Ipls PDF

Standard Operating Procedures (SOP) Manual for
the Integrated Pharmaceuticals Logistics System

in Health Facilities of Ethiopia
Third Edition
Addis Ababa, Ethiopia

January, 2017
Standard Operating Procedures (SOP) Manual
For
The Integrated Pharmaceuticals Logistics System
in Health Facilities of Ethiopia
January, 2017
i
FOREWORD MESSAGE
The Pharmaceutical Fund and Supply Agency (PFSA) is coordinating sector wide effort
aimed at significantly improving sustainable availability of quality assured pharmaceuticals
at an affordable price to the public. The agency is also working to reduce national
pharmaceutical wastage and improve distribution of pharmaceuticals to service delivery
points. As part of this effort, the Agency has developed and further revised standard
operating procedures (SOP) for Integrated Pharmaceuticals Logistics System (IPLS). The SOP
has been in use for the last seven years and passed through series of revisions to keep abreast of
new initiatives and current practices. This is the third edition of the SOP Manual for the
Integrated Pharmaceuticals Logistics System (IPLS) in Health Facilities of Ethiopia.
The SOP manual encompasses major areas of pharmaceutical management at health facilities
including; Logistics Management Information System, inventory control system, recording and
storage. There are ten chapters and thirteen job aids that describe recurring work processes
in these specific areas. The SOP manual promotes quality through consistent implementation
of processes and procedures. The manual is intended to simplify and standardize the work
required for logistics management of pharmaceuticals used in public health facilities. It also
serves as a reference for professionals working at health facilities and those involved in
supervisory support.
Therefore, the implementation of the SOP manual needs to be re-enforced by management

units at all levels.
Finally, I would like to take this opportunity to thank all stakeholders who participated in the
development of this SOP manual.
Pharmaceuticals Fund and Supply Agency
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ACKNOWLEDGEMENT:
The Pharmaceutical Fund and Supplies Agency would like to acknowledge all contributors for
their effort in enriching the Standard operating procedure (SOP) manual for the integrated
pharmaceutical logistics system. The agency would like to extend its gratitude to
USAID│DELIVER PROJECT and SCMS for their technical and financial support throughout
the development of this SOP manual. The agency would also like to thank RHBs, ZHDs,
WoHOs, USAID|DELIVER PROJECT, SCMS, UNFPA, CHAI, TB Care I, HEAL TB, UNICEF and
other supply chain partners for exerting their technical inputs in enriching the manual.
iii
RECOMMENDED CITATION: Pharmaceuticals Fund and Supply Agency (PFSA),2017.
Standard operating procedure manual for the integrated pharmaceutical logistics system in
health facilities of Ethiopia, 3rdEdition.
iv
ACRONYMS
AIDS Acquired Immune Deficiency Syndrome

BPR Business Process Re-engineering
DU Dispensing Unit
EPI Expanded Program for Immunization
FEFO First Expiry First Out
FMOH Federal Ministry of Health
HC Health Centre
HIV Human Immuno- Deficiency Virus
HPMRR Health Post Monthly Report and Re-supply Form
HMIS Health Management Information System
HP Health Post
IFRR Internal Facility Report and Resupply Form
IPLS Integrated Pharmaceuticals Logistics System
LMIS Logistics Management Information System
LSI Look ahead Seasonality Indices
MCH Maternal and Child Health
NPPL National Pharmaceuticals Procurement List
PFSA Pharmaceuticals Fund and Supply Agency
PLMP Pharmaceutical Logistics Master Plan
RDF Revolving Drug Fund
RHB Regional Health Bureau
RRF Report and Requisition Form
SDP Service Delivery Point
SOP Standard Operating Procedures
TB Tuberculosis
VEN Vital – Essential – Non essential
WoHO Woreda Health Office
ZHD Zonal Health Department
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TABLE OF CONTENTS
ACRONYMS ........................................................................................................................................... iv
TABLE OF CONTENTS ............................................................................................................................ i
I. INTRODUCTION ..........................................................................................................................1
II. PURPOSE OF THE STANDARD OPERATING PROCEDURE MANUAL .........................2
III. ROLES AND RESPONSIBILITIES IN IPLS ........................................................................... .3
IV. OVERVIEW TO BASIC COMPONENTS OF IPLS AT HEALTH FACILITY ................. 13
A. Logistics Management Information System (LMIS) in IPLS. ........................................... 13
B. Inventory Control System in IPLS ......................................................................................... 17
C. Storage of Pharmaceuticals in the IPLS ................................................................................ 18
V. RECORDING SYSTEM IN IPLS .............................................................................................. 20
A. Maintaining the Bin Card................................................................................................... 20
JOB AID: Recording Transactions in the Bin Card................................................................................. 21
B. Maintaining the Stock Record Card ..................................................................................... 28
JOB AID: Recording Transactions in the Stock Record Card ............................................................... 28
VI. REPORTING AND ORDERING PHARMACEUTICALS .................................................... 33
A. Reporting by the Health Posts .............................................................................................. 33
JOB AID: Completing the Health Post Section of the Health Post Monthly Report and Re-supply Form
.....................................................................................................................................................33
B. Reporting and Ordering by the Hospitals and Health Centers ............................................ 36
JOB AID: Completing the Report and Requisition Form ....................................................................... 40
JOB AID: VEN Analysis ......................................................................................................................... 45
C. Assessing Stock Status ......................................................................................................... 48
JOB AID: Completing the Health Post Monthly Report and Re-supply Form for an Emergency Order50
JOB AID: Placing an Emergency Order at the Health Centre or Hospital ............................................. 52
VII. ISSUING PHARMACEUTICALS ............................................................................................. 57
A. Issuing Pharmaceuticals within Health Centers and Hospitals............................................ 58
JOB AID: Completing the Internal Facility Report and Resupply Form (IFRR) for Issuing Pharmaceuticals
within Health Centers and Hospitals .............................................................................................. 59
B. Issuing Pharmaceuticals to Health Posts .............................................................................. 64
JOB AID: Completing the Health Centre Section of the Health Post Report and Re-supply Form (HPMRR)
(when issuing from Health Centre to Health Post) ........................................................................ 64
VIII. RECEIVING PHARMACEUTICALS ........................................................................................ 67
A. Receiving pharmaceuticals from PFSA ............................................................................... 67
JOB AID: Receiving Pharmaceuticals ..................................................................................................... 68
B. Distribution of formats involved during receiving .............................................................. 70
C. Funding Pharmaceuticals in the IPLS.................................................................................... 71
IX. STORING PHARMACEUTICALS
A. Storage and Product Shelf Life.................................................................. ................... ............72
B. Storage Guidelines…………………………………………………………………....................74
C. Conducting Visual Inspection………...……………………………………........................…. 77
D. De junking and Organizing storage spaces……………………………………….....................77
E. Product arrangement in the Pharmacy Store…… ................................................................. . ........79
F. Conducting a Physical Count ..................................................................................................... ... 0
JOB AID: Conducting a Physical Count.................................................................................................. 81
G. Handling Damaged or Expired Stocks ...................................................................................87
JOB AID: Handling of Damaged of Expired Products at Health Post or Dispensing Units .....................87
JOB AID: Handling of Damaged or Expired Products at Health Centre / Hospital .................................89
IX. Summary of Activities by Function .................................................................................................93
X. ANNEXES ...................................................................................................................................... 96
vi
I. INTRODUCTION
The provision of complete health care necessitates the availability of safe, effective and affordable
pharmaceuticals of the required quality, in adequate quantity at all times. Despite this fact, in
the past, the pharmaceutical supply chain management system of the country had several
problems including non-availability, unaffordability, poor storage and stock management and
irrational use.
To solve these problems in public health facilities, Pharmaceuticals Fund and Supply Agency
(PFSA) was established in 2007 by Proclamation No. 553/2007 based on the Pharmaceuticals
Logistics Master Plan (PLMP). The Agency is mandated to avail affordable and quality
pharmaceuticals sustainably to all public health facilities and ensure their rational use. So as to
execute its mandate in the area of pharmaceuticals supply in an efficient and effective manner,
integrated pharmaceuticals logistics system (IPLS) has been developed and implemented since
2010.
IPLS is the term applied to the single pharmaceuticals reporting and distribution system based on
the overall mandate and scope of the PFSA. It aims to ensure that patients always get
pharmaceuticals they need. To be successful, the system must fulfill the six rights of supply
chain management by ensuring the right products, in the right quantity, of the right quality, at
the right place, at the right time and for the right cost.
The IPLS integrates the management of essential pharmaceuticals including the following
pharmaceuticals that were used to be managed vertically: HIV/AIDS, Malaria, TB and Leprosy,
EPI, family health and purchased essential pharmaceuticals. It is the primary mechanism
through which all public health facilities obtain essential and vital pharmaceuticals. Products
included on the National pharmaceuticals procurement List (NPPL) are supplied and managed
through the IPLS.
One of the first concrete steps to move the integrated system from concept to detailed
implementation step was the development of the Standard Operating Procedures (SOP) Manual
for health facilities of Ethiopia.
1
II. PURPOSE OF THE STANDARD OPERATING PROCEDURE MANUAL
The manual is intended to simplify and standardize the work required for the logistics
management of pharmaceuticals used in public health facilities. It also serves as a reference for
service providers in facilities supplied by PFSA and for the administrative units that provide
management and supervisory support. The S.O.P manual guides the staff in the completion
of the following tasks:
• Recording and reporting on stock levels and usage of pharmaceuticals.

• Ordering pharmaceuticals from PFSA
• Receiving and storing pharmaceuticals
• Issuing pharmaceuticals between and within facilities
• Maintaining adequate amount of pharmaceuticals
2
III. ROLES AND RESPONSIBILITIES IN IPLS
Overview of Pharmaceuticals and Information flow in IPLS
Program pharmaceuticals are reported and ordered every two months by hospitals and health
centers and delivered by PFSA to these facilities directly or indirectly. Direct delivery sites are
facilities that receive program pharmaceuticals directly from PFSA hubs whereas non-direct
delivery sites are health centers that receive products from PFSA hubs through Woreda Health
Offices (WoHOs).
Health posts report to health centers monthly and collect pharmaceuticals from those health
centers; the health centers use the data in the Health Post report to calculate consumption and re-
supply quantities.
For revolving drug fund (RDF) pharmaceuticals, health centers and hospitals will complete RRF
as per the facilities review period which can be every two month, every quarter or every six
months and collect products from affiliated PFSA branch. The figure below illustrates the overall
flow of program pharmaceuticals and information in the IPLS.
Figure 1: Flow of Pharmaceuticals and Information in the Integrated Pharmaceutical Logistics System (IPLS)
3
Logistics information is collected and reported monthly by health posts and every other month by
health centers and hospitals on logistics management information system (LMIS) forms.
• For direct delivery facilities a combined report and requisition form is completed by
health centers and hospitals and sent to PFSA Hubs for requisition processing; the
health center order includes the pharmaceuticals requirements of the health posts. For
non-direct delivery facilities a combined report and requisition form is completed by
health centers and sent to PFSA branches through WoHOs.
• For management and supervision purposes a copy of the health centre report and
order and a copy of each health post report are sent to the Woreda Health Office a
copy of the hospital report and order is sent to the RHB/ZHD
The overall information system also includes a mechanism for providing feedback to lower
level facilities from upper level facilities. In the feedback reports, facilities will be able to see how
they are performing compared to other facilities in their area and will be able to facilitate stock
transfer. For instance, the Woreda or PFSA Hub may provide a short report to all of the health
centers showing the stock status of priority products (vital pharmaceuticals), number of stock
outs, reporting rate, and consumption trends across health centers. The Woreda or PFSA might
also provide specific feedbacks to health centers pointing out timeliness, completeness and quality
of their reports.
4
A. Roles and Responsibilities
IPLS implementation requires collaborative efforts of different officials and professionals

working at all levels of the FMOH system. The roles and responsibilities for organizations and
personnel involved in this system are listed below.
1. Federal Ministry of Health (FMOH)
The Federal Ministry of healthh has roles and responsibilities in the IPLS. All the differnt
directorates at the MOH has a stake in implementing IPLS, however, the Pharmaceuticals and
medical service directorate through its Pharmaceutical and logistics mangement unit is directly
responsible for the IPLS. The detailed roles and responsibilities of the FMOH are presented in
table 1.
Table 1: Roles and responsibilities of FMOH
1.
Participate in pharmaceuticals forecasting with PFSA
2.
Advocate for financial support for pharmaceuticals
3.
Coordinate donor contributions to ensure pharmaceuticals availability
4.
Monitor stock levels and program supply performance
5.
Process payment to PFSA for delivery of program products
6.
Communicate program plans and donor activities that affect demand for pharmaceuticals
with PFSA
2. PFSA
As an agency with a prime responsibility of managing the pharmaceutical logistics system

of the country, PFSA has indispensable roles and responsibilities in the implementation
5
of the
IPLS. Its responsibilities include forecasting, procurement, storage and distribution of products
and others which are presented in table 2.
Table 2: Roles and responsibilities of PFSA
1 Forecast national pharmaceuticals need based on the demand of Health Facilities.

