HEALTH RESERVE WORKFORCE AND EMERGENCY MEDICAL TEAMS (EMTs)
ATTACHMENT 23 Standard Operating Procedure for Physical and Mental Health Monitoring of
C. Medical (Emergency Box)
2. Disaster Wound Care Kit
4.2 HEALTH LOGISTICS MANAGEMENT .1 Planning
Health logistics planning is the activity of determining the quantity and period of procurement according to the selection results to ensure the fulfillment of the appropriate criteria in terms of type, quantity, time, and efficiency, through the identification of needs, inventory availability, data collection, and analysis to produce minimum standards of needs in disaster management.
Planning is carried out at regular intervals with the aim of bringing planning calculations closer to actual needs, thereby avoiding shortages and ensuring the availability of drugs, which begins with the following activities:
1. Needs Identification a. Consumption Method
The consumption method uses data from the previous period's consumption with necessary adjustments. Calculations using the consumption method are based on the analysis of pharmaceutical consumption data in the previous period plus buffer stock, lead time stock, and taking into account remaining stock. Buffer stock can consider the possibility of changes in disease patterns and an increase in the number of visits (e.g., emergencies, disasters). The amount of buffer stock varies between 10% and 20% of the normal situation's needs. Meanwhile, lead time stock is health logistics stock needed during the waiting time from when the health logistics is ordered until it is received.
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Data that need to be prepared for consumption method calculations include a list of drug names, initial stock, receipts, expenditures, remaining stock, list of lost, damaged, and expired drugs, drug shortages, average drug use in one period, waiting time from when the drug is ordered until it is received (lead time), buffer stock, and visit patterns.
b. Morbidity Method
The morbidity method is the calculation of drug needs based on disease patterns. The morbidity method estimates the specific health logistics requirements based on the number of drugs and common disease incidents and considers standard treatment patterns for specific diseases. This method is generally carried out in scaled-up programs. This method is the most complicated and time-consuming because of the difficulty in collecting valid morbidity data on a specific range of diseases. However, this method remains the best method for procurement planning or estimating budgets for specialized health facility supply systems or new programs that have not had a history of drug use before. Factors to consider are the development of disease patterns and lead time.
Some things to consider in this method are:
i. The number of people to be served.
ii. The number of case visits based on disease frequency.
iii. The standard treatment guidelines used.
iv. Allocation of available funds.
In applying the morbidity method, auxiliary instruments for health logistics management can be used in the form of online and offline-based applications.
For example, during the COVID-19 pandemic in 2020, WHO introduced Essential Forecasting Supply Tools (ESFT) as an application that can predict health logistics needs for COVID-19 response, such as the need for coveralls, gowns, masks, and so on.
2. Inventory Availability
a. Mapping and data collection of logistics availability nationally, provincially, district/ city and community organization with its logistics resources;
b. Minimum health logistics needs per region (province/ district/ city);
c. Mobilization plans to address health logistics shortages in a region.
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Emergency health crisis planning involves identifying needs, inventorying availability, collecting data, and analyzing to produce minimum standard requirements for managing a health crisis. The purpose and objective of planning during a health crisis are to:
1. Determine the quantity and type of aid and equipment required;
2. Determine the number of victims of the disaster who require logistics and equipment assistance;
3. Determine the distribution method;
4. Identify aid recipients; and
5. Determine the time of aid delivery.
To achieve these objectives, the following steps need to be taken:
1. Inventory availability and needs. Data can be collected from:
a. Reports;
b. Recommendations from Rapid Health Assessment (RHA) Teams;
c. Mass media;
d. Requests from relevant instrumentalities;
e. Results of coordination meetings on information about the number of victims, IDPs, damage conditions, etc.
2. Identify Access and Transportation Modes to Affected Areas
During a disaster, an assessment is needed regarding access and transportation modes because often many accesses cannot be passed by vehicles. The transportation modes to be used are the result of this assessment. The assessment can be done by involving stakeholders in the affected area or information from related stakeholders.
4.2.2 Acceptance and/or Procurement
The provision of medical logistics can come from either acceptance or procurement. The provision of medical logistics and equipment during a health crisis situation is one of the vital elements in healthcare service during a crisis. Therefore, there needs to be a supply of medical logistics and equipment as a reserve in case of a health crisis. This supply must be available from the district/ city level, province level, and up to the national level. In addition to medical logistics and equipment from the national, provincial, or district/city level, usually, when a disaster/ health crisis occurs, various parties provide donations or assistance.
Most of the donations are given with noble intentions, which are to alleviate the burden of others, but these noble intentions are not always aligned in their implementation. Some examples include medical logistics sent that do not
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correspond to the type of disaster that occurred, the amount of medical logistics sent exceeds the need during the health crisis/ disaster, drugs sent that do not have the usual dose used by the recipient, human resources to verify the medical logistics assistance, and cross-sector coordination that has not been well-established. These issues will cause several consequences such as a stockpile or overstock of medical logistics, storage problems, security problems, and usage problems.
The process of accepting and/or procuring disaster response logistics and equipment starts from recording or inventorying including the category of logistics or equipment, where the aid was received, when it was received, what type of aid, how much quantity, how to use or operate the logistics or equipment delivered, and whether there is a request for whom this aid is intended.
The process of accepting and/or procuring logistics and equipment for health crisis response is carried out by the health crisis response organizers and must be inventoried or recorded.
Procurement aims to create procurement plans based on contingency plans and inventory availability in the area, and to make requests for logistics procurement to the procurement committee in accordance with regulations of the law.
The purpose of acceptance is to:
1. Determine the type of logistics received from various sources.
2. To match the needs with the availability of logistics.
3. Inform logistics according to the scale of priority needs.
4. As an effort to control and oversee the use of logistics.
5. To adjust in terms of storage.
Sources of acceptance and/or procurement of disaster response logistics and equipment can come from:
1. Domestically, including from the Government (state budget), the public, businesses, and non-governmental organizations.
2. Internationally, including from the Government, the public, businesses, and non- governmental organizations.
The acceptance and/or procurement process includes:
• The procurement process for health crisis response logistics and equipment is carried out in a planned manner, taking into account the type and amount of needs, which can be done through auctions, selections, and direct appointments in accordance with applicable regulations.
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• Acceptance of logistics and equipment through grants is carried out based on applicable regulations of the law, taking into account the conditions in an emergency situation.