17-185_OFDA-Training-Report_FINAL
17-185_OFDA-Training-Report_FINAL
Shiferaw, Gashaw
Nfor, Emmanuel
Joshi, Mohan
George, Alan
June 2017
Training on Pharmaceutical and Medical Commodities Supply Chain Management in Humanitarian Response Settings
This report is made possible by the generous support of the American people through the US
Agency for International Development (USAID), under the terms of cooperative agreement
number AID-OAA-A-11-00021. The contents are the responsibility of Management Sciences for
Health and do not necessarily reflect the views of USAID or USAID/OFDA or the United States
Government.
About SIAPS
The goal of the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program
is to ensure the availability of quality pharmaceutical products and effective pharmaceutical
services to achieve desired health outcomes. Toward this end, the SIAPS result areas include
improving governance, building capacity for pharmaceutical management and services,
addressing information needed for decision-making in the pharmaceutical sector, strengthening
financing strategies and mechanisms to improve access to medicines, and increasing quality
pharmaceutical services.
Recommended Citation
This report may be reproduced if credit is given to SIAPS. Please use the following citation.
Shiferaw G, Nfor E, Joshi M, George A. 2017. Training on Pharmaceutical and Medical
Commodities Supply Chain Management in Humanitarian Response Settings. Submitted to the
US Agency for International Development (USAID), Office of US Foreign Disaster Assistance
(OFDA), by the Systems for Improved Access to Pharmaceuticals and Services (SIAPS)
Program. Arlington, VA: Management Sciences for Health.
Key Words
i
TABLE OF CONTENTS
ii
ACRONYMS
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ACKNOWLEDGMENTS
The authors would like to acknowledge the support of the US Agency for International
Development (USAID)/Office of US Foreign Disaster Assistance (OFDA) pharmacists and the
humanitarian organizations that participated in the training for their invaluable input during the
preparation of the training materials and the training itself. We also would like to thank those
who completed the training needs assessment questionnaire.
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INTRODUCTION
Background
The Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program received
funding from USAID/OFDA to develop training materials and facilitate the Humanitarian
Pharmaceutical and Medical Commodities Supply Chain Management training for USAID/OFDA’s
partners in Jordan, Syria, Iraq, and Turkey. OFDA works closely with humanitarian aid partners to
provide relief to people affected by rapid-onset disasters. Since March 2012, OFDA has funded
international and regional nongovernmental organizations (NGOs) and development partners
operating out of Jordan, Turkey, Iraq, Yemen, and Libya to procure and supply pharmaceuticals and
medical commodities as part of humanitarian aid for victims of the Syrian conflict.
To accomplish this, OFDA requested technical assistance from SIAPS to develop training
materials and facilitate two rounds of training for staff of its collaborating humanitarian aid
partners and local and international NGOs. This training will help to ensure that appropriate
procurement and SCM is implemented for the delivery of quality-assured pharmaceuticals and
medical commodities to conflict-affected, internal, and cross-border displaced people. The
objectives of the training program were to build the capacity of humanitarian aid partner staff on
humanitarian SCM for the effective delivery of pharmaceuticals and medical commodities.
Scope of Work
After OFDA’s request was received, SIAPS prepared a concept note on the scope, approach, and
content of the training, which was submitted to OFDA (annex A). On the basis of the note, the
OFDA and SIAPS teams held a series of planning meetings to agree on SIAPS’ scope of work
and deliverables, the training target audience and venue, and the training agenda.
The summary scope of work for the training workshop on pharmaceutical and medical
commodities supply chain was as follows:
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Training on Pharmaceutical and Medical Commodities Supply Chain Management in Humanitarian Response Settings
• Make logistical arrangements for trainings. Gashaw Shiferaw and Olena Vlasyuk arrived
in Jordan on April 30 and May 1, 2017, respectively, to finalize training preparations,
including printing training materials and organizing the training venue. The rest of the
training team—Emmanuel Nfor, Mohan Joshi, and Alan George—arrived in Jordan on
May 4, 2017.
• Conduct a debriefing meeting with the OFDA team regarding final training materials,
training schedules, and partners’ reception at the beginning of the training.
2
TRAINING WORKSHOP ON HUMANITARIAN PHARMACEUTICAL AND MEDICAL
COMMODITIES SUPPLY CHAIN MANAGEMENT
The purpose of the training was to strengthen the pharmaceutical and medical commodities
procurement and supply chain operations of OFDA partners working in Syria, Jordan, Iraq,
Turkey, and Yemen for improved humanitarian responses to disasters/emergencies.
Following the request by OFDA, SIAPS staff conducted a series of meetings with OFDA and
developed a concept note that laid out the training goals, purpose, objectives, activities, intended
trainees, and deliverables (annex A).
To ensure that the training aligned with the needs of the target trainees, SIAPS conducted a
training needs assessment. Needs assessment questionnaires were developed, agreed upon by
OFDA, and shared with 89 individuals from 16 OFDA partner organizations. However, only five
individuals completed the training needs assessment. The agenda, goals, and objectives of the
training were finalized after considering the collected responses and information from a series of
discussions with OFDA.
A five-day training program was designed to address all components of pharmaceutical and
medical commodities SCM and rational medicine use, with an emphasis on responding to
different phases of humanitarian disaster situations. The title of the training workshop was
“USAID/OFDA Regional Pharmaceuticals and Medical Products Supply Chain
Management Training”. A training team comprising different areas of expertise within in SCM
and rational medicine use was established to develop the training materials. An activity
coordinator was assigned to coordinate the training team during the development of the
materials. The team then developed an activity plan with clear roles and responsibilities. A desk
review was conducted that covered SCM during emergency/humanitarian response as well as
supply chain and pharmaceutical management practices and resources in the private and public
sectors that are amenable to humanitarian situations. The training team prepared training
materials, including PowerPoint presentations and handouts, practical examples, learning
exercises, and case studies.
While the training materials were being developed, workshop logistics were also being
coordinated. The requirements for training venue, accommodations, printing of training
materials, and workshop materials were identified and procured. Two members of the training
team (Gashaw Shiferaw and Olena Vlasyuk) traveled to Jordan one week before the training to
finalize logistical arrangements. Meetings were held with OFDA prior to each workshop to
review progress, discuss any challenges, and finalize planned activities. Activities and timelines
were realigned based on new developments and priorities.