2 Procure and store pharmaceuticals.
3 Determine stock levels.
4 Receive reports and orders from health facilities and distribute pharmaceuticals
accordingly.
5 Maintain stock records and monitor stock status.
6 Build the capacity of health facilities in the areas of pharmaceuticals supply management
and rational medicines use through provision of technical and material support.
7 Exchange information with FMOH RHBs, ZHDs and WoHOs regarding the supply
and use of pharmaceuticals.
8 Coordinate and lead partners working on supply management and rational
pharmaceuticals use.
9 Undertake supportive supervision in health facilities in collaboration with
relevant stakeholders
10 Develop data recording, requisition and reporting formats.

11 Monitor and evaluate the performance of the logistics system and provide feedback to health
facilities.
12 Improve facility store management in collaboration with the ministry and partners.
3. Regional Health Bureaus/Zonal Health Department
Regional health bureaus have significant roles and responsibilities in the implementation of the
IPLS across health facilities found in their respective regions. The major role of the bureaus is
to monitor and evaluate the implementation of the system. In addition, they have significant
responsibilities in the area of funding and other functions presented in table 3.
6
Table 3: Roles and responsibilities of RHBs/ZHDs
1. Provide technical assistance and supervision in logistics management including

stock management, ordering, and reporting functions of Hospitals and WHOs
2. Monitor pharmaceutical budget and pharmaceutical availability

3. Ensure adequate funds for procurement of essential pharmaceuticals at each hospital.
4. Monitor and evaluate system performance (reporting rates, consumption rates,
stock levels, storage conditions); provide feedback to facilities and/or Woreda
5. Provide and develop guidelines to facilities when necessary
6. Enforce policies as related to pharmaceutical logistics management
7. Monitor and oversee annual pharmaceutical quantification of Woreda health offices
4. Woreda Health Offices
The Woreda health offices have major roles and responsibilities in the implementation of
IPLS in health centers directly reporting to them. The following table enumerates their
major roles and responsibilities.
Table 4: Roles and responsibilities of WoHOs
1. Collect Pharmaceuticals logistics data from non-direct delivery sites and send the original copy
of the report and requisition format to respective PFSA hubs
2. Receive pharmaceuticals from PFSA hubs and distribute to non-direct delivery sites based on
Stock and Transfer Voucher(STV)
3. Provide proof of delivery for products received from PFSA based on STV
4. Send catchment health centre logistics data to zonal health departments.
5. Ensure the right pharmaceuticals are provided at Health Centers and Health Posts
6. Supervise stock management, ordering, and reporting functions of health posts and health centers
7. Monitor pharmaceutical budget and pharmaceutical availability

8. Ensure adequate funds for procurement of essential pharmaceuticals at each health centre.
9. Monitor system performance (reporting rates, consumption rates, stock levels, storage conditions)
10. Review client satisfaction with the provision of pharmaceuticals in health facilities.
7
11. Monitor annual pharmaceutical quantification of health facilities
12. Aggregate annual pharmaceutical quantification of health facilities for RDF products and send it
to its respective PFSA hub.
5. Hospitals
Hospitals are health facilities which provide high level curative health services. In order
to ensure the provision of the health services expected from the facilities, the hospitals
have to perform a lot of activities in the implementation of IPLS. The following are the
major roles and responsibilities of hospitals in relation with IPLS implementation.
Table 5: Roles and responsibilities of hospitals
Dispensing Units
1. Maintain bin cards for all pharmaceuticals kept at the dispensing unit
2. Receive products from the hospital store
3. Provide report on essential data following the reporting schedule established
4. Dispense products to clients
Pharmacy case team

1. Complete a physical count of pharmaceuticals every other month
2. Compare results from the physical count to the maximum and emergency order point stock quantities
and take appropriate action
3. Complete and generate (HCMIS sites) Report and Requisition Form every two month and submit it to
PFSA and RHB
4. Receive pharmaceuticals as per the appropriate standard from PFSA and update transactions in
HCMIS sites.
5. Conduct a visual inspection of pharmaceuticals
6. Store pharmaceuticals using appropriate storage procedures
7. Maintain manual and/or electronic Bin Cards and Stock Record Cards, transaction and consumption
records for all pharmaceuticals
8. Maintain appropriate stock levels
9. Calculate Dispensing Unit order quantities based on their data
10. Issue stock (in HCMIS sites based on pick list) to Dispensing Units
11. Provide regular technical support on job training of stock management to dispensing units
12. Process payment to PFSA for delivery of products, if cash and carry method is used for purchase of
pharmaceuticals.
8
13. Provide appropriate reports (stock status, near to expire, damaged/expired products…) to decision
makers.
14. Monitor budget utilization if allocation method is used for purchase of pharmaceuticals.
15. Procure pharmaceuticals not available from PFSA as needed
16. Conducts budget utilization studies and analysis.

17. Dispose damaged/expired stock as per the national medicine waste management and disposal
directive
18. Verify, ensure and follow timely reporting and data quality of RRF (Head of the Pharmacy case team)
19. Conduct annual quantification and send it to PFSA hub timely
20. Proper documentation of models, records, RRFs and IFRRs
Coordinate and participate in the annual quantification of RDF pharmaceuticals.(Head of the

21. pharmacy case team)
Hospital CEO
1. Monitor the performance of the IPLS within the facility (warehouse management, inventory
control system and the logistics management information system )
2. Monitor HCMIS implementation and ensure use of HCMIS
3. Ensure that annual quantification of RDF pharmaceuticals has been conducted timely and submitted to
PFSA.
4. Monitor pharmaceutical budget and availability.
5. Follow and enforce internal report and resupply system implementation which includes:
a. DU recording/reporting/resupply functions
b. Reporting and resupply Calendar/Schedule
6. Approves the RRF at the end of each reporting period

7. Facilitates printing of formats???
8. Follow and enforce timely reporting and data quality of RRF
6. Health Centers
Health centers are units of the supply chain of the country which keeps products to dispense to the
end users and to the health posts managed by them. The roles and responsibilities of the head of
the facility, pharmacy unit and dispensing units of the health centers are presented as follows.
9
Table 6: Roles and responsibilities of health centers
Pharmacy Staff
1. Complete a physical count of pharmaceuticals every two month
2. Complete or generate (in HCMIS sites) the Report and Requisition Form every two month and
submit it to PFSA directly and through the Woreda Health Offices
3. Procure and collect RDF products from PFSA branches
4. Receive pharmaceuticals from PFSA directly or through WoHOs and update the HCMIS (HCMIS
sites)
5. Procure pharmaceuticals not available from PFSA (rarely)
7. Maintain Bin Cards and Stock Record Cards, transaction and consumption records for all
pharmaceuticals
8. Assess stock status and take appropriate actions
9. Calculate health posts order quantities based on health posts data
10. Calculate dispensing unit order quantities based on their data
11. Issue stock to Dispensing Units and HPs based on HCMIS pick list
12. Provide technical support and on job training of stock management at HPs and
Dispensing Units.
13. Process payment to PFSA for delivery of products, if cash and carry method is used
14. Monitor credit/account status, if credit method is used for purchase of pharmaceuticals
Facility Head
1. Monitor the performance of the IPLS within the facility (warehouse management, inventory
control system and the logistics management information system)
2. Monitor HCMIS implementation and ensure use of HCMIS
3. Coordinate and participate in the annual quantification of RDF pharmaceuticals.

4. Monitor pharmaceutical budget and availability.
5. Follow and enforce internal report and resupply system implementation which includes:
6. DU recording/reporting/resupply functions
7. Reporting and resupply Calendar/Schedule
8. Health post resupply
9. Approves the RRF at the end of each reporting period
10. Follow and enforce timely reporting and data quality of RRF
10
Dispensing Units
1. Maintain bin cards for all pharmaceuticals kept at the dispensing unit
2. Receive products from the health centre store
3. Provide report on essential data following the reporting schedule established
5. Visually inspect products when dispensing to clients
11
7. Health Posts
As part of the primary health care unit, health posts manage pharmaceuticals which are used at the
community level. Table 7 shows the major roles and responsibilities of health posts in IPLS.
Table 7: Roles and responsibilities of health posts

2. Maintain Bin Cards for all pharmaceuticals
3. Complete a physical count of pharmaceuticals every month
4. Complete the Completed by Health Post section of the Health Post Report and Re- supply Form
every month
5. Arrange for transport and collect pharmaceuticals from health centers
7. Issue products to community health workers or volunteers
8. Visually inspect products when receiving, issuing and dispensing to clients
12
IV. OVERVIEW TO BASIC COMPONENTS OF IPLS AT HEALTH FACILITY
IPLS at facility level includes three basic logistics functions: LMIS, inventory control system
and storage of pharmaceuticals.
A. Logistics Management Information System (LMIS) in IPLS.
The purpose of a Logistics Management Information System (LMIS) is to

