The objective of the MSH/ SIAPS is to develop individual, organizational, and institutional capacities of in-country entities to manage key components of their national supply chains for essential public health commodities. The SIAPS project will support: 1) Governance: Support the MOHSW to establish policies, institute and implement pharmaceutical regulatory processes; strengthen the MOHSWs capacity to meet the GFs SCM requirements for disbursements of funds from Rounds 8 and 11. 2) Supply Chain Management of Commodities: Support the MOHSW to improve access to pharmaceuticals (HIV/ TB medicines and essential medicines), laboratory commodities and services, ensure good quality of pharmaceutical products and services through supporting rapid quality checks and updating the STGs. The project will support logistics for the Lesotho MBP. 3) M&E, Drug Surveillance: Support the management of ART, pharmaceutical and laboratory data through support for the Rx Solution, pharmaceutical management information system (PMIS) and laboratory logistics management information systems (LMIS). 4) Capacity Building: The PD and the SCM TWG will be supported in information based decision making; capacity of local pharmaceutical organizations will be built; NDSOs capacity for SCM will be strengthened to provide quality and essential commodities at all levels. The partner will continue to support the capacity building, pre service and in service training of pharmaceutical health personnel.

1) Baseline Assessment: MSH/ SIAPS will conduct a baseline assessment of current pharmaceutical capacity, needs and issues (at all levels), human resource capacity needs for supply chain management, identify supply chain tasks and functions by level of the supply chain, detect human resource gaps in terms of skills and numbers of staff.2) M&E, Drug Surveillance: Continue to support the management of ART, pharmaceutical and laboratory data through support for the Rx Solution inventory module (in NDSO), interphase of NDSO Rx Solution with National EMR pharmaceutical component in health facilities and MOHSW; and, implementation pharmaceutical management information system (PMIS) and laboratory logistics management information systems (LMIS).3) Information for decision making: Support the availability and utilization of information from Rx Solution in NDSO and National EMR for SCM logistics, quantification and forecasting of need. Adapt health data collection to mHealth devices (e.g. smart phones, mobile scanners at facility level for reporting ADRs, pharmaceutical logistics data and to strengthen down-referral systems for chronically ill patients. Use PMIS and laboratory LMIS to monitor outcomes of system strengthening activities, derive lessons learned, document and disseminate findings.4) Drug Surveillance: Revise and Track use of STGs and EML through HPTCs at all hospitals, Set up medicine utilization review programs for selected ARVs and essential antibiotics (OI utilization pattern). Establish systems for the PD, MOHSW for pharmacovigilance and tracking of ARV related events.

1) Governance: Support the establishment of favorable pharmaceutical policies, institute and implement pharmaceutical regulatory processes; advocate for pharmacovigilance frameworks development; strengthen the MOHSWs capacity to meet the GFs SCM requirements for disbursements of funds from Round 8 and Round 11, including the establishment of the Central Logistics Office, integration of existing parallel pharmaceutical service/ supply systems and ownership and utilization of the Rx Solution. Management support will be provided through TA to the PD and sustainable staff strength building/ advocacy. The PD and Logistic office will be supported in information based decision making. Provide TA to update the NMP and NMP-SAP.2) Supply Chain Management of HIV Commodities: Support the MOHSW to improve access to pharmaceuticals, laboratory commodities and services by improving forecasting and quantification (through the Central Logistics Office); storage and distribution of pharmaceutical, nutritional and laboratory commodities at central, district and facility levels; and, improving procurement process and quality of pharmaceutical products through supporting rapid quality checks and updating the STGs. The project will also support logistics for the Lesotho MBP.3) Capacity Building: Build the national and district capacity to handle logistics of SCM by supporting the SCM TWG or establishing a Logistics Office in the MOHSW; build the capacity of local pharmaceutical organizations, exploring PPPs in the pharmaceutical sector. NDSOs capacity for SCM will be strengthened to provide essential commodities to every health facility. Support the capacity building, pre service and in service training of health personnel for pharmaceutical and laboratory systems management. Supportive Supervision and Mentoring will be implemented for District Councils and hospitals to adhere to MOHSW guidelines and standard operating procedures for improved patient outcomes.4) PMTCT Acceleration: MSH/ SIAPS will support specific intervention strategies in Supply Chain Management, as outlined in the PMTCT Acceleration plan (Build National, local capacity; SCM strengthening), and establish a 'risk mitigation strategy' for stock outs.

(This budget code focuses specific OHSS activities (under the supply chain management component of the project) for NACS Integration and PMTCT Acceleration)

MSH/ SIAPS will provide TA to improve the overall national supply chain management including logistic management information systems and provide mentorship for quantification at central, district and facility levels, as a necessary step to reduce stock outs and for PEPFAR to provide HTC and PMTCT services unhindered in FY12. The MOH will be supported to provide overall coordination for this system through a central supply-chain management logistics office within the MOH PD or DDC. This office will be capacitated by IP and required to support the Family Health Division (FHD) and the MOHSW SCM TWG with quantification and forecasting of PMTCT and Nutrition products (required for the success of the PMTCT Acceleration Plan and the NACS Integration Plan), logistics for national SCM TWG meetings and developing contingency plans, in conjunction with the MOHSW and other stakeholders, for anticipated or emergent stock outs. TA will be provided to train the logistic officers in this department and eventual skills transfer to the PD of the MOHSW. Working closely with the PMTCT partner, IP will ensure that all levels of the SCM in Lesotho are strengthened to provide PMTCT and care and treatment services. The Essential Medicines List (EML) and Standard Treatment Guidelines (STGs) will be finalized and disseminated widely to all health facilities.

Supply-chain management for ARVs, prophylaxis, Lesotho Mother Baby Pack (MBP) or Minimum Package and nutrition commodities (RUTF, fortified milk, plumpy nuts, etc.) will be supported to ensure the complete PMTCT service package can be provided to pregnant and lactating women and their infants. Support will be provided to the MOHSW to integrate its storage and delivery systems for HIV commodities and other pharmaceutical products. Logistics for prompt distribution of HIV commodities, test kits and reagents to all hospitals and health centers will be supported