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Training on Pharmaceutical and Medical Commodities Supply Chain Management in Humanitarian Response Settings
The goal of the training was to build the capacity of USAID/OFDA partner organizations
working in the Middle East to effectively manage pharmaceuticals and other health commodities
in the context of humanitarian assistance.
The objective of the training workshop was to give participants the knowledge and skills to:
• Apply basic principles and skills for ensuring SCM functions during emergency
humanitarian assistance, including selection, quantification and procurement,
warehousing and distribution, logistics management information system (LMIS), supply
chain performance monitoring, and reverse logistics
• Define and apply data requirements to effectively run supply chain systems
• Describe the problem of irrational use of pharmaceuticals and strategies to improve the use
of pharmaceuticals and other health commodities, including the importance of coordination
Target Audience
The target audience for the training workshop was supply chain and program staff working for
OFDA partner organizations in the Middle East (Jordan, Turkey, Iraq, Yemen, Lebanon, and
Syria) in humanitarian response to crises caused by regional conflicts in Syria, Iraq, and Yemen.
The training comprised all functions of SCM and rational medicine use adjusted to humanitarian
disaster response settings and to OFDA requirements, policies, and procedures. A total of 26 sessions
were presented. Training materials were shared with participants on the first day of the training. To
facilitate effective training and to meet learning objectives, various training and adult learning
methodologies were employed. The following methodologies were used during the training.
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Training Workshop on Humanitarian Pharmaceutical and Medical Commodities Supply Chain Management
Lectures: This method, supported by PowerPoint slides, was used to create a general understanding
of each session and to allow interaction with participants. Each lecture consisted of the title of the
session, presentation outline, purpose and objectives, and technical content of the session and
included discussion questions, individual and group exercises, and summaries that prepared
participants for the next topic. During each lecture, participants were provided with handouts.
Figure 1. Emmanuel Nfor (left) and Mohan Joshi (right) lecture to participants
Group discussion, exercises, and other activities: This method was used to increase learning
opportunities through experience sharing among participants, group and individual exercises,
group activities, and entertaining a variety of viewpoints among participants. After group
discussions or exercises, each group was given time to reflect on the outcome of their work. At the
end of each individual or group presentation, a panel of discussants was given a chance to reflect
on the presentation and exchange ideas. Case studies and exercises were designed to emulate
participants’ practical work situations. This helped participants to collectively make decisions.
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Training on Pharmaceutical and Medical Commodities Supply Chain Management in Humanitarian Response Settings
Plenary sessions: Plenary sessions were used as part of the training to give more time and a
platform for participants to ask questions and get clarification. This method was used for sessions
on quantification, procurement, OFDA pharmaceutical waste management procedures, and the
importance of coordination for rational medicine use. In addition, a general plenary session was
held at the end of the five-day training workshop to review training goals, objectives, and
participants’ expectations. During this session, facilitators discussed with participants whether the
goals and objectives of the training were achieved. In addition, participants’ expectations were
reviewed, and participants reflected on whether those expectations had been met.
Facilitators’ daily appraisal meetings: The SIAPS and OFDA teams held an appraisal meeting
at the end of each day of training. During these meetings, lessons learned and recommendations
for improving the next day’s training were discussed and agreed upon.
The training workshop was designed to achieve the goals and objectives described above. Two
consecutive five-day workshops were organized. A reception was held the night before the
technical content of each of the two workshops began. During the reception, participants were
welcomed and all participants and facilitators introduced themselves and described their
professional responsibilities and the organization they represented. In addition, participants were
asked about their expectations for the workshop and shared their organizations’ experience in
SCM during a humanitarian response to a crisis. The next day, the workshop opened and OFDA
and SIAPS officials gave remarks. The training goals, objectives, and schedule were presented
by Emmanuel Nfor (annex B).
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Training Workshop on Humanitarian Pharmaceutical and Medical Commodities Supply Chain Management
Figure 3. Kathleen Downs, USAID/OFDA, (left) and Emmanuel Nfor, SIAPS, (right)
gave opening remarks
• Understand how OFDA sees a supply chain compared to how partners see it
• Learn from others’ experiences on how they comply with policies, common
problems/obstacles, and best practices
• Learn from others’ experiences with understanding policies and working with
nonprequalified vendors
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Training on Pharmaceutical and Medical Commodities Supply Chain Management in Humanitarian Response Settings
• Get a refresher on LMIS best practices, including how to provide better support to
beneficiaries using an LMIS
• Receive guidance on how to resolve challenges and bring solutions to the field
• Share knowledge and gain information that will allow for better team management
• Understand the limitations for purchasing certain medicines using OFDA funds
Training Activities
This section of the report contains a description of the activities that took place during the
training workshop.
Day One
On day one, after the pretest was administered, the technical training activities started. Topics
covered on day one were:
OFDA Operational Requirements, Policies, and Proposal Guidelines: This session was
presented by OFDA. The purpose was for participants to become familiar with the
USAID/OFDA pharmaceutical and medical commodity subsector. Participants were expected to
understand the OFDA pharmaceutical regulations; use the OFDA proposal guidelines,
particularly the subsector dealing with pharmaceuticals, to submit acceptable descriptions in
proposals; and effectively use the pharmaceutical annexes to submit acceptable documents when
requesting funds for procurement. This session emphasized OFDA requirements, policies, and
procedures related to pharmaceutical procurement and SCM as this was an area that nearly all
participants expressed an interest in.
Introduction to Health Commodity Supply Chain Management: The purpose of this session
was to introduce terminology and objectives related to pharmaceutical and medical commodity
SCM so that participants and facilitators would be on the same page when SCM was discussed.
Participants were expected to describe the objectives of humanitarian supply chains or logistics.