collect, organize, and report information to other levels in the system in order
to make decisions that govern the logistics system and ensure that all six rights
are fulfilled for each client.
The primary function of the LMIS is to support the management of essential pharmaceuticals.
Three essential data items are required to run a logistics system and, therefore, must be
captured by the LMIS. These three essential data items are:
1. Stock on Hand: Quantities of usable stock available at a particular point in time.
2. Consumption Data: The quantity of pharmaceuticals used during the reporting period.
3. Losses/Adjustments: Losses are the quantities of products removed from your stock for
anything other than in the provision of services to patients or issuing to another facility
(e.g. expiry, lost, theft, or damage) and are recorded as negative (-) numbers. Adjustments
are quantities of a product received from any source other than PFSA, or issued to anyone
other than your health facility. An adjustment may also be a correction due to an error in
mathematics. An adjustment may be a negative (-) or positive (+) number.
There are only three activities that happen to pharmaceuticals within a logistics system: they
are stored, moved between facilities, and used to provide health services to patients. A well-
designed logistics management information system will include records and forms that
collect and report the three essential data items as they relate to these three activities.
Records and forms have been designed for the Integrated Pharmaceuticals Logistics System
LMIS and are included in this SOP Manual along with step-by-step instructions on how to
complete them.
The roles and responsibilities of key personnel in the system were highlighted in the previous
section, and these same people are responsible for completing these LMIS forms.
13
Records and Reports Used in Managing Pharmaceuticals
A detailed description of each form used in the LMIS is listed in the table below. These forms
can be found in the Annex part of the SOP Manual. Job aids for completing the forms can
also be found in this SOP Manual.
Table 8: Records and reports used at different level
Name of
Data Items Recorded
Level LMIS Record Purpose Disposition
or Reported
Health Post Bin Card Stock keeping – Kept with item Beginning balance, ending,
track stock in storage quantit
y received/issued, losses and
adjustments
Health Post Report – Submitted For each item:
Monthly report essential data monthly to • Preprinted – item & unit;
Report and items to health health centre. • Beginning and ending
Re-supply centre for use in balance, quantity received,
Form losses and adjustments.
Used by the • Calculated consumption
health centre sto (previous and this month),
quantity needed to reach
max.
Health Centre Bin card Stock keeping – Kept in store • Beginning and ending
& Hospital track stock in storage with item balance, quantity
received/issued, losses
and adjustments
• Additional information:
batch number and expiry
date
14
Name of LMIS
Data Items Recorded or
Level Record or Purpose Disposition
Reported
Report
Stock Record Stock keeping – Kept in the • Beginning and ending
Card track stock in storage Cabinet in the balance, quantity
office of the received/issued, losses/
pharmacy head adjustments.
• Additional information:
unit price, expiry date and
location
Internal Facility Report & Transaction- Submitted For each item –
Report and following the
Resupply Form reporting schedule
Report essential data developed by the • Preprinted – item & unit;
health centre or
items,
the hospital
• Beginning and ending
balance, quantity received
and losses
Issue and receive /adjustments
pharmaceuticals • Calculated consumption,
within a health facility quantity needed to reach
Used by the health max and quantity to be
centre or hospital supplied.
store to issue
pharmaceuticals
to dispensing
units within the
facility
Report & Report & Transaction- Submitted every For each item:
Requisition other month to • Preprinted – item & unit;
Form PFSA with copy • Beginning and ending
Report essential data to WoHO (Health balance, quantity
items, Order Centre) or received and losses/
pharmaceuticals from RHB/ZHD adjustments,
PFSA (Hospital) • Calculated consumption,
days out of stock, quantity
needed to reach max and
quantity ordered.
Cost analysis To prioritize Will be used at For each item:
worksheet for purchased products the health Preprinted – item & unit;
RRF based on budget centre/hospital Original request
availability pharmacy • Quantity needed to reach
To adjust requested department max
quantity of products on • Unit price
the RRF based on cost
• Total Price
analysis
Adjustment
• Quantity needed to reach
max
• Unit price
• Total Price
15
Name of LMIS
Data Items Recorded or
Level Record or Purpose Disposition
Reported
Report
Woreda, Zonal Feedback To provide Will be sent from Stock status of priority (key)
and Regional reporting format ―feedback‖ to lower higher level pharmaceuticals, Reporting
Health Bureau of level facilities from facilities (PFSA, rate or increases/decreases in
(RHB/ZHD/Wo upper level facilities RHB/ZHO/WoH consumption.
HO) and PFSA. on basic indicators: O) to lower level
•Availability of key facilities)
pharmaceuticals
•Consumption trends
•Reporting rates
•Quality of data on
RRF
Reports of logistics information are submitted to relevant management units on a specific schedule. The table
below lists to which unit each facility reports and the frequency and schedule for reporting.
Table 9: Reporting frequency at different level of health facilities

Reports
Unit Every Until the Using this report form
to/Orders from
Health Post Health Centre month 5th day after the Health Post Monthly Report
reporting period and Re-supply Form
Health Centre (Direct) Woreda Health 2 months 10th day after the Report & Requisition Form
Office / PFSA reporting period
Health Centre (Non– Woreda Health 2 months 5th day after the Report & Requisition Form
direct) Office reporting period
Woreda Health Office (for PFSA 2 months 10th day after the Individual Health Centre
non –direct delivery reporting period Report & Requisition Form
Health Centers)
Hospital Regional Health 2 months 10th day after the Report & Requisition Form
Bureau / PFSA reporting period
16
B. Inventory Control System in IPLS
The purpose of an inventory control system is to inform personnel when and how much of a
pharmaceuticals to order and to maintain an appropriate stock level to meet the needs of
patients. A well designed and well operated inventory control system helps to prevent shortages,
oversupply, and expiry of pharmaceuticals.
To help maintain adequate stock levels, the maximum months of stock, minimum months of
stock and an emergency order point have been established for each health facility in the
system.
• The maximum months of stock is the largest amount of each pharmaceutical a facility
should hold at any one time. If a facility has more than the maximum, it is overstocked
and risk of having stocks expire before they are used is probable.
• The minimum months of stock is the level of stock at which actions to replenish
inventory should occur under normal conditions.
• The emergency order point is the level where the risk of stocking out is likely, and an
emergency order should be placed immediately.
The inventory control system for the IPLS is a Forced Ordering Maximum/Minimum
inventory control system. This means that all facilities are required to report on a fixed
schedule (monthly at health posts, every other month at health centers and hospitals) for all
products. In addition, products will be resupplied as soon as possible after report is sent to the
respective PFSA hub. . In emergencies, an emergency order should be placed. In practice,
this means that:
• Health centers and hospitals are required to report and order every two months.
• Health centers and hospitals calculate their own order quantities, ordering sufficient
quantities of all pharmaceuticals to bring stock levels up to the maximum level.
• Health posts report data monthly to their affiliated Health Centre.
• The Health centre calculates the re-supply quantities that are needed to bring health post
stocks up to the maximum level.
• If the stock on hand for any product at a facility falls below a set emergency order point
before the end of the reporting period, an emergency order should be placed. (See the Job
Aid on Placing Emergency Orders.)
17
The maximum months of stock, the minimum months of stock and emergency order points
for the different levels of the health logistics system are shown in the following table:
Table 10: Min Max level
Review Period Maximum Minimum Emergency Order
Level Months of Stock
Months of Stock Point
Health Centers and Every other 0.5 months
4 months 2 months
Hospitals month (= 2 weeks)
Monthly 1 months 0.25 months
Health Posts 2 months
(= 1 week)
Within hospitals and health centers, products will be managed centrally in the Pharmacy
Store. All products will be received into the pharmacy store and most of the products will be
stored there, until they are needed in the various dispensing units within the facility.
The pharmacy store manager and pharmacy head in collaboration with staffs in dispensing
units will establish a re-supply schedule for the dispensing units*. For example, each
dispensing unit will have one day per week/per 2 weeks designated for re-supply. On that
day, dispensing unit staff will complete an Internal Facility Report and Resupply Form; the
Pharmacy Store manager will use the information to determine the re-supply quantity needed
to serve clients until the next scheduled re-supply day. For example, every Monday (on a
weekly or twice monthly basis), the MCH service provider reports data to the pharmacy store
and receives enough product to serve clients during the week or next 2 weeks. This system
ensures that the dispensing units are not overworked with pharmaceuticals management
responsibilities and that the quantities issued to the dispensing units from the pharmacy stores
reflect actual consumption by the clients.
C. Storage of Pharmaceuticals in the IPLS
Storage is the safe way of keeping pharmaceuticals to avoid damage, expiry and theft.
Proper storage procedures help to ensure that storage facilities protect the shelf life of
products, that only high-quality products are issued, and that there is little or no waste due to
damaged or expired products. If proper storage procedures are followed, customers can be
assured that they have received a high quality product.
*Dispensing unit (DU) is any outlet in the hospital and health centre set up in which pharmaceuticals are dispensed out to
clients. It includes high volume DUs such as outpatient pharmacy dispensary and low volume DUs such as MCH and TB
clinics.
18
Storage conditions will affect the quality of the pharmaceuticals being stored. Rooms that are
too hot, stacks of cartons that are too high, and other poor storage conditions can cause
damage or cause a reduction in shelf life. A well-organized storeroom will simplify a
facility‘s work; time will not be wasted trying to find needed supplies.
Facility pharmacy Store improvement is among the major IPLS related pharmaceuticals
management improvement initiatives. Major steps involved are de junking, logical
organization and arrangement following good pharmaceutical storage practices and
overalll pharmacetuical management efficiency
19
V. RECORDING SYSTEM IN IPLS
Bin Cards and Stock Record Cards are used to account for products held in storage, including
their receipt and issue. In the IPLS valuable information used to make re-supply decisions is
recorded on the Bin Card and Stock Record Card; data from these records are used in
reporting, calculating reorder quantities and for monitoring stock levels.
The Bin Card is used at all health facilities (Health Post, Health Centre and Hospital); the
Stock Record Card is used only at the health centers and hospitals.
It is essential that personnel responsible for the management of pharmaceuticals maintain up-
to-date and accurate Bin Cards and Stock Record Cards for each product and individual units
of issues for products having more than one units of issue.
A. Maintaining the Bin Card
The following job aid describes the procedures for maintaining Bin Cards for
pharmaceuticals.
One Bin Card should be maintained for each pack size, form or presentation of
pharmaceuticals. The Bin Card should be kept with the product in the storage area.
20
JOB AID: Recording Transactions in the Bin Card
Task: Recording Transactions in the Bin Card
Completed by: Health staff in charge of pharmaceuticals (Health Extension Worker,

Pharmacy Store manager and Dispensing Units)
Purpose: To record pharmaceuticals received

To record pharmaceuticals issued To
record changes in stock balances
To track supplies moved through non-routine methods (e.g., local purchase,
transfers)
To track losses/adjustments
To record expiry dates
When To Perform: When pharmaceuticals are received or issued

When pharmaceuticals are transferred to another facility When
pharmaceuticals are transferred in from another facility
When pharmaceuticals are removed from the storage area for reasons other
than for use in health services (e.g., for demonstrations, expiration, damage)
At the end of the month when physical counts are conducted at the Health
Post; every other month at the Health Centres and Hospitals
Materials Needed: Bin Cards, pen, pencil (for AMC only)

Note: See the job aid on conducting a physical count for specific instructions for
completing the Bin Card during the physical count.
Step Action Notes
Complete one Bin Card for For examp le, each each of the
1. pharmaceutical you manage. following items should have a
separate bin card.
1. Glove latex disposable, large, 100
peices
2. Glove latex disposable, medlum,
100 pieces
3. Glove latex disposable, small, 100
pieces
IF ⇒
Opening a new Bin Card
Entering a transaction
Steps 3 – 10: Opening a NEW Bin Card
21
3. Name of Health Facility: Write the name of
the health facility where the product is being
managed.
4. Product Name, Strength and Dosage Examples:
Form: Enter the name, pack size, form
or presentation of the pharmaceutical. Amoxicillin, 250 mg, Capsule
RHZE/RH - (150mg +75mg + 275mg

+
400mg /150mg +75mg) – tablet
5. Unit of Issue: Use PFSA unit of Issue and Example: PK of 5 for implanon, PK of 3 cycles
Use kit as unit of issue for products coming for combined oral contraceptive pills
in individual patient kit form e.g. TB kit.
The unit recorded at the top of the Bin Card is
the same unit that is used to record transactions
on the card.
6 Maximum Stock Level: Write ―4 months‖. For health centers and hospitals, the maximum
has been set at 4 months of stock.
For Health Post : Leave it empty
For Dispensing Unit : 2 x reporting interval

7. Emergency Order Point: Write ―0.5 For health centers and hospitals, the Emergency
months‖. Order Point has been set at 0.5 months (= 2
weeks of stock).
For Health Post : Leave it empty

8. Average Monthly Consumption (AMC):
Take 3 months average of monthly Internal
Issues from the Bin Card (BC).
9. Write the product group (Program Vs
Purchased)
10. Record the opening balance at the time
the Bin Card is opened.
• If this is the first line of a new Bin Card

for an existing product, write the date,
write ―Balance Brought Forward‖ Example: ―Balance Brought Forward‖.
under the received column, and record
the ending balance from the old Bin
Card under the balance column.
• If this is the first line of a new Bin Card
for a new product, conduct and record a
physical count and record the results of
the physical inventory on the first line
of the Bin Card. For recording a physical count, refer to the Job
Aid Conducting a Physical Count in Chapter
VIII.
If you do not have a transaction to record, you are finished with this part of the task.
If you have a transaction to record, continue with Step 11 below.
22
STEPS 11 – 22: Recording Stock Transactions
11. Date: Enter the date of the transaction. Example: 01/09/05
12. Document No. (Receiving or Issuing): Example: 736529

