1. Medicines Stock Status Rose SHIJA April –June 2015

2. Outline Introduction Stock status as of June 2015 Challenges Shipments on Pipeline up to September 2015 Trend of stock status of some products between first and second quarter Conclusion

3. Introduction These are just indicative figures for most of the medicines especially for the percentage availability (% of health facilities with available stock) as information was mostly drawn from the eLMIS whose information however is still not 100% accurate as some health facilities eg hospitals are yet to start inputing data in it. Please note that health facilities report in groups each quarter ie A, B and C so the information available is from April to June. The Stock on hand includes the stock on hand at the central and from all the zonal MSD stores.

4. Stock status 1 ProductUOM Group B Group C Group A % Average AprilMayJune Stock On Hand Months Of Stock AlbendazoleT/10075%74%79% 76% MebendazoleT/10059%63%67% 63% ALU 1x6B/3080%77%75% 77% 61,517 6.7 ALU 2X6B/3079%78%71% 76% 71,054 9.10 ALU 3X6B/3077%78%70% 75% 46,791 6.72 ALU 4X6B/3078% 74% 77% 46,170 3.71 Qunine inj 300mg/ml, 10mlAmp69%66%70% 68% 78,959 7.00 Qunine Tabs 300 mgT/50076%75%50% 67% 16,099 2.90 Artesunate inj, 60mgeach73%67% 69% 219,769 0.90 Malaria Rapid Diagnostic Test (MRDT) K/2563%64%54% 60% 421,007 6.88 Amoxycillin TabletT/100069%61%76% 69% Amoxicilin suspensionBot67%55%60% 61% Cotrimoxazole SuspensionBot59%54% 56%

5. Stock status 2 AprilMayJune % Averag e Stock On Hand Months Of Stock OxytocinAmp73%75% 74% 40,1200.30 Oral Rehydration Salts (ORS) sachet73%76%72% 74% Benzyl Penicilline Injection Vial76%81% 79% Combine Oral Contraceptives (microgynon) cycle64%68%66% 2,122,7018.00 Depo Provera Vial69%77%67% 71% 1,249,3943.00 Emergency contraceptive 2tab 716,436111.00 Jadelle 1st 72,0325.00 Implanon Each64%71% 69% 208,4017.00 Male latex condoms piece63%70% 67% 25,174,32413.00 Female condoms 1000 pc68%73%65% 69% 41815.00 Copper T each79%81%75% 78% 207,6619.00 Sodium Chloride each69% 70% Dextrose 5% Each69%75%79% 74% Sodium Chloride + Dextrose Each62%65%70% 66% Ferrous + Folic Acid Tablets T/100086%89% 88% 873,215 39 Magnesium Sulphate Inj 500mg/ml, 10ml inj Vials80%83%86% 83% 104,61312.00 Determine HIV 1&2 kit59%60%57% 59% Unigold kit61% 64% 62% DBS 68%70%55% 64%

6. Stock status 3 UOMAprilMayJune % AV Stock On Hand Months Of Stock Efavirenz 600 mg tabletsT/3099% 97% 98% 848,485 7.7 Zidovudine 300 mg + Lamivudine 150 mgT/6081%90%76% 82% 906,741 8.7 Lamivudine 150mg + Zidovudine 300mg +Nevirapine200 tabs T/6096%97%98% 97% 702,198 5.4 Tenovofir 300mg+emtricitabine 200mg+efavirenz 600 mg tablets T/3090%85%83% 86% 419,865 5.1 Tenovofir 300 mg +emtricitabine 200mgT/3092%94%90% 92% 72,294 4.8 Atazanavir 300mg/Ritonavir 100mgT/3067%91%83% 80% 4,418 0.3 Tenofovir 300 mg+ Lamivudine 300mg + Efavirenz 600 mg tablets (TLE) T/3098%96%97% 2,836,186 7.7 HIV Paediatrics Lamivudine 30 mg + Zidovudine 60 mg tabletsT/6098%90%98% 95% 306,766 21.4 Lopinavir/Ritonavir 100/25mgT/6080%100%86% 89% 94,063 15.5 Lamivudine 30mg + Zidovudine 60mg + Nevirapine 50 mg dispersible tabs T/6085%71%85% 80% 801,250 28.6 Nevirapine oral suspension with syringe 10 mg/ml 100 ml87%89%95% 90% 201,961 12.6

7. Challenges Overstock –Emergency contraceptives are overstocked to last 111 months. Concerted efforts are needed to increase awareness to health workers as well as members of the public on their use –Amount in stock for FeSO4/Folic Acid is for 39 months –Magnesium Sulphate currently amount in stock is for 12 months. However two consignments are expected by September 2015 for stock to last 20 months. As this is a slow moving product, it could lead to expiry. MSD and RCHS need to share procurement plans.

8. Challenges Stock outs –Currently Ergometrine Injection and Misoprostol tablets are out of stock –Oxytocin Inj stock on hand is low but 1,000,000 ampoule equivalent to 7.5 MOS has been delivered to MSD –Atazanavir 300mg/Ritonavir 100mg stock is low but there is an incoming consignment between August and November equivalent to 11 MOS

9. Shipments in Pipeline July –September 2015 CommodityUOMSHIPMENTS ON PIPELINE Total Amount on Order Months of Stock ALU 1x6B/30 35,6603.8 ALU 2X6B/30 32,1834.1 ALU 3X6B/30 31,5604.5 ALU 4X6B/30 44,3963.6 Artesunate inj, 60mgeach 1,606,4836.9 Malaria Rapid Diagnostic Test (MRDT)K/25 200,5963.2 OxytocinAmp 1,000,0007.5 Jadelle 1st 2,058,27518.0 Implanon each 494,72016.0 Magnesium Sulphate Injection 500mg/ml, 10ml injVials 180,66620.0 Zidovudine 300 mg +Lamivudine 150 mgT/60 740,0007.1 Lamivudine 150mg +zidovudine 300mg +Nevirapine200 tabsT/60 614,0734.8 Tenovofir 300mg+emtricitabine 200mg+efavirenz 600 mg tabletsT/30 345,8144.2 Tenovofir 300 mg +emtricitabine 200mgT/30 167,83211.3 Atazanavir 300mg/Ritonavir 100mgT/30 144,30511.4 Tenofovir 300 mg+ Lamivudine 300mg + Efavirenz 600 mg tablets (TLE)T/30 2,500,5966.8 Paediatrics HIV Lamivudine 30 mg +zidovudine 60 mg tabletsT/60 119,4158.3 Lopinavir/Ritonavir 100/25mgT/60 79,96513.2 Lamivudine 30mg + Zidovudine 60mg + Nevirapin 50 mg dispersible tabsT/60 280,00010.0 Nevirapine oral suspension with syringe 10 mg/ml100 ml 172,10310.7

10. Trend of stock status of some products between first and second quarter

11. Conclusion In general the stock status is good for most products, with more products with stock of over 6 months. For example, Average Months of Stock of ARVs Regimens is 6.4 and for paediatric is 17.7. For ALU regimens is 6.2 Procurement processes have already been initiated and shipments are expected for many products except for Ergometrine and Depo provera, To avoid overstock of some products and for rational use of the resources, procurement plans of MSD and those of programmes need to be harmonised MOHSW need to work on increasing awareness on emergency contraceptives