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Training Workshop on Humanitarian Pharmaceutical and Medical Commodities Supply Chain Management
Selection of Medicines and Other Health Products and the Concept of Essential Medicines:
The purpose of this session was to introduce the concept of medicine selection and demonstrate
the value of a limited list of essential medicines in disaster management settings. Participants
were expected to explain the basis and criteria used for medicine selection; explain the value of
essential medicines and how they impact medicine supply and use; and outline the importance of
the OFDA EML. Topics included the rationale and benefits of selecting a limited list of essential
medicines; processes for selecting essential medicines and categorization for different levels of
care; linkages between EMLs and standard treatment guidelines; why EMLs are especially
critical during humanitarian emergencies; indicators to monitor the use of EMLs in disaster relief
settings; and internationally recognized essential medicines/medical device lists (e.g., the World
Health Organization’s (WHO) model list, OFDA list, interagency lists). At the end of the
session, a case study was shared with participants.
Quantification of Health Commodities: In this session, which included forecasting and supply
planning, participants were introduced to the definition, processes, and applications of
quantification; how to identify problems caused by poor quantification; and common challenges
during quantification. In addition, there were discussions on different methods of forecasting, data
requirements, assumption building, and how to choose appropriate methods of forecasting. This
session was supplemented by examples and group exercises on forecasting and supply planning.
Day Two
Day two started with participants presenting their work from the day one exercises on
quantification. Facilitators then walked participants through the exercises and clarified questions.
Introduction to Health Commodity Procurement: The purpose of this session was to introduce
the concepts of procurement as part of the overall supply chain before discussing procurement
during humanitarian disaster situations. Also discussed in this session were the principles and
different methods of procurement and challenges of poor procurement practices.
Procurement Transparency: Special agents from the Office of the Inspector General (OIG)
presented findings from several investigations into procurement integrity during humanitarian
crises in the Middle East. In this session, investigative priorities, including procurement fraud,
bribery and kickbacks, diversion to armed groups, misconduct by USAID personnel, ring-type
theft activity, and corruption targeting beneficiaries, were discussed. Investigated cases on
procurement fraud, bribery, and kickbacks were presented. The most common fraud schemes
found around health programs were:
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Training on Pharmaceutical and Medical Commodities Supply Chain Management in Humanitarian Response Settings
The Procurement Cycle and Processes in Conventional and Disaster Relief: The purpose of
this session was to clarify the sequence of the procurement cycle and identify minimum
requirements to follow during humanitarian disaster relief operations. Output from each
procurement process was presented. Also discussed in this session were the unique challenges
related to the procurement process during humanitarian disaster relief and the contributing
factors to and possible strategic interventions for the challenges. This session also highlighted
that 65% of resources are spent on procurement of pharmaceuticals and other supplies, and that
special attention needs to be given to managing such a large proportion of resources.
Automated Directive System 312: The purpose of this session was to familiarize participants
with the requirements of the USAID Automated Directives System (ADS), Section 312 (ADS
312). Topics discussed during this session included the definition and purpose of ADS 312, a list
of restricted commodities, requirements for purchasing pharmaceuticals with USAID funding,
and approval processes. In addition, a list of USAID/OFDA authorized sources for
pharmaceuticals was shared.
Plenary Session on Quantification and Procurement Challenges: During this plenary session,
participants shared common challenges that each organization encountered in the quantification
and procurement of health commodities for humanitarian disaster relief and interventions they
used to address those challenges. On quantification, the most common challenges highlighted
were the availability of data on the anticipated target population to estimate demands and a lack
of internal and external coordination. Participants also mentioned that to address such
challenges, they communicate with host country governments and UN agencies. During the
discussion, facilitators highlighted the importance of regularly reviewing quantification
exercises to compare the forecast results with the actual data and making adjustments
accordingly. Facilitators also emphasized the importance of coordination for quantification.
Regarding procurement, the most common challenges raised by participants were the limited
number of prequalified suppliers and long procurement lead times. Additional prequalified
suppliers, revisions to long-term framework agreements, and improvements in relationship with
suppliers were emphasized as intervention to address the challenges.
Receipt and Inspection, Good Storage Practices, and Distribution of Health Commodities:
Minimum standards for receipt, inspection, and good storage and distribution practices for
health commodities were discussed during this session. The session was supplemented by
individual exercises and plenary discussions. It was also emphasized that during disaster relief
situations, organizations need to maintain the quality, security, and integrity of health products
in different kinds of storage facilities, such as schools and community centers.
Day Three
Day three was largely dedicated to inventory management and LMIS, including tools and
records used to capture information about pharmaceuticals and health commodities. In these
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Training Workshop on Humanitarian Pharmaceutical and Medical Commodities Supply Chain Management
sessions, different types of inventory management systems and their parameters were discussed.
In addition, factors affecting the selection of the inventory management system and
considerations during humanitarian responses were discussed. Facilitators emphasized the
importance of setting up flexible/nimble inventory control holding policies based on maximums
and minimums across all levels of an organization’s supply chain. The importance of inventory
records, different categories of inventory records, and important data points that should be
captured were discussed. In particular, it was underscored that organizations need to improve
end-to-end data visibility on pharmaceuticals and health commodities by tracking at different
levels (from suppliers to beneficiaries). The sessions were supplemented by group activities
focusing on how to set up inventory control systems and mapping LMIS data and processes,
followed by group presentations.
Day Four
On day four, participants were trained on routine LMIS data quality monitoring, its
capabilities, and how to ensure data quality throughout the process. Another session focused on
basic supply chain reports. Best practices on innovative approaches for LMIS using current
technologies were demonstrated. At the end of the LMIS data quality monitoring session, an
activity was conducted on how to identify and address data quality issues. In addition,
pharmaceutical waste minimization, reverse logistics, disposition of pharmaceuticals, and
OFDA requirements on pharmaceutical waste were presented. A general discussion on
challenges on pharmaceutical waste was facilitated by OFDA. The last session of the day was
“The problem of irrational use of medicines”. In this session, an overview of the global
problems of irrational medicine use was presented. This session also discussed the extent and
types of irrational medicine use, underlying factors, consequences, and potential reasons for the
increase of irrational medicine use during humanitarian disasters.