Write the pre-printed number from the issue
(Model 22) or receipt voucher (Model 19)
that was used to document the receipt or
issue of the pharmaceuticals.
13. Received From or Issued To:
• If receiving products, enter the name
of the facility from which the item was Example: PFSA
received.
• If issuing at a health post, write
―dispensed to patients‖.
• If issuing within a health centre or
hospital, or if issuing from a health
centre to a health post, write the name
of the dispensing unit or health post to
which the pharmaceuticals are being
issued.
• If a physical count was conducted,
write ―Physical Count‖.
• If a positive adjustment (such as a
transfer in) is being recorded, note
from what facility products are being
received.
14. Quantity/Received: Enter the exact amount The quantity should be written in terms of
of the product received on this date. units of issue, the units noted at the top of
the card, for example, bottle.
Stock transferred from one facility to

another should be recorded as an
adjustment (see Step 16 for information on
entering adjustments). Therefore, the only
quantities entered in the Quantity/Received
column should be those quantities received
from the health centre (at the health post)
or from PFSA (at the health centre or
hospital).
23
15. Quantity/Issued: Record the number of
units issued as indicated:
At the health post, write the total quantity of

the product that was given to clients during
the day.
At the health centre and hospital, write the

quantity of the product each time the
product is issued to dispensing unit and
health post.
At the dispensing units
• Write the quantity of the product in the

pack each time the package is opened or
brought to the dispensing area from the
shelf, or
• Write the quantity of the product after
counting and calculating for each
product at the end of each reporting
period. That is, Quantity Issued =
Balance at the beginning of the
reporting interval + Quantity Received
+/- Loss/Adjustment – Ending Balance
(Mostly applied for bottles and tubes),
or
• Write the quantity of the product after
adding total quantities from tick or tally
sheet at the end of the day
• For products coming in individual
patient kit form like TB kit, record the
quantity of opened kits at the end of the
day
24
16. Quantity/Loss/Adj.: Enter the exact Losses are quantities removed from your
amount of losses or adjustments to the stock for anything other than issuing to
inventory on this date. patients or another unit in the facility (e.g.
expired, lost, stolen, or damaged). Losses
Explain any losses or adjustments in the are recorded as (-) negative numbers.
―Remarks‖ column (see Step 20).
Adjustments are quantities of a
pharmaceuticals received from any source
other than the regular source, that is, health
centre (for health posts) or PFSA (for
health centers and hospitals), or issued to
anyone other than within your facility.
Always use a (+) sign to indicate positive
adjustments, and a (-) sign to indicate
negative adjustments.
Adjustments may also be made to correct

mathematical mistakes previously made in
recording. Be sure to indicate if the
adjustment was negative or positive and
note the reason for the adjustment in the
―Remarks‖ column.
For TB kits at TB clinic - Newly

reconstituted kits from the supply box at
the end of the reporting period will be
recorded as positive adjustment
17. Quantity/Balance: The Balance should show only the
quantities of usable stock. Any unusable
If receiving products: Add the ―Quantity stock should have been removed from
Received‖ to the Balance from the previous inventory and an adjustment made on the
row and then enter the new balance. Bin Card.
If issuing products: Subtract the ―Quantity

Issued‖ from the Balance from the previous
row and then enter the new balance.
If recording a loss or adjustment: Add (if

+ve adjustment) or subtract (if -ve
adjustment) the loss or adjustment quantity
to the Balance from the previous row and
then enter the new Balance.
25
18. Batch Number: If the pharmaceuticals received or issued
have more than one batch number, use a
At the health post: Leave this column blank. separate row for each batch number and
indicate the quantity received or issued for
At the health centre or hospital: Write the each batch number.
batch number of the pharmaceuticals
received or issued.
19. Expiry Date: If the pharmaceuticals received or issued
have more than one expiry date, use a
At the health post: Leave this column blank. separate row for each expiry date and
indicate the quantity received or issued for
At the health centre or hospital: Write the each expiry date. Each expiry date should
expiry date of the pharmaceuticals received match with the corresponding batch
or issued. number.
For kits, write expiry date of product with

shortest expiry as an expiry date of the
whole kit
20. Remarks: Provide a brief explanation for Examples:
any loss/adjustment or add any other
comments as needed. Damaged product.
Purchase from local pharmacy.
Correction of mathematical error.

21. If you have filled the last line of the front of Turn to the back of the card and write
the Bin Card…. ―Balance Brought Forward‖ in the
―Received From‖ column and carry the
balance from the front of the card and
write it in the ―Balance‖ column of the
back of the card.
If you have filled the last line of the back of You will need to start a new Bin Card. Go
the Bin Card… to Step 3.
22. Keep the Bin Card close to where
pharmaceuticals are being stored and
issued.
26
The task is complete when:
 A separate Bin Card has been completed for each pharmaceuticals managed in the store.
 The Name of Health Facility, Product Name, Strength and Dosage Form, Unit of Issue,
Maximum Stock Level, Emergency Order Point and Average Monthly Consumption
(AMC) have been written at the top of the Bin Card.
 Each transaction is recorded on the Bin Card as it occurs.
 The Bin Card is kept close to where the pharmaceuticals are stored and issued.
 A separate Bin Card has been completed for each pharmaceuticals managed in the store.
 The Name of Health Facility, Product Name, Strength and Dosage Form, Unit of Issue,
Maximum Stock Level, Emergency Order Point and Average Monthly Consumption
(AMC) have been written at the top of the Bin Card.
 Each transaction is recorded on the Bin Card as it occurs.
 The Bin Card is kept close to where the pharmaceuticals are stored and issued.
27
B. Maintaining the Stock Record Card
The following job aid describes the procedures for maintaining Stock Record Cards for
pharmaceuticals at the Health Centre and Hospital. Note: The Stock Record Card is not used
at the Health Post.
One Stock Record Card should be maintained for each pack size, form or presentation of each
pharmaceutical.
JOB AID: Recording Transactions in the Stock Record Card
Task: Recording Transactions in the Stock Record Card

Completed by: Pharmacist, Pharmacy Technician or health staff in charge of
pharmaceuticals
Purpose: To record pharmaceuticals received

To record pharmaceuticals issued
To record changes in stock balances
To track pharmaceuticals moved through non-routine methods (e.g.,
local purchase, transfers)
To track losses/adjustments
To record expiry dates
When To Perform: When pharmaceuticals are received or issued

When pharmaceuticals are transferred to another facility
When pharmaceuticals are transferred in from another facility
When pharmaceuticals are removed from the storage area for reasons
other than for use in health services (e.g., for demonstrations,
expiration, damage)
At the end of every other month when physical counts are conducted
Materials Needed: Stock Record Cards, pen, pencil (for AMC only)
Note: See the job aid on conducting a physical count for specific
instructions for completing the Stock Record Card during the physical
count.
28
Step Action Notes
Complete one Stock Record Card for each For example, each of the following should
1. pharmaceutical you store. have a separate Stock Record Card:
• Glove, latex disposable, large, 100 pieces
• Glove, latex disposable, medium, 100 pieces
• Glove, latex disposable, small, 100 pieces
2. Enter only one transaction on each line.
IF ⇒ THEN
Opening a new Stock Record Card Continue ith Step 3.
Entering a transaction Skip to p 12.
S
Steps 3 – 11: Opening a NEW Stock Record Card
3. Name of Health Facility: Write the name
of the facility where the product is being
managed.
4. Product Name, Strength and Dosage Examples:
Form: Enter the name, pack size, form or
presentation of the pharmaceutical. RHZE/RH - (150mg +75mg + 400mg +
275mg/150mg +75mg) - tablet
5. Unit of Issue: Use PFSA unit of Issue and Example: PK of 64 sets for implanon, PK of 30
Use kit as unit of issue for products coming cycles for microgynon
in individual patient kit form e.g. TB kit.
Be sure to note that the unit recorded at the top
of the Stock Record Card is that which is used
to record transactions on the card.
6. Location: Write the location where the Examples: Storeroom, refrigerator, shelf
product is stored. number 11
7. Maximum Stock Level: Write ―4 months‖. For health centers and hospitals, the maximum
has been set at 4 months of stock.
8. Emergency Order Point: Write ―0.5 For health centers and hospitals,
the months‖. Emergency Order Point has been set at 0.5
months (= 2 weeks of stock).
29
9. Average Monthly Consumption (AMC):
Take 3 month average of monthly Internal
Issues from the Stock Record Card (SRC).
10. Write the product group (Program Vs
Purchased)
11. Record the opening balance at the time the Example: ―Balance Brought Forward‖.
Stock Record Card is opened.
• If this is the first line of a new Stock For recording a physical count, refer to the
Record Card for an existing product, Job Aid Conducting a Physical Count in
write ―Balance Brought Forward‖ on the Chapter VIII.
first line of the Stock Record Card and
continue with Step 16 in this Job Aid.
• If this is the first line of a new Stock
Record Card for a new product, conduct
and record a physical count and record
the results of the Physical Inventory on
the first line of the Stock Record Card.
STEPS 12 – 23: Recording Stock Transactions
12. Date: Enter the date of the transaction. Example: 01/08/2005
13. Document No. (Receiving or Issuing): Write Example: 736529

the pre-printed number from the issue (Model
22) or receipt voucher (Model 19) that was
used to document the receipt or issue of the
pharmaceuticals.
14. Received from or Issued to: Example: ―PFSA‖
• If receiving products, write the name of
the facility from which the item was
received. Example: TB clinic
• If issuing within a facility or to a health
post, write the name of the dispensing For recording a physical count, refer to the
unit or health post to which the Job Aid Conducting a Physical Count in
pharmaceuticals are being issued. Chapter VIII.
• If a physical count was conducted, write
―Physical Count‖. Note: Positive adjustment for
• If a positive adjustment (such as a pharmaceuticals received from any source
transfer in) is being recorded, note from other than PFSA
what facility products are being received.
30
15. Quantity/Received: Enter the exact amount The quantity should be written in terms of
of the product received on this date. units of issue, for example, bottles.
The only quantities entered in this column

should be those quantities received from
PFSA. Stock transferred from one facility to
another should be recorded as an adjustment
(see step 17 for information on entering
adjustments).
16. Quantity/Issued: Record the number of Issuing in a facility may include issuing to
units of the commodity issued on this date. the health post and dispensing unit (ART
clinic, or other areas) in the facility.
At the health centre and hospital, write the
quantity of the product each time the product
is issued to a health worker or unit (ward,
clinic, dispensary, Health Post).
17. Quantity/Loss/Adj.: Enter the exact Losses are quantities removed from your
amount of losses or adjustments to the stock for anything other than issuing to
inventory on this date. another unit in the facility (e.g. expired, lost,
stolen, or damaged). Losses are recorded as
Explain any losses or adjustments in the (-) negative numbers.
―Remarks‖ column (See Step 21).
Adjustments are quantities of
pharmaceuticals received from any source
other than PFSA, or issued to anyone other
than within your facility. Always use a (+)
sign to indicate positive adjustments, and a (-
) sign to indicate negative adjustments.
Adjustments may also be made to correct

mathematical mistakes previously made in
recording. Be sure to indicate if the
adjustment was negative or positive and note
the reason for the adjustment in the
―Remarks‖ column.
31
18. Quantity/Balance: The balance should show only the quantities of
usable stock. Any unusable stock should have
If receiving products: Add the ―Quantity been removed from inventory and an
Received‖ to the Balance from the previous adjustment made on the Stock Record Card.
row and then write the new balance.
If issuing products: Subtract the ―Quantity

Issued‖ from the Balance from the previous
row and then write the new balance.
If recording a ―Balance Brought Forward‖:

