Medical supplies / equipment in primary health …

1 ECHOM edical suppliesand equipment forprimary health careA practical resourcefor procurement andmanagementbyManjit Kaur and Sarah HallEditorKathy AttawellECHO InternationalHealth Services LimitedUllswater CrescentCoulsdon Surrey CR5 2 HRUnited KingdomT+44 (0)20 8660 2220F+44 (0)20 8668 Medical supplies and equipment have a significant impact on the quality ofpatient care and account for a high proportion of health care costs. health servicesneed to make informed choices about what to buy in order to meet priority healthneeds and avoid wasting limited resources.

2 Many organisations have produced useful information about essential drugs, but lessinformation is available about essential Medical supplies and equipment . Despite thefact that there is a much wider range of different brands and items to choose from,selecting supplies and equipment is often given little attention. This often results inprocurement of items that are inappropriate because they are technically unsuitable,incompatible with existing equipment , spare parts and consumables are not available,or because staff have not been trained to use them.

3 Procurement is only one part of managing Medical supplies and equipment , andeffective storage, stock control, care and maintenance are also critical if health servicesare to get the most out of what they buy. However, there is also limited informationavailable about these aspects of management of Medical supplies and equipment . To address this situation, ECHO has produced Medical supplies and equipment forprimary health care. The manual is intended to be a practical resource for thoseresponsible for procurement and management of Medical supplies and equipment atprimary health care level.

4 It includes guiding principles for selecting supplies andequipment, provides guidelines for procurement, storage and stock control, care andmaintenance, and considers safe disposal of Medical waste. The manual alsodiscusses the use of standard lists as a tool for encouraging good procurementpractice and includes model lists of Medical supplies and equipment required forprimary health care activities in health facilities and in the community, and for basiclaboratory facilities. Although Medical supplies and equipment for primary health care is mainly intended forprimary health care level, it will also be a useful resource for those at national anddistrict levels responsible for health planning and management, training, and managingmedical stores.

5 0-9541799-0-0 Medical supplies and equipmentfor primary health care A practical resource for procurementand managementby Manjit Kaur and Sarah HallEditor Kathy AttawellECHOI nternational health Services LimitedPublished by ECHO International health Services Ltd, 2001. ECHO International health Services Ltd, rights reserved. This publication can be freely reviewed,abstracted, reproduced or translated, in part or in whole, but not forsale or for use in conjunction with commercial purposes, andprovided that ECHO is acknowledged as the source.

6 The contentand information contained in this publication are intended asguidelines only. Medical supplies and equipment for primary health careA practical resource for procurement and managementISBN 0-9541799-0-0 Printed in the United Kingdom by Dunns. Price: One copy free of charge to organisations in the South, additional copies and for international organisations. Available from: ECHO International health Services LtdUllswater CrescentCoulsdonSurrey CR5 2 HRUKTel: +44 (0) 20 8660 2220 Fax: +44 (0) 20 8668 0751E-mail: is a UK registered charity supplying low-cost, quality assuredpharmaceuticals, Medical supplies , equipment , teaching aids andbooks to the public and non-profit health sector in developingcountries.

7 ECHO also provides advice and training, and publishespractical information on Medical supplies and equipment . It is not the knowing that is difficult, but the doing Chinese proverbContentsForewordiPrefaceiiAcknowl edgementsiiiGlossary, acronyms, abbreviations and symbolsivIntroduction1 Who is this book for?1 What is the purpose of the book?2 Why are standard lists useful?2 What information is included is this book?3 How can you use this book?3 Section 1 Guiding principles for selecting supplies and equipment5 Need5 Appropriateness5 Quality6 Costs 7 Source8 Use and maintenance8 Material9 Disposable or reusable11 Table and performance standards 6 Table provided by manufacturers7 Table plastic-ware10 Section 2 Procurement and management of supplies and Ordering and procurement13 Estimating and calculating requirements13 Quantification methods13 Lead time and frequency of orders15 Stock levels15 Calculating for an increase or decrease

8 In order quantity16 Ordering guidelines17 Estimating costs17 Freight and insurance charges for imported goods18 Pre-Shipment Inspection18 Identifying suppliers19 Placing an order19 Specifications20 Handling Storage and stock control23 Organising the store23 Stock control24 Store records25 Receiving supplies27 Issuing supplies28 Stock taking28 Inventory of Care and maintenance29 User maintenance29 Planned preventive maintenance30 Stainless steel instruments 32 Choosing new instruments33 General rules34 Refrigerators 35 Choosing a refrigerator35 General Cleaning, disinfection and sterilisation38 Cleaning39 Disinfection39 Disinfection by boiling40 Chemical disinfection40 Sterilisation41 Sterilisation by steam under pressure41 Sterilising reusable syringes and needles49 Before sterilisation49 Sterilisation50 After Disposal of waste55 Waste handling and management55 Waste collection.

9 Treatment and disposal55 Collection and disposal of sharps waste56 Safety box56 Puncture resistant container56 Needlyzer57 Balcan destructor57 Table consumption14 Table time and reserve stock15 Table order quantity16 Table costs17 Table terms18 Table storage temperatures23 Table after SS instruments35 Table after refrigerators 37 Table procedures 38 Table Cleaning methods39 Table Disinfection by boiling and chemical disinfection44 Table Sterilisation 48 Table Sterilising syringes and needles51 Table Different methods of waste disposal58 Table Different types of waste 60 Figure order form20 Figure specification form20 Figure stock card 25 Figure stock control ledger forms26 Figure issue voucher form28 Figure inventory form28 Section 3 supplies and equipment for primary health General supplies and equipment for health facilities64 General supplies and equipment64 Diagnosis71 General patient treatment and care76 Boiling and supplies

10 And equipment for primary health care activities93 Preventive child health93 Reproductive and sexual health103 Dressings, minor surgery and first aid115 Dressings115 Suturing and minor surgical procedures120 First aid123 Eye care125 health education and supplies and equipment for laboratory facilities131 Major equipment131 supplies and minor equipment136 Miscellaneous consumables143 Reagents and supplies and equipment for community New developments153 Appendix 1 Useful resources157 Books and manuals157 Free materials and guidelines160 Sources of low-cost supplies .