Day Five
On the last day of the training workshop, strategies to improve the use of medicines and the
importance of coordination in promoting rational medicine use in humanitarian emergencies
were discussed. Four strategies to improve medicine use were highlighted (educational, managerial,
regulatory, and economic). Other sessions focused on WHO-recommended core intervention,
rational medicine use indicators, and the United Nations High Commissioner for Refugees’
emphases on the use of standard treatment guidelines. The above sessions were complemented by a
plenary discussion on challenges and possible solutions regarding rational medicine use during
humanitarian emergencies. Among other topics, this plenary session discussed the use of standard
treatment guidelines, adherence to medications, and the use of medicines and technologies for
chronic noncommunicable diseases in humanitarian response settings.
The technical sessions for the training workshop concluded with a general discussion session that
looked at participants’ expectations of SIAPS and USAID/OFDA. In this session, the training
goals, objectives, and participant’ expectations were reviewed. Participants confirmed that the
training goals and objectives were achieved and their expectations were met.
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Training on Pharmaceutical and Medical Commodities Supply Chain Management in Humanitarian Response Settings
During this discussion, participants were asked how they could use the knowledge and skills they
acquired in the training workshop and what USAID/OFDA and SIAPS should expect from them
after this training. Participants responded as follows:
• Share skills (on quantification, procurement, and supply management), experiences, and
knowledge within their organization’s team/staff members and among implementing
partners working at different locations
• Ensure that supply chain staff get involved in the early stage of proposal development
• Involve different stakeholders, including IT and program staff, when designing an LMIS
• Build supply chain systems and strategize priorities during an emergency response; at the
operational level, link programs with supply chain units (coordination within the project)
• Use the knowledge and skills acquired in the workshop to develop procurement and SCM
policies and procedures
• Review the existing supply chain system through focused group discussion with partners
• Collect and analyze data on rational medicine use and plan and implement improvements
• Put systems, tools, and indicators in place for procurement and supply chain performance
measurement
• Comply with OFDA requirements and make informed supply chain decisions
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Training Workshop on Humanitarian Pharmaceutical and Medical Commodities Supply Chain Management
A post-test was administered to evaluate the knowledge and skills acquired during the training
workshop using the same questions asked in the pretest (annex C). The results of the pre- and
post-test analysis are presented below.
General Observations
In the first round of the training, all 29 participants took both the pre- and post-tests; 11
participants (37.9%) were female. In the second round, not all of the 23 participants took both
pre- and post-test: 22 took the pretest, 20 took the post-test, and 19 took both the pre- and post-
tests. The percentage of female participants in the second round was 21.7% (n=5). The pre- and
post-test results showed sizeable improvements in knowledge and skills in both trainings.
Among first-round participants, 89.6% showed an average improvement of 28.9% in their post-
test result, while 73.6% of participants in the second round demonstrated an average
improvement of 20.5%.
Three participants in the first round and two in the second round earned the same scores on both
tests. In addition, post-test results for three participants from the second round showed an average
decline of 8.3% from the pretest. Figures 4 and 5 show the pre- and post-test scores by participant.
73.3%
57.2%
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Training on Pharmaceutical and Medical Commodities Supply Chain Management in Humanitarian Response Settings
82.1%
68.2%
Note: Participants P1, P2, and P11 took only the pretest, while participant P23 took only the post-test.
Score Range
First round—Among all participants, the number scoring 60% or lower decreased from 18
(62.1%) on the pretest to five (17.2%) on the post-test; the number of participants scoring 61% or
higher increased from 11 (37.9%) on the pretest to 24 (82.8%) on the post-test. No participant
scored higher than 80% on the pretest; however, four participants (13.8%) scored 81% or higher
on the post-test. The highest score achieved on the post-test was 90% by two female participants.
Second round—The number of participants scoring 60% or lower decreased from seven (31.8%)
on the pretest to one (5.0%) on the post-test; the number scoring 61% or higher increased from
15 (68.2%) on the pretest to 19 (95%) on the post-test. The percentage of participants who scored
81% or higher increased from 13.6% (n=3) to 55% (n=11); four participants scored between 90%
and 95%. The highest score on the post-test was 100% by two participants. Tables 1–4 show the
number and percentage of participants with the range of scores and genders for both trainings.
Table 1. Summary Range of Scores from Pre- and Post-test (First Round)
Score Range Pretest Results Post-test Results
No of participants No. of participants
Percentage (n=29) % of participants (n=29) % of participants
0–20% 1 3% 0 0%
21–40% 2 7% 0 0%
41–60% 15 52% 5 17%
61–80% 11 38% 20 69%
81–100% 0 0% 4 14%
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Training Workshop on Humanitarian Pharmaceutical and Medical Commodities Supply Chain Management
Table 2. Summary Range of Scores from Pre- and Post-test (Second Round)
Score Range Pretest Results Post-test Results
No. of participants No. of participants
Percentage (n=22) % of participants (n=20) % of participants
0–20% 0 0% 0 0%
21–40% 1 5% 0 0%
41–60% 6 27% 1 5%
61–80% 12 55% 8 40%
81–100% 3 14% 11 55%
Table 3. Summary Range of Scores from Pre- and Post-test by Gender (First Round)
Score Range Pretest Results Post-test Results
Male participants Female participants Male participants Female participants
Percentage (n=18) (n=11) (n=18) (n=11)
0–20% 6% 0% 0% 0%
21–40% 6% 9% 0% 0%
41–60% 67% 27% 28% 0%
61–80% 22% 64% 67% 73%
81–100% 0% 0% 6% 27%
Table 4. Summary Range of Scores from Pre- and Post-test by Gender (Second Round)
Score Range Pretest Results Post-test Results
Male participants Female participants Male Female participants
Percentage (n=17) (n=5) participants (n=15) (n=5)
0–20% 0% 0% 0% 0%
21–40% 6% 0% 0% 0%
41–60% 24% 40% 7% 0%
61–80% 53% 60% 33% 60%
81–100% 18% 0% 60% 40%
In the first round, all participants showed an improved response on 18 of 20 questions on the
post-test. However, the number of participants who answered questions 5 and 20 correctly
decreased on the post-test. The proportion of participants who answered question 5 correctly
decreased from 69% on the pretest to 59% on the post-test, while for question 20, correct
responses decreased from 79% to 72%. A marked increase in the correct post-test response was
observed on questions 3 and 16 by 164% and 125%, respectively.