Record the balance from the previous Stock
Record Card.
If recording a loss or adjustment: Add or

subtract the loss or adjustment quantity to the
Balance from the previous row and then write
the new Balance.
19. Unit Price/Birr/Cent: If receiving products, The unit price is indicated on the invoice
write the unit price of the product received. received from PFSA.
Only fill in the Unit Price when receiving

products. Do not fill in the Unit Price when
issuing, conducting a physical count or at any
other time.
20. Expiry Date: Write the expiry date of the If the pharmaceuticals received or issued have
pharmaceuticals received or issued. more than one expiry date, use a separate row
for each expiry date and indicate the quantity
received or issued for each expiry date.
For kits, write expiry date of product with

shortest expiry as an expiry date of the whole kit
21. Remarks: Provide a brief explanation for Example: lost, damaged ,expired
any loss/adjustment or add any other
comments as needed.
22. If you have filled the last line of the front of the Turn to the back of the card and write
Stock Record Card…. ―Balance Brought Forward‖ in the
―Received From‖ column and carry the
balance from the front of the card and write it
in the ―Balance‖ column of the back of the card.
If you have filled the last line of the back of the Start a new Stock Record Card. Go to Step 3.
Stock Record Card…
23 Keep the Stock Record Card in the
Pharmacy Manager’s office.
32
VI. REPORTING AND ORDERING PHARMACEUTICALS
Reporting and ordering form in IPLS is mechanism by which health facilities (health centers and
hospitals) communicate information with their respective administrative offices and order requests
from their supplying PFSA hubs. Health Posts, however, only report the essential data items to their
supplying health centers.
Hospitals and health centers use RRF and health posts use HPMRR for reporting.
Note: VRF (Vaccine Requisition Form) is used to report vaccine related data. The form is annexed
A. Reporting by Health Posts
Health Posts complete one part of the Health Post Monthly Report and Re-supply Form every
month and carry the report to the health centre. The health centre uses the information found
on the Health Post Monthly Report and Re-supply Form to complete the form and calculate
the quantity of pharmaceuticals needed by the health post. Each month, the health centre will
issue enough stock to bring the health post up to its Maximum Stock Level of 2 months of
stock for each product.
The following job aid provides instructions on how to complete the Health Post section of the
Health Post Monthly Report and Re-supply Form.
JOB AID: Completing the Health Post Section of the Health Post Monthly
Report and Re-supply Form
Task Completing the Health Post Section of the Health Post Monthly Report
Completed Health Extension Worker
Purpose To report the logistics data that the health centre needs to calculate
the
When to perform: At the end of the month and send it until the 5th day of the current month
Materials needed: BinCard for each pharmaceutical, blank Health Post Monthly Report and Re-
supply Form and copy of the previous month‘s Health Post Monthly Report
and Re-supply Form.
Note The health extention worker comes with three copies of HPMRR to health
center for resupply. After the store manager completed the health center
section; two copies should be given to the Health Centre and one copy
should remain in the booklet for the Health Post. The Health Centre will send
one copy to the Woreda.
33
Step Action Notes
1. Name of the Health Post: Write the name
of the Health Post for which the report is
being completed.
2. Supplying Health Centre: Write the name The Supplying Health Centre is assigned
of the Health Centre from which you will by MOH (Woreda Health Offices).
receive your products.
3. Current Reporting Period, From: … To: The Reporting Period should be from the
Write the starting month, day and year and 1st day of the month through to the last day
the ending month, day and year that covers of the month.
the reporting period. Example: Ginbot 1, 2005 – Ginbot 30,
2005
4. Maximum Level (pre-printed): The The maximum stock level for the Health
Maximum Stock Level for the Health Post. Post is 2 months of stock.
5. Serial Number (Ser. No.) (Pre-printed): Example: 1, 2, 3 …
The serial number of the product on the
form.
6. Product Name (pre-printed): The name If reporting on products that are not listed,
and description of each pharmaceutical. write the Product Name and description on
a blank row.
7. Unit (pre-printed): The unit for each If reporting on items that are not listed,
pharmaceutical. write the unit for the item next to the
Product Name and description on a blank
row.
8. Beginning Balance (A): Write in the This information is on the Bin Card, it is
quantity of stock you had available at the the quantity of product you started with.
beginning of this reporting period.
The Beginning Balance for the current
month should be the same as the Ending
Balance from the previous month.
9. Quantity Received (Column B): Write the This information is the sum of the
quantity of the item received during this quantities found in the ―Received‖ column
reporting period. of the Bin Card for the dates during the
current reporting period.
10. Losses/Adjustments (C): Write the total This information is the sum of the
quantity of the item lost or adjusted during quantities found in the
this reporting period. ―Losses/Adjustments‖ column of the Bin
Card for the dates during the current
reporting period.
Write any remarks related to the

loss/adjustment in the Remarks section;
34
11. Ending Balance (D): Write the quantity Conduct a physical count to determine the
of the product on hand at the end. Stock on Hand. Stock on Hand can also be
found on the Bin Card, if the Bin Card is
up-to-date.
12. Remarks: Write any remarks related to Remarks on losses and adjustments should
the product or any explanation related to be found on the Bin Card.
losses and adjustments that you have
reported.
13. Completed by Health Centre section: The store manager at the supplying Health
Leave all columns in this section blank. Centre will complete these columns for
you.
14. Completed by/Signature/Date: Write The report should be completed and signed
your name, sign the report and write the until the 3rd day of the month.
date on which the report was completed.
15. Take all copies of the report with the The report should be taken to the Health
completed report to the Health Centre. Centre for re-supply until the 5th day of
the month.
 The Health Extension Worker has completed the information identifying the facility and the
reporting period, completed the information required for each product, and signed and dated
the report.
 The Health Extension Worker has taken the report to the Health Centre for re-supply.
35
B. Reporting and Ordering by the Hospitals and Health Centres
This section of the manual addresses the process for reporting on and ordering
pharmaceuticals. Hospitals and Health Centres use the Report and Requisition Form (RRF)
to:
• Report on the quantities of pharmaceuticals used, lost or transferred, and the
quantities of stock available
• Order pharmaceuticals
The actual RRF used by hospitals and health centres to report and order pharmaceuticals are
the same except the hospital RRF includes larger number of pre-printed items on the form
than the health centres. And also, to improve pharmaceuticals management by level, the
level specific RRFs will have 5 subgroups (pads) for program and 4 for RDF
pharmaceuticals:
• RRF 1 - Hospitals and ART Health Centres (Program Medicines)
• RRF 2 - PMTCT Health Centres ( program medicines and laboratory Regents)
• RRF 3 - Special Lab Monitoring Sites (Program Reagents, Supplies and Diagnostics)
• RRF 4 - Hospitals and Lab Monitoring Health Centres (Program Reagents, Supplies and
Diagnostics)
• RRF 5: Non Lab Monitoring ART Health Centres (Program Reagents, Supplies and
Diagnostics)
• RRF 6 - Hospitals ( RDF Medicines)
• RRF 7 – Health Centres (RDF Medicines)
• RRF 8 – Hospitals (RDF Supplies and Diagnostic Reagents)
• RRF 9- Health Centres (RDF supplies and Diagnostic Reagents)
Table 11: RRF category for program pharmaceuticals
Medicines Supplies and Diagnostic Reagents
Hospitals PMTCT Special Lab Non Lab PMTCT
and ART HCs Monitoring Sites/ Monitoring HCs
HCs Hospitals and Lab ART Health
Monitoring HCs Centres
Program RRF # 1 RRF # 2a RRF # 3/ RRF # 4 RRF # 5 RRF # 2b
36
Table 12: RRF category for RDF pharmaceuticals
Medicines Supplies and Diagnostic Reagents

Hospitals Health Centres Hospitals Health Centers
RDF RRF # 6 RRF # 7 RRF # 8 RRF # 9
In preparing the order for pharmaceutical to be purchased, the facility should complete ―the
cost analysis worksheet‖ to know the monetary value of products to be ordered. If the budget
is insufficient to order all pharmaceuticals, the facility should do VEN analysis and order all
pharmaceuticals in Group V first, the items in Group E second, and the Group N items last as
funds allow. Additional funds from other sources can be used to supplement the budget.
Products need to be reported in agreed upon defaults units, which are pre printed in level
specific RRF. That is, all other units of issue should be converted to the default unit to be
added later on the product with default unit using the following conversion factor:
Conversion Formula = Number of Units in the pack X Quantity in the Bin Card +...
Number of Units in each standard pack
For products coming in individual patient kit form the unit of issue remains kit or no need to
convert the unit to other default unit of issue.
Facilities that submit their RRF on time should always have sufficient stocks of
pharmaceuticals to serve their patients. Facilities should send their completed and approved
RRF to PFSA until the 10th day of the month following the end of the reporting period.
Health centres that are served through WoHO should submit the original and one copy of
RRF to WoHO until the 5th day of the month. Woreda health offices will send the original
RRF reports to affiliated PFSA branch until the 10th day of the month on the behalf of the
health centres. For example, if the last month of the reporting period was Tikimt, the RRF
would be due at PFSA by Hidar 10th.
37
At PFSA, data from RRF will be used for national quantification and procurement activities
after being aggregated in addition to routine resupply decisions.
In addition, Hospitals and Health Centres should submit a copy of the RRF to
RHB/ZHD/WoHO until the 10th day of the month following the reporting period as
specified below. The RRF has 3 copies. Copies are distributed and kept during the process as
follows:
• Hospital or Health Centre complete 3 copies of the RRF

• Sends 1 copy to PFSA
• Sends 1 copy to administrative body (RHB/ZHD or WoHO)
• Keep one copy with them
The RRF form may be sent by post, electronically (for HCMIS FE sites), courier or hand-
carried. It is important that it should be received as quickly as possible after completion. The
following job aid describes how to complete the Report and Requisition Form.
Pharmaceuticals logistics data (RRF) acquisition options

Completed RRFs at SDPs should reach to respective PFSA branches on time to make
resupply and other decisions. PFSA identified and proposed the following options of
acquiring the data. All of these methods have their own advantages and limitations.
Some of these options are designed solely to RRF data collection whereas; others are
designed to leverage the already existing system to serve the health system. This section of
the SOP addresses the definition of and the processes of each option.
Postal Service: Option 1. The health facilities will prepare their pharmaceutical logistics
report and requisition according to a prearranged timeline and may submit the report to the
local post office. The local post office will deliver the report to respective hubs.
38
Option 2: PFSA may enter a contract with the postal service so the postal office may
collect the pharmaceutical logistics report from health facilities on a predetermined
schedule and deliver the reports to the respective hubs.
Health Management Information System (HMIS) Route: Two copies of completed RRFs
will be sent every other month to respective management units (WoHO/ZHD/RHB) along
with other HMIS Reports. WoHOs/ZHDs/RHBs will keep one copy and sends the original
to respective PFSA branch.
Fax: This option is recommended for facilities having a fax machine. If a facility has a fax
machine, the RRF should be faxed to PFSA and to the appropriate management unit, and
then the original copies would be sent by post.
Electronically (Email or any other means): If a facility has internet access and a scanner,
they may scan their competed RRFs and send it electronically, then the original copies would
be sent by post.
Data Processors: Trained professionals are assigned to collect facility RRFs and provide
onsite technical assistance on RRF completion and data quality.
Telephone: This method of pharmaceutical logistics data acquisition is a means of getting

pharmaceutical logistics report from health facilities through the telephone.
Other Delivery Means: The other delivery means is a way by which health facilities deliver
their pharmaceutical logistics report and requisition, hand-carried to the nearby hub for
resupply decision.
The current experience of reporting in some regions of the country: facilities sent to their
woreda, woredas to zones and zones to the supplying hubs.
Each PFSA hub works closely with the ZHDs and RHBs of their respective catchment area
to map the data acquisition of all sites served by the branches and it is communicated to the
health facilities by the RHBs/ ZHDs. The methods used in each site are documented by the
branch and it is periodically reviewed based on the situation of the health facilities. In
addition to this, the performance of each health facility is monitored and evaluated.
39
JOB AID: Completing the Report and Requisition Form
Task: Completing the Report and Requisition Form

Completed by: Health Centre or Hospital Store Manager (verified by the Pharmacy
Manager and Approved by Head of the Health Centre or Hospital.
Purpose: To report on pharmaceuticals used and stocks available
To order pharmaceuticals
When to perform: RRF should be completed at the end of the month and send to PFSA
until the 10th day of the month following the end of the reporting period
Materials needed: Blank Report and Requisition Form, the Report and Requisition Form from
the previous reporting period, Stock Record Cards/Bin Cards for all
pharmaceuticals, pen, calculator
Note: Each page of the form has three (3) copies. Press hard with your pen so that
everything you write appears on the bottom copy.
Much of the information needed to complete the RRF is obtained from the
Bin Card/Stock Record Card; be sure that the Bin Card/Stock Record Cards
are up-to-date and that they include the most recent physical count.
Step Action Notes

