS)/ Senior TB Laboratory Supervisor (STLS) which are utilised in supply chain management, i.e., to deliver medicines to patients' homes as well as to collect samples for testing and follow-up, from the patients in their homes.

    Third-party Logistics (3PL)

    Central TB Division (CTD) has offered 3PL services at the district level where the agency is providing the transport services to pick the supplies from the District Drug Stores (DDS) and supply them to the TB Unit (TU) level. At present, 3PL service is being offered to all the DDS under the NTEP. 

     

    Significance

    • Utilising the existing government facilities for the transport of supplies is a cost-effective strategy.

    • Quick transportation of specimens can lead to effective TB testing and enhance the resulting output. 

    • Early diagnosis and treatment initiation can contribute to minimising the further transmission of disease.

    • Strengthening the NTEP's supply chain management system to ensure the last-mile delivery of drugs.

    • Timely availability of drugs and other related supplies can majorly contribute to the treatment outcome.

    • Reaching out to the key populations served by various ministries such as workers, miners, migrants, tribal populations, women & children, etc. who are also highly vulnerable to TB.

     

    Resources

    Assessment

    Question    

    Answer 1    

    Answer 2    

    Answer 3    

    Answer 4    

    Correct answer    

    Correct explanation    

    Page id    

    Part of Pre-test    

    Part of Post-test    

    Which of the following services does India Post provide in collaboration with NTEP?

    Initiation of treatment

    Changing treatment regimen

    Transport of sputum specimens and other supplies.

    All of the above

        3

    Indian post supports NTEP in specimen transportation from peripheral health facility to TB diagnostic laboratory as well as in the supply of drugs and other items.

        

       Yes

     Yes

     

  • Key considerations during transportation of Supplies

    Content

    Transportation in a supply chain refers to the movement of products from one location to another, which begins at the start of the supply chain as materials make their way to the warehouse and continue all the way to the end-user.

    The following considerations should be kept in mind before transporting the supplies:

     

    Packaging

    Proper packing of supplies is the most important aspect of transportation. Following are the components of good packaging:

    • Labelling: All the supplies should be labelled properly before transportation. The important information which should be displayed on the labels include product name/ content, product strength (for drugs only), batch number, date of manufacturing, date of expiry, and storage conditions requirement. Safety instruction in the form of labels (like fragile, temperature-sensitive, direction) should be pasted on the boxes.
    • Radio Frequency Identification (RFID)/ Barcode Scanning: Barcoding of packages before transporting ensure better tracking of the packages. In addition, entering data using barcoding is fast and reliable, significantly reduces human error and increases efficiency, and easy identification of product information.
    • Security: Supplies that are damaged upon arrival can cause major problems. Not only do we lose the cost of the original item and shipping, but we may also have to send replacements at an additional cost. Hence, it is important that the supplies are packed in such a manner that the packaging keeps them safe during the transit.
    • Storage Conditions: Majority of the supplies transported under National TB Elimination Programme (NTEP) are temperature sensitive and fluctuations above or below the manufacturer’s labelled storage temperature range may adversely affect product quality. Hence, the supplies should be transported in such a manner that the transportation temperatures meet manufacturer’s instructions.  

     

    Resources

     

     

    Assessment

    Question​

    Answer 1​

    Answer 2​

    Answer 3​

    Answer 4​

    Correct answer​

    Correct explanation​

    Page id​

    Part of Pre-test​

    Part of Post-test​

    Why is barcode important during transportation of drugs?

    Fast and reliable data entry

    Decreases scope for human error

    Makes product identification easy

    All the above

    4

    For ensuring better tracking and supply chain management, the packages should ideally be bar coded before transporting. Use of barcodes offer the following advantages:

    • Entering data using bar coding is fast and reliable

    • Significantly reduces human error and increases efficiency

    • Easy identification of product information.

     

    YES

    YES

  • Supply to DDS/TU

    Content

    The following supplies are sent to the District Drug Store (DDS)/ TB Units (TUs):

    1. Anti-TB drugs (first and second-line):

    Drugs once received by the State Drug Store (SDS) are transported to the districts. The districts then transfer the drugs to the TUs which in turn supply them to the Peripheral Health Institutes (PHIs).

    1. Diagnostic materials

    The following diagnostic materials will be supplied by the SDS to the DDS and TUs:

    • Cartridge-based Nucleic Acid Amplification Testing (CBNAAT) machines and cartridges
    • Truenat machines and chips
    • Binocular Microscopes (BMs) and Light Emitting Diode (LED) Fluorescence Microscopes (FM)
    • Laboratory consumables: Sputum containers, slides, and 50 ml centrifuge tubes.
    1. Treatment-related supplies

    These include the following:

    •  Syringes
    •  Needles
    •  Water for injections
    •  Water containers
    •  Disposable tumblers, etc.
    1. Stationery, forms, Information, Education and Communication (IEC) materials

    Different registers, forms, and IEC material will also be supplied from the SDS to the DDS/ TUs.

     

    Transportation

    The states may hire Third-party Logistics (3PL) for transporting these supplies to the DDS and TUs.

     

    Resources

     

    Assessment

    Question​

    Answer 1​

    Answer 2​

    Answer 3​

    Answer 4​

    Correct answer​

    Correct explanation​

    Page id​

    Part of Pre-test​

    Part of Post-test​

    What is included in the supplies from the SDS to the DDS and TUs?

    Diagnostic materials

    Anti-TB drugs and treatment-related supplies

    Stationery, forms, IEC materials

    All the above

    4

    The supplies from the SDS to the DDS and TUs include diagnostic materials, anti-TB drugs, treatment-related supplies, stationery, forms and IEC materials.

     

    Yes

    Yes

  • Supply from TU to PHI

    Content

     

    Based on the reports from Ni-kshay Aushadhi, the stock is supplied from SDS to the district drug store to its Tuberculosis Units (TUs) and then to the Peripheral Health Institutions (PHIs).

    This is done through the transport agencies which is hired from  Central /State level.

    Below is the details of transport mechanism from SDS TO DDS & DDS TO TU.

     

     

    Figure 1. Operational flow from SDS TO DDS

     

     

    Figure 2. Operational flow from DDS TO TU

    Resources

    1. Standard Operating Procedure Manual Procurement & Supply Chain Management RNTCP, MoHFW, GoI 2018

          

    Assessment:

    Question​

    Answer 1​

    Answer 2​

    Answer 3​

    Answer 4​

    Correct answer​

    Correct explanation​

    Page id​

    Part of Pre-test​

    Part of Post-test​

    PHI Stocks will be given for

    One month

    first month along with a reserve stock of one month

    Two month along with a reserve stock of one month

    Three month

     2

    PHI Stocks will be given for first month along with a reserve stock of one month