In the second round, a marked increase in the correct post-test response was observed on
questions 14 and 6 by 120% and 395%, respectively. Questions 8, 18, 19, and 20 were most
often answered correctly, with 90% of participants answering them correctly. Figures 6 and 7
show the percentage of participants who answered pre- and post-tests questions correctly and the
changes of responses in first and second rounds of training.
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Training on Pharmaceutical and Medical Commodities Supply Chain Management in Humanitarian Response Settings
100%
80%
60%
40%
20%
0%
Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 Q9 Q10 Q11 Q12 Q13 Q14 Q15 Q16 Q17 Q18 Q19 Q20
Post-Test Pre-Test
100%
80%
60%
40%
20%
0%
Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 Q9 Q10 Q11 Q12 Q13 Q14 Q15 Q16 Q17 Q18 Q19 Q20
Post-Test Pre-Test
Participant Expectations
During the evening reception, participants were asked about their expectations for the training
workshop (annex D). At the end of the workshop, facilitators displayed the goals, objectives, and
expectations from participants to review whether the goals and objectives had been achieved and
the expectations met. All participants responded that the goals, objectives, and expectations had
been met. This was reinforced by their feedback in the course evaluation.
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Training Workshop on Humanitarian Pharmaceutical and Medical Commodities Supply Chain Management
Evaluations were administered at the end of each workshop. In the first round, 82.7% of the 29
of participants responded that the training workshop met its set goals and objectives. This
proportion increased to 90% of 20 participants during the second round. One participant in the
second round mentioned that only 80% of the set goals and objectives of the training workshop
had been met.
When asked if they would recommend the training course to their colleagues, 96.6% from the
first round and 95% from the second round responded affirmatively. One participant (3.4%) from
the first round would not recommend the training. This participant expected more specific
training about the Middle East regional supply chain context.
4.6
4.4
4.2
4.0
3.8
3.6
3.4
3.2
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
Overall
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Training on Pharmaceutical and Medical Commodities Supply Chain Management in Humanitarian Response Settings
4.8
4.7
4.6
4.5
4.4
4.3
4.2
4.1
4.0
3.9
3.8
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CHALLENGES AND OPPORTUNITIES
• The response rate on the training needs assessment survey was low, with five of 16
organizations (31%) participating in the assessment.
• Addressing all components of the pharmaceutical SCM cycle in just five days of training
resulted in the workshops being too intense for both trainers and participants.
• The target audience for the workshops on the invitation letter was not specific enough.
• During the workshops, participants discussed several challenges around data collection for
forecasting and supply planning, including delayed and burdensome custom processes in
country, insufficient coordination and poor communication with local stakeholders, and short
funding and procurement cycles.
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LESSON LEARNED
• For future workshops, consider adding more time for the training and including more
practical sessions for participants.
• Communication with partner organizations about goals and objectives of the workshop as
well as target audience requirements was a major challenge for both SIAPS and OFDA and
needs to be addressed for future workshops.
• Experiences and participants’ feedback from the first round helped to shape the second round
sessions by translating SIAPS’ development experience into the humanitarian disaster
response context.
• Coordination among humanitarian aid organizations was found to be helpful for sharing
information and avoiding duplication.
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RECOMMENDATIONS
• Facilitate another round of training for partners in Yemen and others who did not have the
opportunity to participate in these workshops.
• USAID/OFDA partner organizations could operate more effectively if they designed their
supply chain systems to better respond to disasters.
• It would be helpful to have a shared supply chain information repository for all OFDA
partners working in disaster response in the Middle East for improved sharing of knowledge
and challenges.
21
NEXT STEPS
• Revamp the training needs assessment to align with target audiences and ensure that
appropriate individuals respond to the needs assessment.
22
ANNEXES
Concept note
September 21, 2016
Pharmaceutical procurement and supply management training for
USAID/OFDA humanitarian aid implementing partners
Background
The United States Agency for International Development’s Office of Foreign Disaster
Assistance (USAID/OFDA) works in close collaboration with humanitarian partners to provide
relief to people affected by rapid onset disasters. It is in this light that USAID/OFDA,
beginning in March 2012, has funded international and regional nongovernmental
organizations (NGOs) and development partners operating out of Jordan and Turkey to procure
and supply pharmaceuticals as part of humanitarian aid for victims of the Syrian conflict.
However, most of the NGOs and partners who work with USAID/OFDA face significant
challenges in pharmaceutical procurement and supply management, as well as difficulties
complying with USAID/OFDA policies and funding/donation guidelines. Therefore,
USAID/OFDA seeks to ensure excellence in its operations and programs and continues to push
for significant changes to establish a humanitarian system that is more nimble, effective, and
accountable.
It is in this light that USAID/OFDA has requested technical assistance from the USAID |
SIAPS Program to develop a curriculum and use it to train staff of its collaborating
humanitarian aid partners and local and international NGOs in order to assure appropriate
procurement and supply of quality pharmaceuticals to conflict-affected people in Syria.
Activity Purpose
The purpose of this activity is to ensure that knowledge and skills of supply chain personnel
managing health products to internal and cross-border displaced people requiring humanitarian
aid due to Syrian conflicts are adequate to ensure compliance with USAID regulations and
permit the delivery of quality, safe, and effective pharmaceuticals for this target population.
23
Training on Pharmaceutical and Medical Commodities Supply Chain Management in Humanitarian Response Settings
Objectives
Subobjectives:
a) Assess procurement and supply chain management, quality assurance, and appropriate
use competencies for OFDA partners and NGOs that are responding to disaster caused by
Syrian conflict.
c) Facilitate two (or four?) training workshops, subject to OFDA approval, one (or two) in
Jordan and the other (one or two) in Turkey using the developed curriculum.
2. Improve partner and NGO compliance with OFDA funding proposal and procurement
guidelines. SIAPS will work with OFDA to ensure that curriculum includes a section on
funding proposal and procurement guidelines.