To Report and Order Pharmaceuticals
Health Facility/Woreda/Region: Write the Example: [region : Oromia], [Woreda :
1. location of the health facility (Health Centre Lume], [health facility : Modjo Health
or Hospital). Center]
Current Reporting Period: From: … To: Example:
2. Write the first and last day of the reporting
period (In Ethiopian Calendar).
Ginbot 1, 2005 – Sene 30, 2005.
3. Serial Number (S/No.) (Pre-printed): The Example: 1, 2, 3,
serial number of the product on the form.
4. Product (pre-printed): The name and If reporting on and ordering items that are
description (Strength, Dosage Form and not listed, use a blank line at the end of the
Minimum Unit of Issue) of each form. Write the product name and
pharmaceutical is pre-printed on the form. description.
If note pre printed write those descriptions
on the blank form
40
Step Action Notes
Unit of Issue (pre-printed): The unit of If reporting on and ordering items that are
5. issue for each pharmaceutical is pre-printed not listed, write the unit of issue, if it is
on the form. If note pre printed write those known, next to the item description written
descriptions on the blank form in Step 5.
Beginning Balance (Column A): Write the This information can be found on the Report
6. balance of the item at the beginning of the and Requisition Form from the previous
reporting period. reporting period.
The Beginning Balance for the current If this is the first RRF,
report is equal to the Ending Balance of the
previous report.
• This information can be found on the Bin
Card/Stock Record Card.
• Convert other units to the default unit
using the following formula (except for
products coming in individual patient kit
form like TB kit):
Number of Units in the pack X Quantity

on the Bin Card
Number of Units in standard pack
7. Quantity Received (Column B): Write the This information is the sum of the quantities
quantity of the item received during this found in the ―Received‖ column of the Bin
reporting period. Card/Stock Record Card for the dates during
the current reporting period.
• Convert other units to the default unit

form like TB kit):
on the Bin Card
41
Step Action Notes
8. Losses/Adjustments (Column C): Write This information is the sum of the
the total quantity of the item lost or adjusted quantities found in the
during this reporting period. ―Losses/Adjustments‖ column of the
Bin Card/Stock Record Card for the
dates during the current reporting period.
Convert other units to the default unit

form like TB kit):

on the Bin Card

Ending Balance in DUs (Column D): The Ending Balance (D) is the ending
9. Write the ending balance or Stock On Hand balance from the latest IFRR reports
quantity of the item at the end of the from DUs
reporting period in the dispensing units.
form like TB kit);
Number of Units in the pack X Quantity on the Bin
Card Number of Units in standard pack
Ending Balance Store (Column E): Write The Ending Balance (E) is the balance on
10. the ending balance or Stock On Hand the Bin Card on the last date of the
quantity of the item at the end of the reporting period. The Ending Balance
reporting period in the store room. should also b e equal to the results of the
physical count of the item.

form like TB kit);
Number of Units in the pack X Quantity on the Bin
Card Number of Units in standard pack
11. Calculated Consumption (Column F): Calculated Consumption (Column F)

Calculate the total amount of + Loss/Adjustment (C) - Ending
pharmaceuticals Issued out of the Pharmacy Balance at DUs (D)- Ending Balance at
Store using the beginning balance in the Store (E)
store, Quantity Received, Loss/Adjustment
and Ending balance in the store.
42
Steps Action Notes
12. Days Out of Stock (Column G) : The total Count the number of days of Stock Out
number of day a product was out of stock at of the product in the health facility .
facility
Maximum Stock Quantity (Column

13. H): Calculate and write the maximum For program pharmaceuticals the
stock quantity maximum quantity is calculated after
• For program RRF using the formula H multiplying CC adjusted for DOS by 2
= 120 F/ (60 – G). (4 MOS).
• For RDF RRF using the formula
H= F*2*RP*30/ ((RP*30)-DOS)
• For Malaria pharmaceuticals, use this For RDF pharmaceuticals the maximum
formula H = (120 F/ (60 – G))*LSI of quantity is calculated based on adjusted
the requisition (resupply) period. CC for DOS for consumption within
the review period (Maximum for RDF is
adjusted CC in the review period).
LSIs- Look-ahead Seasonality Indices

or adjustments factors are used due to
seasonality and demand variability.
Using the previous calculated
consumption to resupply would lead to
stock out, under or overstock. Each
resupply period will have its own index
to adjust historical consumption. The
order quantity considers the specific
reporting period indices.
Requisition (resupply) period: is the

• Quantity Ordered (Column I): I (Quantity Ordered) = H (Maximum
14. Calculate and write the quantity Stock Quantity) – D (Ending Balance in
needed to reach max by subtracting the DU) - E (Ending Balance in store)
ending balance in the store from the
maximum stock quantity using the The formula is also found on the RRF.
formula I= H- D-E
If the calculated quantity is a zero or a
negative number then no additional
stock is required. Write 0 in the
―Quantity Ordered‖ column.
43
15. Products with shelf life < 6 months: Note: You will find the definition for
Write the serial number in the list, ―shelf life‖ in chapter VIII.
quantity and expiry dates of
pharmaceuticals with shelf life less than or
equal to 6 months.
Remarks: Write any remarks related to Remarks on losses and adjustments

16. the product or any explanation related to should be found on the Bin Card.
losses and adjustments that you have
reported. (Write the serial number in the
list, quantity and reason for loss and/or
Completed by/ Name/Signature/Date:
17. The person (Store Manager)
completing the Report and Requisition
parts should write and sign his or her
name, and write the date on which he
or she has completed these sections of
h f
Verified by/ Name/Signature/Date: The
18. Head of the Pharmacy Section should
write and sign his or her name, and write
the date on which he or she has reviewed
Approved by/Name/Signature/Date:
19. The Head of the facility should write
and sign his or her name, and write
the date on which he or she has
reviewed the form.
Task is complete when:
 The Health Centre or Hospital has completed the information identifying the facility and
the reporting period, has completed columns A through I, and signed the form.
 The Health Centre or Hospital has sent 1 copy to PFSA and 1 copy to the appropriate
administrative body (RHB/ZHD or WHO), and keeping one copy.
Prioritizing pharmaceuticals for procurement
VEN is one of the methods that health facilities use to procure pharmaceuticals that are of the
most importance with their available resources. The other method that could be used to
prioritize products for procurement is ABC analysis (Annex %)
44
VEN Analysis
VEN analysis is a system of setting priorities, in which pharmaceuticals are classified

according to their health impact and decisiveness to the service: vital, essential, and less-
essential (non-essential).
If funds are limited, VEN analysis is a method to prioritize for pharmaceuticals purchase.
This analysis is used to identify high-priority pharmaceuticals for procurement and low-
priority pharmaceuticals that the DTC should analyze carefully for deletion from the
Pharmaceutical List.
VEN stands for: V =

Vital:
• Potentially lifesaving, the best tool to curl the morbidity of the area: in the absence of
this pharmaceutical, the patient may die, or may be hurt.
• Crucial to provide the basic health services; without which it is impossible to deliver the
basic services in a specific area
• It is mandatory 24 hours of a day, 7 days of a week, and or 12 months of a year
• Known, easily manageable by the health care team and is the most fit with the clinical
setup of the facility than the other alternatives.
E = Essential:
• Effective against less severe but significant illness,
• In the absence of these items, it may be difficult to deliver the service; somehow one
may deliver the service by using alternatives
• Are manageable by the medical staff and fits in a better way to the clinical setup of the
facility than the other alternatives
N = none essential/less essential:
• Effective for minor illnesses
• But may have high cost compared to its therapeutic advantage
• The service will not be stopped due to the absence of N items
• Cannot be managed by the clinical setup and medical staffs even if it is the best
pharmaceutical
45
JOB AID: Completing the Cost Analysis worksheet for purchased drugs RRF
Task: Completing the Cost Analysis worksheet for RRF

Completed by: Health Centre or Hospital Pharmacy Head/Manager
Health Centre or Hospital Store Manager (verified by the Pharmacy
Manager)
Purpose: To prioritize purchased products based on budget availability

To adjust requested quantity of products on the RRF based on cost
analysis
When to perform: After the store manager completes the RRF up ‗ the quantity to
reach Max‘ column and before the 10th day of the month
following the end of the two months‘ reporting period
Materials needed: Partially completed (up to ‗Quantity needed to reach Max‘ column)
Report and Requisition Form (RRF), Blank cost analysis
worksheet, pen, calculator, updated product-price list and VEN
classification of the facility specific pharmaceuticals list.
Note: The Store Manager fills the RRF up the column ‗Quantity required
to reach Max‘. The Pharmacy Manager performs cost analysis
based on VEN analysis procedure, and then selects prioritzed
products with their required quantities. The prioritized products
with their adjusted/required quantities are then entered into the last
column in the RRF (Quantity Ordered), approves by signing in the
appropriate place at the bottom of the RRF.
Step Action Notes
To complete the Cost Analysis worksheet for RRF

Health Facility: Write the name of Example: [Modjo Health Center]
20. the health facility (Health Centre or
Hospital).
21. Reporting Period: From: … To: Example:
Write the first and last day of the
reporting period (In Ethiopian
Calendar). Ginbot 1, 2005 – Sene 30, 2005.
22. Serial Number (S/No.) Example: 1, 2, 3,
23. Product: Write the name and
description (Strength, Dosage Form
and Minimum Unit of Issue) of each
pharmaceutical
24. Unit of Issue (pre-printed):
46
Step Action Notes
25. VEN Group: Group products Note: Facility specific VEN categories
according to their importance to help are developed by the facility Drug and
facilities in prioritizing Therapeutic Committee (DTC) as part of
pharmaceuticals in budget limited facility specific formulary and drug list
settings (see the job aid of VEN development.
analysis )
Original Request
Quantity Needed to reach Max:

26. Copy the quantity needed to reach
Max from the partially completed
RRF by the Store Manager into the
cost analysis worksheet.
Unit Price: Write the latest unit price The latest unit price can be obtained from
27. into the cost analysis worksheet. previous invoices or updated PFSA price
list
28. Total Price: Multiply the total Note: Column A x Column B

quantity needed to reach Max by the
unit price.
Adjustment
Quantity Ordered: Enter the Note: Pharmaceuticals in V groups

29. quantity of products determined after should be selected first, then E and
the prioritization and cost analysis finally N. But, select logically (eg. by
proportion) if it is within the same group.
30. Total Price: Multiply the quantity Note: Column D x Column E
ordered by the unit price.
Completing the Quantity Ordered column of the RRF

Copy the quantity ordered from the
31. cost analysis worksheet to the
‗Quantity Ordered‘ column on the
RRF
Place your name, signature, and
32. stamp in the appropriate place at the
bottom of the RRF.
47
Task is complete when:
 The Health Centre or Hospital Pharmacy Manager has completed the information on
columns “ A through E” in the cost analysis worksheet, copied the Quantity Ordered
into the RRF, and completed the signatory part in the RRF.
C. Assessing Stock Status
“The purpose of assessing your stock status is to determine how long your stock will last” 1. You
should assess your stock status at any time you think that :
1. your current stock on hand will not last until the end of the current review period. This may
occur if there is a loss of supplies due to damage, expiry, or theft, or if there is an
unexpected increase in consumption or
2. if you think it will last for more than the set maximum. This may be rare but could occur
when there is a decrease in consumption, over-supply of a products from a different
source…etc
Note: Your stock on hand is expressed in Months of Stock.
Determining Months of Stock (MOS)
To determine your months of stock, do the following calculation:
𝑆𝑆𝑆𝑆𝑆𝑆𝑆𝑆𝑆𝑆 𝑜𝑜𝑜𝑜 𝐻𝐻𝐻𝐻𝐻𝐻𝐻𝐻

𝑀𝑀𝑀𝑀𝑀𝑀 =
𝐴𝐴𝐴𝐴𝐴𝐴𝐴𝐴𝐴𝐴𝐴𝐴𝐴𝐴 𝑀𝑀𝑀𝑀𝑀𝑀𝑀𝑀ℎ𝑙𝑙𝑙𝑙 𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶
Example:1
If the Stock on Hand in a facility of a certain product = 16, and the calculated consumption of the product
during the reporting period= 40, to calculate the MOS,
𝑆𝑆𝑆𝑆𝑆𝑆𝑆𝑆𝑆𝑆 𝑜𝑜𝑜𝑜 𝐻𝐻𝐻𝐻𝐻𝐻𝐻𝐻 16

