MINISTRY OF HEALTH PHARMACY DEPARTMENT JUNE 2020 FACILITY TRACER MEDICINES STOCK STATUS REPORT A Publication of the Ministry of Health Uganda This monthly report on the facility stock status of the 41 tracer items (in different baskets) provides information about the stock situation of health facilities in the country in order to inform the Ministry of Health and all stakeholders to make appropriate logistics decisions that ensure an effective health commodities supply chain. The report shows the number and percentages of facilities that are appropriately stocked, over stocked or out of stock by level of care and ownership based on Months of Stock (MOS). The MOS highlights the number of months a product will last based on the present consumption rate. It also further indicates facilities that have over 8 months of stock (MOS) broken down by level of care and ownership. The report shows the availability of the different and overall baskets using two indicators i.e. 1) Average percentage availability of a basket of 41 commodities based on all reporting facilities in the previous cycle Definition : Availability is measured as the number of days for which a specific commodity was in stock at the facility store during the reporting period. 2) Percentage of facilities that had over 95% availability of a basket of commodities in the previous cycle Definition : This indicator measures the % of health facilities that reported having the basket of commodities available during the reporting period. The contents of the different baskets are listed below: ARV BASKET LOC EMHS BASKET LOC Tenofovir/Lamivudine/Efavirenz (TDF/3TC/EFV) 300mg/300mg/ 600mgHC2 Artemether/Lumefantrine 20/120 mg HC2 AZT/3TC/NVP 300mg/150mg/200mg HC2 Therapeutic milk F75 (75Kcal/100ml) Hospital Atazanavir/ritonavir(ATV/r)300/100mg table* HC3 Oral Liquid Morphine 5ml/ml* HC3 Tenofovir/Lamivudine (TDF/3TC) 300mg/300mg* HC3 Ready to use Therapeutic feeds (RUTF) HC2 TDF/3TC/DTG 300mg/300mg/50mg(TLD)* HC3 Cotrimoxazole 960mg tablet HC2 TLE 300mg/300mg/400mg HC2 Chlorhexidine Digluconate Gel 7.1% HC2 Abacavir/Lamivudine (ABC/3TC) 120mg/60mg (Paediatric) HC3 Bendrofulazide (Aprinox) 5mg HC3 Lopinavir40mg/ritonavir 10mg pellets in capsules* HC3 Artesunate 60mg* HC3 Nifedipine tablets 20mg tablet HC3 LAB BASKET LOC Captopril 25mg tablet HC4 Determine HIV 1 & 2 screening test HC2 Metformin 500mg HC3 Stat -pack HIV Confirmatory rapid tests, tests HC2 Glibenclamide 5mg tablet HC4 SD Bioline test-Tie Breaker HC2 Insulin short-acting HC4 CD4 reagent HC4 Cardiac Aspirin 75/80 mg HC4 Malaria Rapid Diagnostic tests HC2 GeneXepert Catridges* HC3 Blood 450 ml HC4 RMNCAH BASKET LOC TB BASKET LOC Depot medroxy progesterone acetate (DMPA) HC2 (RHZE) blister strip 150/75/400/275 mg HC3 Amoxicillin 250 mg capsule* HC2 RHZ Blister 75mg/50mg/150mg HC3 Sulfadoxine/ Pyrimethamine tablet HC2 ORS Sachets with zinc tablet HC2 Measles-Rubella Vaccine HC2 Misoprostol 200mcg Tablet HC2 Amoxicillin dispersible 250mg tablet HC2 Ceftriaxone 1g Injection HC3 Oxytocin Injection HC3 Note: * New commodity Mama Kit HC2 With the revision of the HMIS tools and change in treatment guidelines a total of eight new commodities were introduced. KEY FINDINGS 1. The average facility reporting rate per district on HMIS-105 (Stock status) for the month of June 2020 was at 81% and nationally it was at 58% (4456/7659). •A total of twelve districts had 100% reporting for all their facilities while 4 districts had less than 50% of their facilities reporting. Notably, the least reporting districts include; Kayunga, Mukono, Wakiso, and Kampala. •Out of the 14 Regional Referral Hospitals; four submitted complete reports and 6 submitted incomplete reports on the 41 tracer commodities. •Arua, Fort Portal, Gulu and Mubende Regional Referral Hospitals did not submit report on the 41 tracer commodities. 2. Overall average availability for the basket of 41 commodities was 81% (n=1692), indicating no percentage change from the month of May 2020 which was 81% (n=1747). a) TB commodities had better availability of 87% (n=665) than other baskets while ARV basket had the least with 73% (n=1157). b) An average of 57% (n=1692) of facilities reported over 95% availability of a basket of commodities, increasing from the month of May 2020 which was 55%. 3. Stocked-outs were reported for; Oral Liquid Morphine 5ml/ml (92%),TLE 300mg/300mg/600mg (89%), RUTF (71%), CD4 reagent (63%) and SD-Bioline test (59%). 