Intended audience
Deliverables
Technical Resources
• One SIAPS Senior Technical Advisor and one SIAPS Technical Advisor to support
assessment, curriculum, and materials development
24
Annex A. OFDA Partners’ Training Concept Note
• Three SIAPS Principal Technical Advisors (limited LOE) to support planning and review of
deliverables
• Two SIAPS Principal Technical Advisors, one Senior Technical Advisor, and one Project
Support Associate to support delivery of workshops
• Two quality assurance consultants (from Quamed) to be engaged by SIAPS
• Two USAID/OFDA Technical Staff to support delivery of workshops (not funded by SIAPS)
Budgetary Assumptions
USAID/OFDA suggested that 50 participants be trained in one workshop in each country, Jordan
and Turkey. However, SIAPS considers this number is too large, compromising effective
transfer of competencies during a workshop. 25–30 is a more manageable workshop size,
allowing better facilitator-participant interaction. Therefore, SIAPS proposes as an alternative to
organize four workshops: two back-to-back workshops in each country, two of the workshops
are assumed to be held in Istanbul and the other two in Amman.
Therefore, two budget scenarios have been developed (Scenario #1): two 50-participant
workshops, one in Amman and the other in Istanbul, and (Scenario #2): four 25-participant
workshops, two in Amman and two in Istanbul.
25
ANNEX B. GOALS, OBJECTIVES, AND AGENDA
Goal:
The goal of this training is to build the capacity of USAID/OFDA partners working in the
Middle East in the context of humanitarian assistance to effectively manage pharmaceuticals and
other health commodities.
Objectives:
2. Apply basic principles and skills of different supply chain management functions during
emergency humanitarian assistance: Selection, Quantification and Procurement,
Warehousing and Distribution, logistics management information system (LMIS), and
Supply Chain Performance monitoring
4. Define and apply data requirements to effectively run supply chain systems
6. Give an overview of irrational use of pharmaceuticals and strategies to improve the use of
pharmaceuticals and other health commodities, including the importance of coordination
26
Annex B. Goals, Objectives, and Agenda
WORKSHOP AGENDA
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Training on Pharmaceutical and Medical Commodities Supply Chain Management in Humanitarian Response Settings
28
ANNEX C. PRE- AND POST-TEST
Name Organization
Instruction: Read each question carefully and choose the best answer from the choices
provided
2. Which of the following is CORRECT regarding buying medicines that are NOT on the
OFDA EML?
a) Need to request an exception with signed justification
b) Need separate request for each pharmaceutical exception
c) Including exceptions in the request may slow the review and approval process, and there
is no guarantee of approval
d) All of the above
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Training on Pharmaceutical and Medical Commodities Supply Chain Management in Humanitarian Response Settings
6. Which of the following data points is not required for the consumption method of
forecasting?
a) List of health commodities with full specifications
b) Dosage information
c) Reliable records of consumption/issue
d) Estimation of days out of stock
10. Which of the following is NOT true about pharmaceutical and medical commodity
procurement?
a) Procurement is an integral part of the supply chain
b) Strategic objectives of good procurement can be achieved through better procurement
unit organization, skilled manpower, adequate laws and regulations, and efficient
management of processes and procedures
c) By following the principles of good procurement practices it is not possible to increase
effectiveness and efficiency of procurement and achieve objectives
d) Both visible and invisible costs should be considered when determining total costs of
procurement and value for money
11. All of the following with regard to procurement are correct EXCEPT:
a) Procurement within humanitarian operations is not subjected to unique challenges
b) Uncertainty, lack of demand visibility, and lack of alternatives are some of the
procurement challenges during humanitarian situation
c) Alternative speed of deliveries and changes in urgency could be requirements during the
procurement process for humanitarian organizations
d) Decisions regarding procurement strategies impact effectiveness and efficiency, e.g.,
local vs. global
30
Annex C. Pre- and Post-test
13. FEFO:
a) Is a manner of managing products that prioritizes the use/distribution of products in the
order in which they were received
b) Is a strategy for calculating resupply quantities
c) Is a manner of managing products that prioritizes the use/distribution of products closer
to the expiration date
d) Is a strategy for simultaneous order picking in the warehouse
15. One of the following is NOT true about reverse logistics and pharmaceutical waste:
a) Reverse logistics is the opposite of forward logistics
b) Multiple dynamics complicate the concept of reverse logistics
c) Moving usable and unusable products, recovering value, and reducing hazards are some
of the activities in reverse logistics
d) Waste minimization reduces cost associated with reverse logistics
16. In a periodic review inventory control system, which one of the following parameters is
the trigger for placing new orders
a) Minimum stock level
b) Review period
c) Maximum stock level
d) Desired stock level
17. Which of the following statements is NOT true about inventory management
a) Proper inventory management ensures that the right quantities of the right products are in
stock at the right time and available to dispense to users as needed
b) The basic parameters to set up inventory control systems are consumption, stock on hand,
and losses/adjustments
c) Inventory control systems set the rules for stock-keeping practices within a country,
organization, warehouse, or clinic
d) Inventory management systems need to be flexible, especially in rapid onset
humanitarian disasters
18. Which of the following records should be used to track information about products?
a) Stock keeping records
b) Transaction records
c) Consumption records
d) All of the above
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Training on Pharmaceutical and Medical Commodities Supply Chain Management in Humanitarian Response Settings
20. Which of the following is a factor that contributes to poor medication adherence by
patients?
a) Poor affordability on the part of the patient
b) Poor communication between health provider and patient
c) Adverse drug reactions
d) All of the above
32
Annex C. Pre- and Post-test
33
ANNEX D. PARTICIPANTS’ EXPECTATIONS
First-round participants
2. Learn from others’ experiences on how they are complying with policies, common
problems/obstacles, and best practices
7. More efficient way of managing a supply chain while complying with regulations
11. More guidance on how to resolve challenges and bring solutions to the field
Second-round participants
3. Learn from others’ experiences on how they are complying with policies, common
problems/obstacles, and best practices
6. Share knowledge and get information that will allow for better team management
10. Understand why we cannot purchase certain medicines using OFDA funds
34
ANNEX E. TRAINING WORKSHOP EVALUATIONS
a) Evaluation questions
Session Evaluations
Thank you for attending the workshop. We’d like to hear your impression of the various aspects
of the training so that we can continually improve the experience. It is VERY IMPORTANT that
you complete the “overall rating of the sessions”
I. General:
1. Has this training workshop met its set goals and objectives? ______
Comment (optional):