𝑀𝑀𝑀𝑀𝑀𝑀 = = = 0.4
𝐴𝐴𝐴𝐴𝐴𝐴𝐴𝐴𝐴𝐴𝐴𝐴𝐴𝐴 𝑀𝑀𝑀𝑀𝑀𝑀𝑀𝑀ℎ𝑙𝑙𝑙𝑙 𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶𝐶 40
This means, the stock you have will last for 0.4 months, which would be about 12 days.
48
Determining your stock status will help you decide to make decisions regarding your stock status. In
this case, if this were in a health post, you would consider your stock status is normal and you may
not do anything as your stock status is above the set emergency order point (0.25); on the other
hand, if this were in a health center or hospital, your stock status is below the emergency order point
(0.5), therefore, you would need to place an emergency order.
To determine your months of stock for malaria products, do the following calculation:
𝑺𝑺𝑺𝑺𝑺𝑺𝑺𝑺𝑺𝑺 𝒐𝒐𝒐𝒐 𝑯𝑯𝑯𝑯𝑯𝑯𝑯𝑯

𝑴𝑴𝑴𝑴𝑴𝑴 =
𝑨𝑨𝑨𝑨𝑨𝑨 ∗ 𝑳𝑳𝑳𝑳𝑳𝑳 𝒐𝒐𝒐𝒐 𝒕𝒕𝒕𝒕𝒕𝒕 𝒓𝒓𝒓𝒓𝒓𝒓𝒓𝒓𝒓𝒓𝒓𝒓𝒓𝒓𝒓𝒓 𝒑𝒑𝒑𝒑𝒑𝒑𝒑𝒑𝒑𝒑𝒑𝒑
Example 2
On Dec 26, while assessing a stock status, if the stock o n hand of Artemether + Lumifantrine,
in a facility supplied by Adama hub is 16 and the average calculated consumption of Nov-Dec
from RRF is 40. Calculate the MOS considering the LSI of reporting period as 0.66
MOS= SOH/(AMC*LSI): 16/(40*0.66)=0.61.
This means, the stock on hand will last for 18 days i.e. the stock status is above the set emergency
order point and the facility won’t place an emergency order.
D. Placing Emergency Orders

A maximum/minimum inventory control system is designed so that facilities always have
enough stock to serve their clients and to prevent emergency orders. However, every system
must have a procedure for placing emergency orders if they are ever needed. An emergency
order would be needed to avoid reaching a stock-out before the end of the review period.
Note: Never let your stock status level reach ― zero (stock-out). Take action before a stock-out
occurs!
At Health Centres and Hospitals an emergency order is needed if the stock level falls below 2
weeks of stock (0.5 months of stock) before the end of the review period.
At the Health Posts an emergency order is needed if the stock level falls below 1 week of stock
(0.25 months of stock) before the end of the review period.
Note: When making an emergency order, only report on the product(s) that require the
emergency order. Do not report on all products managed by the health facility.
49
JOB AID: Completing the Health Post Monthly Report and Re-supply Form for an
Emergency Order
Task: Placing an Emergency Order (Health Post to Health Centre)
Completed by: Health Extension Worker
Purpose: To place an emergency order for any product which goes equal to or
below 1 week (0.25 months) of stock?
To avoid a stock out of a pharmaceuticals.
When to perform: As soon as the Stock on Hand for any product goes equal to or below 1
week (0.25 months) of stock
Materials needed: Blank Health Post Monthly Report and Re-supply Form, Bin Card(s),
calculator, pen
Note: Same as HPMRR Job Aid
For any product which go equal to or below 1 week (0.25 months) of stock and that require
an emergency order, follow the steps below:
Step Action Notes

1. Name of the Health Post: Write the name
of the Health Post for which the report is
being completed.
2. Supplying Health Centre: Write the name The Supplying Health Centre is
of the Health Centre from which you will assigned by MOH (Woreda Health
receive your products. Office).
Reporting Period, From: … To: Write the The Reporting Period should be from the
3 starting month, day and year and the ending 1st day of the month through to the last
month, day and year that covers the reporting day of the month. Example: Jan. 1, 2015
period. – Jan. 31, 2015
50
Step Action Notes
4. Maximum Level (pre-printed): The The maximum stock level for the Health
Maximum Stock Level for the Health Post is 2 months of stock.
Post.
5. Serial Number (Ser. No.) (Pre- Example: 1, 2, 3,
printed): The serial number of the
product on the form.
6. Product Name (pre-printed): The If reporting on products that are not listed,
name and description of write the Product Name and description on
pharmaceuticals. If not write those a blank row.
descriptions on the blank form.
7. Unit (pre-printed): The unit for If reporting on items that are not listed,
pharmaceuticals. If not write those write the unit for the item next to the
descriptions on the blank form. Product Name and description on a blank
row.
8. Beginning Balance (A): Write in the This information is on the Bin Card, it is the
quantity of stock you had available at quantity of product you started with.
the beginning of this reporting period.
The Beginning Balance should be the same
as the Ending Balance from the previous
month.
9. Quantity Received (B): Write the This information is the sum of the
reporting period. of the Bin Record Card for the dates during
the current reporting period.
10. Loss/Adjustment (C): Write the total This information is the sum of the
quantity of the item lost or adjusted quantities found in the
during this reporting period. ―Losses/Adjustments‖ column of the Bin
reporting period.

loss/adjustment in the Remarks section;.
11. Ending Balance (D): Write the quantity Conduct a physical count to determine the
of the product on hand when about to Stock on Hand. Stock on Hand can also be
place emergency order. found on the Bin Card, if the Bin Card is
up-to-date.
12. Write the words “Emergency Order” .
at the top of the Report.
51
Step Action Notes
13. Remarks: Write the reason for the Example: Loss of 25 cycles. Damage of 50
emergency. pieces.
14. Completed by Health Centre section:
Leave all columns in this section blank.
The store manager at the supplying
Health Centre will complete these
columns for you.
15. Prepared by/Signature/Date: Write
your name, sign the report and write the
date on which the report was completed.
16. Take all three copies of the completed
report to the Health Centre.

 The Health Extension Worker has completed the information identifying the facility and the
reporting period, completed the required information for each product that needs an
emergency order, and signed and dated the report.
 The Health Extension Worker has taken the report to the Health Centre for emergency re-
supply.
JOB AID: Placing an Emergency Order at the Health Centre or Hospital
Task: Placing an Emergency Order (Health Centre or Hospital to PFSA)
Completed by: Health Facility In-Charge and store Manager
Purpose: To order supplies when stock levels are equal to or below the 0.5 Months
of Stock emergency order point.
To avoid a stock out of a pharmaceutical.
When to perform: As soon as the Stock on Hand for any product goes equal to or below 2
weeks (0.5 months) of stock
Materials needed: Blank Report and Requisition Form, Bin Card(s), calculator, pen
Note: Complete the requisition for the product(s) that are equal to or below 2
weeks (0.5 months) of stock and that require an emergency order.
For any products which go below 2 weeks (0.5 months) of stock, follow the steps below:
52
Step Action
Health Facility/Woreda/Region: Example: [region], [Woreda], [health

1. Write the location of the health facility]
facility (Health Centre or
Reporting Period: From: … To: Example:
2. Write the first and last day of
the reporting period. Megabit 1, 2005 to Miazia 30, 2005
3. Write “EMERGENCY
ORDER” at
Serial Number (S/No.) (Pre- Example: 1, 2, 3 …
4. printed): The serial number of
the product on the form.
5. Product (pre-printed): The If reporting on and ordering items that are not
name and description listed, use a blank line at the end of the form.
pharmaceuticals are pre- printed Write the product name and description.
th fof Issue (pre-printed):
Unit If reporting on and ordering items that are not
6. The unit of issue for listed, write the unit of issue, if it is known,
pharmaceuticals are pre- printed next to the item description written in Step 5.
on the form.
Beginning Balance (Column A): This information can be found on the Report
7. Write the balance of the item at and Requisition Form from the previous reporting
the beginning of the reporting period.
period. If this is the first RRF,
• This information can be found on the Bin

The Beginning Balance for the Card/Stock Record Card.
current report is equal to the • Convert other units to the default unit using
Ending Balance of the previous the following formula (except for products
report. coming in individual patient kit form like TB
kit):
Number of Units in the pack X Quantity on the

Bin Card
Number of Units in default pack
8. Quantity Received (Column B): This information is the sum of the quantities
Write the quantity of the item found in the ―Received‖ column of the Bin
received during this reporting card/Stock Record Card for the dates during the
period. current reporting period.
Convert other units to the default unit using the

following formula (except for products coming in
individual patient kit form like TB kit):
Bin Card
53
9. Losses/Adjustments (Column C): This information is the sum of the quantities
Write the total quantity of the item found in the
lost or adjusted during this reporting ―Losses/Adjustments‖ column of the Bin card/
period. and Stock Record Card for the dates during the

following formula (except for products coming
in individual patient kit form like TB kit):
Bin Card

loss/adjustment in the Remarks section; see Step
17.
Ending Balance in DUs (Column The Ending Balance (D) is the ending balance
10. D): Write the ending balance or from the latest IFRR reports from DUs
Stock On Hand quantity of the item
at the end of the reporting period in The Ending Balance should also equal the
the dispensing units. results of the physical count of the item at the
dispensing units.

in individual patient kit form like TB kit);
Number of Units in the pack X Quantity on the Bin Card Number
of Units in standard pack
Ending Balance in the Store This information should be obtained from a

11. (Column E): For each item, write the physical count of the item.
quantity of the item at the end of the
reporting period. Convert other units to the default unit using the
in individual patient kit form like TB kit):
Bin Card
12. Calculated Consumption (Column Calculated Consumption (Column F) = Beginning

F): Calculate the total amount of Balance in the store(A) + Qty Received
Commodities Issued out of the (B) + Loss/Adjustment (C) - Ending Balance in
Pharmacy Store using the beginning DU(D)- Ending Balance in store (E)
balance, Quantity
Received,
Loss/Adjustment and Ending balance
54
Days Out of Stock (Column G): Count the number of days of Stock Out (DOS).
13. The total number of days a product
was out of stock.
Maximum Stock Quantity
14. (Column H): Calculate and write For program pharmaceuticals the maximum
the maximum stock quantity quantity is calculated after multiplying CC
• For program RRF using the adjusted for DOS by 2 (4 MOS).
formula H = 120 F/ (60 – G).
• For RDF RRF using the formula
H For RDF pharmaceuticals the maximum quantity
= F*2*RP*30/ ((RP*30)-DOS) is calculated based on adjusted CC for DOS for
• For Malaria, using the formula consumption within the review period (Maximum
H = 120 F/ (60 – G)*LSI of the for RDF is adjusted CC in the review period).
resupply period
The letters in the formula refer to the columns in the
RRF.
Quantity Ordered (Column I): I (Quantity Ordered) = H (Maximum Stock