4. Overstocked commodities include; ACTs (44%), (RHZE) blister strip 150/75/400/275 mg (45%) and Sulfadoxine/ Pyrimethamine tablet (45%). 5. Expiry of some commodities were reported for RHZ Blister (8%), Determine HIV (5%), (RHZE) blister strip 150/75/400/275 mg (5%), Artemether (4%) and Blood (4%). ACTION POINTS 1. Pharmacy Department working with regional IPs to ensure that all facilities get adequate stock of legacy regimens from central warehouses. 2. Pharmacy Department will continue monitoring the blood stock levels to inform blood bank decisions for improved blood availability. 3. Pharmacy Department to target their supervisions to the poor performing Regional Referral Hospitals and health facilities 4. Work with the IPs to prioritize and strengthen health facility reporting and quality of data especially for quantity expired. Quality Assurance of the data submitted should be prioritized. 5. Pharmacy Department to support health facilities to report using the new HMIS tools. There is a plan to conduct Regional and Facility Based HMIS Training. This should impove the reporting rate and quality of reports submitted. June 2020 Facility Stock Status Report 1 of 10 AVAILABILITY INDICATORS Percentage Average Availability of Basket of commodities Feb'19-Jun'20 Percentage of facilities with over 95% availability of a Basket of commodities 90 Feb'18-Jun'20 90 80 80 70 70 60 60 50 50 40 40 30 30 20 20 Feb- Apr- Aug- Oct- Feb- Apr- Jun- Aug- Oct- Jun-Jul'19 Jan-20 Feb-20 Mar-20 Apr-20 May-20 Jun-20 Jan-20 Feb-20 Mar-20 Apr-20 May-20 Jun-20 Mar'19 May'19 Sep'19 Nov'19 Mar'19 May'19 Jul'19 Sep'19 Nov'19 EMHS (14 items) 84 81 77 75 76 81 84 83 81 82 80 EMHS (14 items) 48 44 39 38 39 56 59 58 57 57 56 ARV (8 items) 76 76 75 72 72 74 74 73 71 71 73 ARV (8 items) 41 42 42 37 35 43 42 43 39 39 43 LAB (7 items) 87 86 84 84 84 82 83 83 84 84 83 LAB (7 items) 59 57 54 53 54 57 57 59 63 61 61 TB (2 items) 87 88 87 86 85 84 85 87 86 87 87 TB (2 items) 71 72 70 66 67 74 75 77 75 77 76 RMNCAH (10 items) 85 85 82 83 85 78 82 81 81 81 81 RMNCAH (10 items) 45 44 40 42 45 36 41 41 42 41 46 Percentage availability for each item (EMHS basket) Percentage availability for each item (ARV basket) Item n % availty % expiry Item n % availty % expiry 7 Artemether/Lumefantrine 20/120 mg 2010 93% 4.0% Tenofovir/Lamivudine/Efavirenz (TDF/3TC/EFV) 300mg/300mg/1059 79% 600mg 2.4% 8 Therapeutic milk F75 (75Kcal/100ml) 39 54% AZT/3TC/NVP 300mg/150mg/200mg 909 75% 1.3% 11 Oral Liquid Morphine 5ml/ml 283 12% 0.4% Atazanavir/ritonavir(ATV/r)300/100mg table 664 86% 1.1% 12 Ready to use Therapeutic feeds (RUTF)630 36% 0.5% Tenofovir/Lamivudine (TDF/3TC) 300mg/300mg 671 90% 2.4% 14 Cotrimoxazole 960mg tablet 1054 73% 1.0% TDF/3TC/DTG 300mg/300mg/50mg(TLD) 697 94% 1.5% 15 Chlorhexidine Digluconate Gel 7.1% 1019 71% 1.5% TLE 300mg/300mg/600mg 520 16% 0.3% 16 Bendrofulazide (Aprinox) 5mg 644 85% 1.7% Abacavir/Lamivudine (ABC/3TC) 120mg/60mg (Paediatric)650 93% 2.6% 19 Artesunate 60mg 755 86% 0.8% Lopinavir/ritonavir 40mg/10mg pellets in capsules 586 74% 2.9% 20 Nifedipine tablets 20mg tablet 704 82% 1.7% 23 Captopril 25mg tablet 141 69% 0.7% 27 Metformin 500mg 644 83% 1.1% Percentage availability for each item (TB basket) 30 Glibenclamide 5mg tablet 151 83% 2.0% Item n % availty % expiry 32 Insulin short-acting 129 65% 2.8% 4 (RHZE) blister strip 150/75/400/275 mg 639 94% 5.0% 37 Cardiac Aspirin 75/80 mg 147 66% 0.7% 31 RHZ Blister 75mg/50mg/150mg 551 78% 7.8% 38 38 38 147 38 38 38 38 38 38 Percentage availability for each item (RMNCAH basket) Percentage availability for each item (LAB basket) Item n % availty % expiry Item n % availty % expiry Depot medroxy progesterone acetate1499 (DMPA) 79% 1.5% 2 Determine HIV 1 & 2 screening test 1518 83% 5.2% Amoxicillin 250 mg capsule 1966 86% 1.8% 9 Stat -pack HIV Confirmatory rapid tests, tests 1236 80% 1.8% Sulfadoxine/ Pyrimethamine tablet 1706 88% 2.1% 10 SD Bioline test-Tie Breaker 1000 67% 2.1% ORS Sachets with zinc tablet 1892 90% 1.9% 17 CD4 reagent 94 50% 1.7% Measles-Rubella Vaccine 1364 89% 1.6% 33 Malaria Rapid Diagnostic tests 1929 92% 2.8% Misoprostol 200mcg Tablet 1296 85% 2.9% 39 GeneXepert Catridges 90 80% 3.3% Amoxicillin dispersible 250mg tablet 1567 82% 1.4% 40 Blood 450 ml 91 60% 3.9% Ceftriaxone 1g Injection 778 84% 1.2% Oxytocin Injection 682 78% 0.9% Mama Kit 1004 67% 0.8% Note: % expiry - percentage of facilities the reported on expiry DISTRICT LEAGUE TABLE Note: The district league table ranks districts based on the percentage of facilities with over 95% availability within the district.