2. Would you recommend this course to your professional colleagues?
3. Which part of the training did you like the most?
4. What do you think should be improved?
5. General comment:
II. Please rate and comment on the following sessions:
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Training on Pharmaceutical and Medical Commodities Supply Chain Management in Humanitarian Response Settings
1 2 3 4 5
Session 9: Introduction to procurement Poor Excellent
1 2 3 4 5
Session 10: The procurement cycle and processes in Poor Excellent
conventional and humanitarian disaster relief 1 2 3 4 5
Session 11: Procurement planning Poor Excellent
1 2 3 4 5
Session 12: Automated Directives System (ADS) 312 Poor Excellent
1 2 3 4 5
Session 13: Receipt and inspection Poor Excellent
1 2 3 4 5
Session 14: Introduction to distribution Poor Excellent
1 2 3 4 5
Session 15: Good storage practices Poor Excellent
1 2 3 4 5
Session 16: Inventory management Poor Excellent
1 2 3 4 5
Session 17: Inventory control records Poor Excellent
1 2 3 4 5
Session 18: Introduction to logistics management Poor Excellent
information systems 1 2 3 4 5
Session 19: Routine LMIS data quality monitoring Poor Excellent
1 2 3 4 5
Session 20: Supply chain reports and information use Poor Excellent
1 2 3 4 5
Session 21: Pharmaceutical waste minimization and reverse Poor Excellent
logistics 1 2 3 4 5
Session 22: Disposition of pharmaceuticals and OFDA Poor Excellent
requirements 1 2 3 4 5
Session 23: The problem of irrational use of medicines Poor Excellent
1 2 3 4 5
Session 24: Strategies to improve the use of medicines Poor Excellent
1 2 3 4 5
Session 25: Importance of coordination in promoting rational Poor Excellent
medicine use 1 2 3 4 5
Session 26: Plenary discussion on challenges and possible Poor Excellent
solutions regarding rational medicine use during 1 2 3 4 5
humanitarian emergency
Session 27: What’s expected from participants after this Poor Excellent
training—discussion session 1 2 3 4 5
Overall rating of the workshop: Poor Excellent
1 2 3 4 5
36
Annex E. Training Workshop Evaluations
Question Comments
1. Has this training • In the first round, of 29 participants, 82.7% answered positively to this
workshop met its set question; another 10.3% felt the training objectives were partially met;
goals and objectives? one participant (3.4%) answered negatively; and another participant
(3.4%) did not answer
• In the second round, 95% of 20 participants considered that the
objectives of the workshop were met; one participant said that 80% of
the objectives were met
2. Would you recommend • In the first round, one participant (3.4%) mentioned that he/she would
this course to your not recommend this training to colleagues. This participant expected
professional colleagues? more specific training about the Middle East regional supply chain
context.
• Among second-round participants, 95% responded that they would
recommend this workshop to colleagues. One participant (5%) did not
answer this question.
37
Training on Pharmaceutical and Medical Commodities Supply Chain Management in Humanitarian Response Settings
38
Annex E. Training Workshop Evaluations
39
Training on Pharmaceutical and Medical Commodities Supply Chain Management in Humanitarian Response Settings
P P P P P P P P P P P P P P P P P P P P P P P P P P P P P Aver
Session
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 age
1 4 5 5 5 4 5 4 4 5 4 5 4 5 5 5 3 5 5 4 5 4 5 4 4 5 4 2 5 5 4.4
2 4 5 5 5 4 5 4 5 4 5 5 4 5 4 5 3 5 5 4 5 4 5 4 4 4 4 3 2 5 4.3
3 4 5 5 5 5 4 4 2 5 4 4 5 4 4 4 3 5 4 5 5 4 4 4 4 4 3 5 5 4.3
4 4 5 5 4 4 4 4 1 4 4 4 4 4 3 4 3 5 4 3 3 5 5 4 4 3 2 4 5 3.9
5 3 5 5 4 4 4 4 2 4 5 5 4 5 3 4 4 4 4 4 5 4 5 4 4 3 4 4 4 3 4.0
