Pharmacist: Monitoring of sub-stores

Monitoring is the process of observing whether an activity or service is occurring as planned or not.  It implies systematic and purposeful observation, aiming to identify any diversion from the planned course of action. It also helps to identify the need for more formal evaluation of activities and find timely solutions to the problems.

Monitoring of sub-stores (drug stores at Tuberculosis Unit/Peripheral Health Institution level)  in National Tuberculosis Elimination Programme (NTEP) is carried out by the officer-in-charge at the District Tuberculosis Centre(DTC).

Importance of monitoring of sub-stores

• Ensures uninterrupted supply of drugs and consumables
• Prevention of overstocking to avoid wastage of unusual resources leading to expiry of high value drugs.
• Prevention of stock-outs to avoid delay in treatment initiation. 

Resources

1. Supervision and Monitoring Strategy Document RNTCP - Ver 2  MoHFW, GoI 2011
2. Standard Operating Procedure Manual-Procurement & Supply Chain RNTCP , MoHFW, GoI 2019         

Assessment:

Monitoring of supply chain management is carried out by a two-tier monitoring system:

1. Central system- at central level, Central TB Division (CTD) reviews and ensures adequacy of drugs and consumables at State level.
2. Decentralized system- by the State TB Officers (STOs) and the District TB Officers (DTOs) whereas they ensure adequacy of drugs and consumables up to the level of the DOT Centers.

The various methods for monitoring include:

1. Store Visits

• Essential, as it checks the accuracy of store records and brings about an overhaul of the store section, especially its physical condition.   
• Ensures that the stores are well preserved against any damage or deterioration due to wrong storage or other hazards.

2.Physical Verification

• It is an audit requirement that physical verification of all stocks are carried out at least once in a year.
• Ensure that the quantity of drugs in the stock register/Ni-kshay Aushadhi matches with the physical stock balance in the drug store.
• Carried out under the supervision of officer-in-charge at the State, District Tuberculosis Centre(DTC), Tuberculosis Unit (TU) & Peripheral Health Institution (PHI) drug stores regularly at the end of each month.
• Any shortage or excesses should be substantiated by submission of a separate report and to be rectified in Ni-kshay Aushadhi after approval from competent authority.
•  The physical verification register/sheet should be verified by officer-in-charge and maintained at drug store.

3.Usage of Ni-kshay Aushadhi / desk monitoring

• Ni-kshay Aushadhi is an online web portal which ensures quality of data  the real-time monitoring of drugs and consumables availability, usage, requirement along-with expiry management.
• The various desks in Ni-kshay Aushadhi - acknowledge desk, dispatch desk, online transfer detail desk, issue to patient desk and return request desk, which help in monitoring the flow of drugs from various points. 
• CTD ensures drug adequacy at states/districts by reviewing stock availability through Ni-kshay Aushadhi which enables continuous monitoring of drug stock position at all levels.

Resources

1.Standard Operating Procedure Manual-Procurement & Supply Chain RNTCP, MoHFW, GoI 2019

2. NTEP training modules 5-9, Central TB Division, MoHFW, GoI 2020

Assessment:

Desk monitoring of supply chain

Desk monitoring of supply chain refers to the process of remotely monitoring drug stores in the network for their activities and performance. Under NTEP, this process can be done through Nikshay Aushadhi. Nikshay Aushadhi may help in real-time monitoring of supply chain by generating various reports related to consumption, requirement, and expiry management. Following are the ways that will enable the officer-in-charge to effectively monitor the supply chain through Nikshay Aushadhi.

Generation and Analysis of reports

Nikshay Aushadhi autogenerates a number of reports that keep a track of the stock availability, consumption, and expiry of supplies. These include Stock in Hand Record, Stock ledger report, expiry details report, Issue report, Stock ledger report, receipt register and issue register.

Analysis of the reports enable the Officer in-charge to ensure that adequate stock of supplies for consumption is available at the stores. At the same time, it will highlight the stores that are overstocked, understocked, or have supplies that have a near expiry date. This would allow the supervisor to take timely actions to ensure that these imbalances are corrected without any wastage.

Random checks

 In addition to reviewing and analysis of monthly/quarterly reports, the officer in-charge may randomly check the reports at any point in time to ensure that the records about the receipt and consumption of supplies are updated on real time basis.

Audit trails:

The officer in-charge can check the audit trails i.e., transaction related to the receipt and consumption of supplies by analyzing the reports to ensure that relevant records are maintained on real-time basis. The officer in-charge through this process would be able to check information about the receipt, consumption, and balance stock of any item in the inventory at random.

Performance of the sub-stores

Analysis of reports such as the enquiry status will enable the officer in-charge to assess the performance of the sub-stores in terms of their Nikshay Aushadhi usage status. Analysis of these records will help in determining whether the relevant entries are being done on real time basis or not. In addition to this, thorough inspection of the reports will give officer in charge a fair idea about quality and accuracy of the data entered by the sub-stores.

Any problems/gaps identified can be discussed with the sub-stores through regular video conferencing.

Resources

Standard Operating Procedure Manual Procurement & Supply Chain Management, Ministry of Health and Family Welfare, Government of India 2018

Assessment