Continuous Results Monitoring and Support System Report—SIAPS/Sierra Leone, September 2016

A total of 104 health facilities were assessed using a comprehensive checklist based on selected service and system indicators. The exercise was conducted by five teams comprising members of the district health management team and other stakeholders. The purpose of the report is to highlight the findings and observations of the CRMS exercise. The CRMS evaluation examined different indicators that focused on stock availability, consumption, expiry, number of patients treated, availability and performance of pharmaceutical information tools, storage conditions, staffing, training, and supervision. The exercise involved observation, interviews, and review of documents/tools used to document dispensing, supply chain, and other related information. The CRMS evaluation will be conducted in all districts and facilities every quarter to achieve continuous performance improvement. Preliminary findings have indicated several good practices, challenges, and gaps that need immediate attention. A total of 37,391 patients visited the facilities, with 54% under the age of five and 46% age five or above. Among the patients, 34,493 were treated for malaria, and acute respiratory infections (ARIs) comprised approximately 60% of all conditions treated, followed by diarrhea and sexually transmitted infections (STIs) at 15% each. The availability, consumption, and expiry status of 68 tracer products representing antimalarials, antimicrobials, reproductive health/family planning (RH/FP) products, gastrointestinal (GIT) and antiparasitic medicines, antiseptics, medical supplies, and other miscellaneous medicines were the focus of the exercise. The findings indicate that the health facilities in Bombali District have a good stock availability of essential medicines, with 95% of the facilities having a stock level of 3-6 months. However, the consumption rate of some medicines is high, indicating a potential stock-out risk. The CRMS exercise also examined the performance of pharmaceutical information tools, including the Pharmaceutical Management Information System (PMIS). The findings indicate that the PMIS is not fully functional in all facilities, and there is a need for training and support to improve its performance. The exercise also highlighted the importance of proper storage conditions, with 80% of the facilities having a temperature-controlled storage area. The CRMS evaluation will be conducted in all districts and facilities every quarter to achieve continuous performance improvement. Following the report production, a review meeting of key stakeholders and partners will be conducted to examine the findings and observations of the report, address challenges, and set targets to be realized in subsequent CRMS exercises. Each district health management team will be the owner of the system and will have support and oversight from the Directorate of Drugs and Medical Supplies as part of its ownership and sustainability goal.