Identified bottleneck | Proposed action | Key stakeholders |
---|---|---|
Lack of appropriate IFA need forecasting | Standardized demand forecasting based on accurate estimates of district needs and previous consumption | SHS, BMSICL, District Officialsa, District Storekeeper, Block Officialsb, Block Storekeeper, ANM |
 | Computerization and clear documentation of inventory, stock requests, and expiry dates | SHS, BMSICL, District Officialsa, District Storekeeper, Block Officialsb, Block Storekeeper, ANM |
 | Estimates to include lactating women population; IFA distribution and counseling standard | SHS, BMSICL, District Storekeeper, Block Storekeeper, ANM, ASHA, AWW |
Late supplier deliveries resulting in inconsistent supply | Utilization of updated BMSICL policy to deduct payment upon late delivery, damaged stock, etc.c | SHS, BMSICL, District Officialsa, District Storekeeper |
Indents not being utilized nor perceived as effective | Training and monitoring to assure indent use and effectiveness | SHS, BMSICL, District Officialsa, District Storekeeper, Block Officialsb, Block Storekeeper, ANM, ASHA |
Perceived or actual inability to procure IFA when needed through local purchasing | Explore use of untied funds through Rogi Kalyan Samiti or others to purchase IFA locally in times of shortage | SHS, BMSICL, District Officialsa, District Storekeeper, RKS, Block Officialsb, Block Storekeeper, ANM, ASHA |
Lack of buffer stock use at all levels | Implementation, monitoring, and evaluation of existing buffer stock requirementsd | SHS, BMSICL, District Officialsa, District Storekeeper, Block Officialsb, Block Storekeeper, ANM, ASHA |
 | Ensure adequate storage facilities so stock can be stored safely | SHS, BMSICL, District Officialsa, District Storekeeper, Block Officialsb, Block Storekeeper, ANM |
No safe disposal plan for expired medicines and pushing of expiring drugs to patients and frontline workers | Transparent plan to prevent expired medicines through appropriate purchasing practices and safe disposal of expired medicines | SHS, BMSICL, District Officialsa, District Storekeeper, Block Officialsb, Block Storekeeper, ANM, ASHA |
Storeroom transiency and disorder | Construct, purchase, or long-term rental of adequate storerooms. Funding for racks, labels, and shelves. | SHS, BMSICL, District Officialsa, District Storekeeper, Block Officialsb, Block Storekeeper, ANM |
 | Training for storekeepers including storeroom order and inventory protocols. | SHS, BMSICL, District Officialsa, District Storekeeper, Block Officialsb, Block Storekeeper |
Inconsistent training on IFA counseling/distribution across FLW types | IFA counseling/distribution training for all frontline workers who work with pregnant women | Block Officialsb, ANM, ASHA, AWW |
 | Training for all frontline workers together at health sub-centre level to improve coordination and communication | Block Officialsb, ANM, ASHA, AWW |