How many condoms do we really need?

I have spent the last two weeks in Lilongwe, Malawi, working with the Ministry of Health to help them quantify their national health commodity needs- from TB drugs to HIV test kits to contraceptives to oxytocin to paracetamol to x-ray films and everything in between! The quantification process involves a few steps that may sound easy but actually are quite challenging at a number of levels. This pict is of the quantification process that we put up on a flipchart for the week.

Quantification 101:
1) Collect your data: we needed to know number of products dispensed from all health facilities in the country over a one year period. Not too challenging except that two of the largest central hospitals didn't have their data complete and were on the phone trying to collect it while we were there. Imagine being the largest hospital in your town and using entirely paper records- no automated inventory records!?!? If you don't have data on the quantities dispensed, we need information on the number of cases you treated. This data is even harder to come by!

2) Take your data and make projections into the future for expected consumption. So....if you don't have good historical data, your forecast numbers might not be that great either!

3) Take your forecast quantities and compare those to how much you have on hand in the country now. For example, from physical inventory data we need to know how many condoms are in Malawi at the beginning of 2011, how many are scheduled to arrived, and how much have we forecast? Will we end the year with any extra? with a negative balance? This helps us determine how much we need to order. Try to imagine getting stock on hand data for 600 health facilities using a paper-based system.

4) Cost out the order quantities that you have determined and present those figures to the Ministry and partners to determine who will buy what.

Seems relatively simple but it's not when the data you have is not complete!

We did the best we could and documented all of our assumptions and processes so that next year's forecasting team will be able to take what we did and build from there.

Below are a few picts of some of the different quantification teams by commodity group!



Malawi hasn't been all work and no play. I've been fortunate to have a few colleagues here with me to enjoy a few meals with and lots of laughs. Rich(a retiree who is still working for us now and again) and his wife Margie (an independent consultant in health financing), my colleague Farouk, our Senior Lab Advisor in Zambia, Amanda, a regional logistics advisor based in Kenya, and Chris Warren, a DC based advisor, are all here with me! And we've got our local staff of course!

Check out a few more photos here. Especially those of of me, Farouk, Rich and Margie, Chris and Willy (our local Malaria advisor) out at Surf 'n Turf on Friday night to celebrate being finished with the quantification exercise.

Off to Tanzania on Tuesday!