6 4 3 4 4 5 5 3 4 4 4 4 4 4 4 4 3 4 5 4 5 3 5 3 4 3 3 4 3 5 3.9
7 3 4 5 4 4 5 3 3 5 4 4 4 4 4 4 3 4 4 3 5 3 5 2 4 4 3 4 3 5 3.9
8 3 5 5 4 4 4 3 2 5 4 4 4 4 4 4 3 4 4 3 5 3 5 4 4 4 3 3 3 5 3.9
9 4 5 5 4 3 5 3 2 4 3 5 4 4 4 4 3 4 4 4 5 3 5 4 4 3 3 2 3 4 3.8
10 4 5 5 4 4 5 3 2 4 3 5 4 4 4 4 3 3 4 4 5 2 5 4 4 3 3 2 3 4 3.8
11 3 5 5 4 4 4 3 2 5 3 4 4 4 5 3 3 4 4 4 5 3 4 4 4 3 3 2 3 4 3.7
12 4 4 5 4 3 5 4 3 4 4 4 3 3 4 3 3 3 4 4 5 2 4 3 3 3 4 5 4 3.7
13 3 5 5 4 3 4 3 4 5 4 4 4 4 4 4 3 3 4 3 5 3 4 4 4 4 4 1 3 3.8
14 3 5 5 4 4 4 3 3 4 4 5 4 5 4 4 3 4 5 3 5 3 5 5 4 4 4 1 4 3 3.9
15 3 5 5 4 4 4 3 3 4 4 4 4 5 5 4 3 5 5 4 5 4 5 5 4 5 4 1 4 4 4.1
16 3 5 5 4 4 5 3 3 4 5 4 4 5 5 4 3 5 4 4 5 3 5 5 4 5 3 2 3 4 4.1
17 3 5 5 5 4 5 3 2 4 5 4 4 5 5 4 3 4 4 3 5 3 5 5 4 5 3 4 3 3 4.0
18 4 3 5 5 4 5 3 2 5 4 5 3 4 3 3 4 4 4 5 4 5 4 5 4 3 3 3 3 3.9
19 4 3 5 5 4 5 3 1 4 3 5 3 4 3 3 4 3 4 5 4 4 4 5 4 3 4 2 4 3.8
20 3 5 5 4 4 5 3 1 4 4 5 4 4 4 3 3 5 3 4 5 3 4 3 5 4 3 3 3 3 3.8
21 3 5 5 4 3 4 3 3 3 4 4 5 5 4 3 3 4 4 5 4 5 4 4 5 4 4 3 3 3.9
22 3 5 5 5 3 5 3 4 3 3 4 4 5 5 4 3 3 4 4 5 4 4 4 4 5 4 4 5 5 4.1
23 4 5 5 5 3 5 4 4 4 4 5 4 5 5 4 3 3 5 4 5 3 5 4 4 5 4 5 3 5 4.3
24 4 5 4 5 4 4 4 2 4 4 5 4 5 5 4 3 5 4 4 5 3 5 4 4 4 5 4 3 5 4.2
25 4 5 4 5 4 4 4 3 3 4 5 4 5 5 4 4 4 4 4 5 4 5 3 4 4 5 3 2 5 4.1
26 4 4 4 5 4 5 5 4 5 4 5 3 5 5 4 4 4 4 4 5 3 4 4 4 3 4 3 2 4 4.1
27 4 4 5 5 4 5 4 3 4 4 5 4 3 5 4 4 4 4 3 5 4 4 4 4 3 4 1 2 4 3.9
Overall 4 5 5 5 4 5 2 4 4 5 4 5 5 4 3 4 4 4 5 3 5 4 4 4 4 3 3 4 4.1
40
Annex E. Training Workshop Evaluations
Session P 1 P2 P3 P4 P5 P6 P7 P8 P9 P 10 P 11 P 12 P 13 P 14 P 15 P 16 P 17 P 18 P 19 P 20 Ave
1 5 5 5 5 4 5 5 4 4 5 5 5 5 4 4 4 5 4 5 5 4.7
2 4 5 5 5 5 5 5 4 4 4 5 4 5 4 4 4 4 4 5 5 4.5
3 4 5 4 5 4 5 5 4 4 5 5 4 4 4 4 4 4 5 4 5 4.4
4 5 5 5 5 5 5 4 3 4 5 5 3 4 4 5 4 5 4 4 4.4
5 5 5 5 5 5 5 5 4 5 5 5 4 4 5 5 4 4 4 5 5 4.7
6 5 5 5 5 5 5 4 3 5 5 5 4 3 5 5 5 5 3 5 5 4.6
7 5 5 5 5 5 5 4 3 5 5 5 4 3 5 5 4 5 3 4 5 4.5
8 5 5 5 5 5 5 4 4 5 5 5 4 4 4 5 4 4 4 5 5 4.6
9 5 5 4 5 4 4 4 4 3 4 5 4 5 4 4 4 5 4 4 5 4.3
10 4 5 5 5 4 5 4 4 3 4 5 4 4 4 4 4 5 4 4 5 4.3
11 4 5 5 5 4 4 4 3 3 4 5 4 4 4 5 4 4 4 4 5 4.2
12 4 5 5 5 4 4 5 3 4 4 5 4 3 4 4 4 4 3 4 5 4.2
13 5 5 5 5 4 5 5 4 4 4 5 4.5 4 4 4 4 4 4 5 5 4.5
14 5 5 5 5 4 5 5 3 4 5 5 4 4 4 4 4 5 5 5 5 4.6
15 5 5 5 5 4 5 5 3 4 5 5 4 5 4 3 4 5 5 4 5 4.5
16 5 5 5 5 4 4 5 4 4 5 5 4 4 4 4 4 5 5 4 5 4.5
17 5 5 4 5 4 5 5 4 4 5 5 4 4 4 3 4 5 5 4 5 4.5
18 4 5 4 5 4 5 5 4 4 4 5 4 5 5 4 4 5 5 5 5 4.6
19 5 5 3 4 4 5 5 4 4 5 5 4 4 4 4 4 4 3 4 5 4.3
20 5 5 4 5 4 5 5 4 4 5 5 4 4 4 3 4 4 4 4 4.3
21 5 5 3 5 5 5 5 4 4 5 5 4 5 5 4 4 5 4 5 4 4.6
22 4 5 4 5 4 4 5 3 5 5 5 4 5 5 4 5 5 5 4 5 4.6
23 5 5 4 5 4 5 5 4 4 5 5 4.5 4 5 4 5 5 5 5 5 4.7
24 5 5 4 5 4 5 4 5 5 5 4 4 5 5 4 4 5 4 5 4.6
25 5 5 4 5 5 5 3 4 4 5 5 4 4 4 4 4 4 4 5 5 4.4
26 5 5 4 5 4 4 5 3 3 4 5 4 4 4 4 4 5 4 5 5 4.3
27 5 5 4 5 4 5 5 3 3 5 5 4 5 5 4 4 5 3 5 5 4.5
Overall 5 5 4 5 4.5 5 5 4 4 5 5 4 5 4 4 4.5 4 4 5 4.5
41
Training on Pharmaceutical and Medical Commodities Supply Chain Management in Humanitarian Response Settings
First round
Second round
42
Annex F. List of Participants
Abdikarin
13 Jalal Abdul Rahman jabdulatef@immap.org UNICEF
14 Olexander Babanin babanino@who.int WHO
15 Waad Adel Ahmed ismailwa@who.int WHO
Ismail
16 Ines Morgan imorgan@worldrelief.de World Relief Germany
17 Abdelhadi Eltahir Abdelhadi_eltahir@wvi.org World Vision
18 Elie Diab elie_diab@wvi.org World Vision
19 Joel Thorpe joel_thorpe@wvi.org World Vision
20 Zaidoun Hijazeen XXXXX FAO
21 Mohammad Awad* Mohammad.Awad@rescue.org IRC
22 Nafis Khan* Nafis.Khan@fao.org FAO
23 Michele DiBenedetto* Michele.DiBenedetto@fao.org FAO
* These participants attended only a few days of the training at the beginning.
43