15. Calculate and write the quantity needed Quantity) – D (Ending Balance in DU) - E
to reach max by subtracting the ending (Ending Balance in store)
balance in the store from the maximum
stock quantity using the formula I= H- The formula is also found on the RRF.
D-E The letters in the formula refer to the
columns in the RRF.
If the calculated quantity is a zero or a negative

number then no additional stock is required. Write
0 in the ―Quantity Ordered‖ column.
16. Remarks: Write reason for Be sure to include any comments related to losses
―EMERGENCY ORDER‖. that are noted in column D.
Examples:
Paracetamol: - 100 damaged
Completed by/ Name/Signature/Date:
17. The person (Store Manager) completing
the Report and Requisition parts should
write and sign his or her name, and
write the date on which he or she has
completed these sections of the form.
Verified By/ Name/Signature/Date:
18. The Head of the Pharmacy Section
should write and sign his or her name,
and write the date on which he or she
has reviewed the form.
55
19. Approved By/Name/Signature/Date:
The Head of the facility should write
and sign his or her name, and write the
date on which he or she has reviewed
the form.
20. Submit the Emergency Order to PFSA Take the emergency order to PFSA in
as soon as possible and by the fastest person, fax the form, or telephone.
means possible.
 The name of the unit receiving the products, the date, and the pharmaceuticals
information has been completed.
 ―EMERGENCY ORDER‖ has been written on the top of the form.
 The re-supply quantity has been calculated and written.
 The form has been signed by the person requesting the products and by the person
approving the emergency order.
 The form has been submitted to PFSA.
56
VII. ISSUING PHARMACEUTICALS
Pharmaceuticals used by a facility should be stored in the pharmacy storeroom. When

pharmaceuticals are issued from the storeroom to dispensing unit (DU), the dispensing unit
(DU) staff will provide essential logistics data on the Internal Facility Report and Resupply
Form (IFRR). After completing the report section of the form, the DU staff will take the
IFRR to the pharmacy to obtain the needed pharmaceuticals. The store manager will use the
information in the report section to determine re-supply quantities and issue the
pharmaceuticals.
When issuing the pharmaceuticals both the person receiving the pharmaceuticals and the
pharmacist and pharmacy store manager sign the Internal Facility Report and Resupply
Form (IFRR). After issuing the pharmaceuticals, the pharmacy store manager updates the
Bin Card, the pharmacy head updates the Stock Record Card, and files the Internal Facility
Report and Resupply Form (IFRR). See the Job Aids Recording Transactions in the Bin
Card and Recording Transactions in the Stock Record Card for instructions on how to
complete these forms.
The diagram below summarizes how pharmaceuticals will move from the Health Centre
Stores to Health Posts and Dispensing Units and from Hospital Stores to Hospital Dispensing
Units.
Key
Flow of pharmaceuticals
Flow of Information
Health Center Hospital

Store Internal Facility Report Store
and Re supply Form
(IFRR)
Dispensing Unit Dispensing Unit

within Health Center within Hospital
Bin Card
Health Service Providers

Post
CLIENTS
Figure 2. Movement of Products and Information between Health Centre and Health
Posts and between Facilities and Internal Dispensing Units
57
A. Issuing Pharmaceuticals within Health Centers and Hospitals
In order to maintain the quality of the pharmaceuticals, and to better manage the
pharmaceuticals in a Health Centre or Hospital, most of the commodities should be stored in
the Health Centre or Hospital pharmacy store. Pharmaceuticals should be issued to the
service providers (nurses, clinicians, out-patient pharmacies etc.) referred in this document as
dispensing units (DUs) at their work area (in the ward, in a clinic, in the dispensary) in small
quantities once or more during the month.
Service providers at dispensing units will come to the Health Centre or Hospital pharmacy
store between 2 and 4 times a month for re-supply. It is recommended that service providers
hold enough pharmaceuticals at their work area to serve clients for two or four weeks.
When issuing pharmaceuticals to a unit within a Health Centre or Hospital, the Internal
Facility Report and Resupply Form (IFRR) is used to capture data of the products that are
reported and resupplied. The Internal Facility Report and Resupply Form (IFRR) should be
kept in the respective Dispensing Units and completed when a service provider is scheduled
to come for re-supply.
Products are needed to be reported in agreed upon defaults units, which are pre-printed in the
IFRRs. So, quantities in basic units from Bin Cards should be converted to default units using
the following formula:
Conversion Formula = Quantity in Basic Unit

Number of Units in each default pack
NB; For kits - Both the basic unit in bin cards and default units in IFRR will be in kit( e.g TB
kit).
The following job aid provides instructions for completing the Internal Facility Report and Resupply
Form (IFRR).
58
JOB AID: Completing the Internal Facility Report and Resupply Form (IFRR) for Issuing
Pharmaceuticals within Health Centres and Hospitals
Task: Issuing Pharmaceuticals within a health facility
Completed by: The person from the Dispensing Unit reporting/receiving

the pharmaceuticals (Completed by Unit section)
The Health Centre or Hospital pharmacy manager (Pharmacist, Pharmacy
Technician or other) (Completed by Store Section)
Purpose: To report on and issue pharmaceuticals within a health facility.
When to perform: According to the schedule established at the Health Centre/Hospital

Pharmacy Store for re-supply to the dispensing units
Any time pharmaceuticals are needed by dispensing units within a health
facility (emergency).
Materials needed: IFRR , Bin Card(s) for pharmaceuticals being issued, calculator, pen
Note: It is recommended that products be issued to the dispensing units on a

weekly, every two week or monthly basis.
Step Action Notes

Steps 1 – 10 should be completed by the Dispensing Unit before going to the Pharmacy
Store according to the agreed schedule.
1. Name of Dispensing Unit: Write the Example: MCH/Family Planning
name of the Dispensing Unit
2. Reporting Period From: -- To --- From: Tikimt 1, 2007 to Tikimt 7, 2007
Write the first and last date of the
reporting period covered by this IFR. The reporting period should be the same as
your scheduled re-supply interval (weekly,
bi-weekly).
3. Maximum Level (ML): Write in the The Maximum Level is based on how often
maximum level for the dispensing unit you receive products from the pharmacy
(2 X Reporting Interval) in weeks store.
Examples:
If you receive products from the pharmacy
store every week, write (―1 week‖) X 2.
If you receive products from the pharmacy
store every two weeks, write (―2 weeks‖) X
2.
59
4. Serial Number (pre-printed): The Example: 1, 2, 3,
serial number of the product on the
form.
5. Item: Write the name and description of Amoxicillin 250 mg tablets
each pharmaceuticals you are reporting
on or use the preprinted IFRR if any
6. Beginning Balance (A): Write in the This information is on the Bin Card; it
quantity of stock you had available is the quantity of product you started
at the beginning of this reporting with.
period. Convert other units to the default unit
products coming in individual patient
kit form like TB kit):
Quantity in Basic Unit (BU) Number of
Units in default pack
7. Quantity Received (B): Write the This information is the sum of the
reporting period. of the Bin Card for the dates during the
Convert other units to the default unit using
the following formula (except for products
coming in individual patient kit form like
TB kit):
Quantity in Basic Unit (BU)
8. Losses/Adjustments (C): Write the This information is the sum of the
total quantity of the item lost or adjusted quantities found in the
during this reporting period. ―Losses/Adjustments‖ column of the Bin
reporting period.
TB kit):

Example: Positive adjustment for
reconstituted TB kit products in resupply
box
60
9. Ending Balance (D): Write in the Conduct a physical count to determine the
quantity of stock that you have on hand Stock on Hand. Stock on Hand can also be
at the end of the reporting period. found on the Bin Card, if the Bin Card is
up-to-date.

TB kit):
10. Remarks: Write any remarks related to the Remarks on losses and adjustments should be
product or any explanation related to losses and found on the Bin Card.
adjustments that you have reported. (Write the
serial number in the list and reason for loss or
adjustment)
11. Reported by/Signature/Date: Write
your name, sign and date the form.
Steps 12 – 18 are completed by Pharmacy Store.
61
12. Calculated Consumption (E): Example #1:
Calculate the estimated quantity Beginning Balance(A): 50
consumed: Beginning Balance plus Quantity Received (B) : 35
Quantity Received plus/minus
Borrowed from other Dispensing unit (C): 10
Loss/Adjustment minus Ending
Balance. Ending Balance (D): 12
A + B +/– C - D= E A +B+/– C - D= E 50 +35 +10 - 12 = 83

Calculated Consumption = 83
If DU was stocked out in the reporting Example #2:

interval, the pharmacy store manager
Beginning Balance(A):: 70
should use Calculated Consumption in
the last reporting intervals to calculate Quantity Received (B) : 30
the resupply quantity. Expired Product (C): -5
Ending Balance (D):: 25
A + B +/- C -D = E
70 +30 – 5 - 25 = 70
13. Maximum Quantity (F): Multiply To calculate the maximum quantity,
calculated consumption by 2. multiply the calculated consumption by 2.
Example:
F=EX2
70 X 2 = 140
Maximum Quantity = 140
14. Quantity Needed to Reach Max. (G): Example:
Write in the quantity of the product that Maximum Quantity = 140
is needed to reach the maximum stock Ending Balance = 12
level.
140 – 12 = 128
Quantity Needed to Reach Max. = 88
From the Maximum Quantity subtract
the Stock on Hand (Ending Balance), If the Quantity Needed to Reach Max. is
. negative, write ―0‖ (zero); no re-supply is
G=F- D needed.
15. Quantity Supplied (H): Write in the If no products were needed, write ―0‖ (zero)
quantity of products supplied to the unit. and do not re-supply that product.
16. Update the Bin Card and the Stock See the Job Aid Recording Transactions in
Record Card for the product you have the Bin Card and Recording Transactions
issued. in the Stock Record Card.
62
17. Completed/Signature/Date: The The person issuing the product (store man)
person issuing (completing the should also fill and sign Model 22.
―Completed by Store‖ section) writes
name and sign and date the form.
18. Approved by/Signature/Date: The The IFRR can be approved by Pharmacy
person approving the issue writes his or Head or Health Facility head
her name and signs and dates the form
NB:
In HCMIS sites, enter DU remaining stock/Ending Balance from IFRR, decide the amount based on
either the HCMIS recommended quantity or over ride it to adjust the quantity, and generate pick list. To
complete it follow the steps in 17 & 18.

 The name of the Unit receiving the products, the date, and the commodity information has
been completed on the IFRR.
 The re-supply quantity has been calculated and written.
 The IFRR has been signed by the person reporting, issuing and approving the products.
 Other legal documents such as Model 22 has been filled and signed by the person issuing the
product.
 The Bin Cards and Stock Record Cards for the products issued have been updated.
63
B. Issuing Pharmaceuticals to Health Posts
At the end of each month, the Health Extension Worker should bring the Health Post
Monthly Report and Re-supply Form (HPMRR) to the Health Centre for re-supply. Using the
information contained in the report, and using the “Completed by Health Post” part of the
form, Health Centre staff determines the re-supply quantities and issue pharmaceuticals to the
Health Post staff. All pharmaceuticals will be re-supplied to the Maximum Stock Level (2
Months of Stock) each month.
JOB AID: Completing the Health Centre Section of the Health Post Report and
Re-supply Form (HPMRR) (when issuing from Health Centre to Health Post)
Task: Issuing Pharmaceuticals to Health Posts
Completed by: The Health Centre (Pharmacist, Pharmacy Technician or others h

other);
Purpose: To re-supply the Health Post with pharmaceuticals up to the Maximum

Stock Level.
When to perform: At the end of each month when the Health Extension Worker comes to the
Health Centre for its regular monthly re-supply
When the HEW comes to the Health Centre with an emergency order
Materials needed: Current Health Post Monthly Report and Re-supply Form (HPMRR),
Health Post Monthly Report and Re-supply Form (HPMRR) from the
previous month, calculator, pen
Note: The Health Extension Worker should have already completed the
―Completed by Health Post‖ section and signed the report before arriving
at the Health Centre. See the Job Aid Completing the Health Post Section
of the Health Post Monthly Report and Re-supply Form (HPMRR).
64
Step Action Notes
1. Calculated Consumption this month Example #1:
(E): Calculate the estimated quantity Beginning Balance (A): 500
consumed by taking the Beginning Quantity Received (B) : 300
Balance plus the Quantity received, plus
Transfer in (C): 100
or minus Loss/Adjustment and
subtracting the Ending Balance. Ending Balance (D): 120
E = A + B +/– C - D 500 + 300 + 100 -120

E = A +B+/- C - D = 780
Example #2:
Beginning Balance (A): 700
Quantity Received (B) : 400
Quantity Stolen (C): -50
Ending Balance (D): 250
D = A + B +/– C - D 700 +400 – 50 - 250

= 800
2. Calculated Consumption last month Refer to column E in the previous month‘s
(F): Write the calculated consumption HPMRR to obtain the Calculated
(column E) from the previous month. Consumption for the previous month.
3. Maximum Quantity (G): Write the The Maximum Level for the Health Post is
total of the current Calculated two months of stock. Adding two months‘
Consumption (E) plus the Calculated consumption gives two months of stock.
Consumption last month (F). Example:
Current Calculated Consumption 800
Previous Calculated Consumption 850
G = E+ F
800 + 850 = 1650
Maximum Quantity = 1650
4. Quantity Needed to Reach Max. (H): Example:
Subtract the Ending Balance from the Maximum Quantity = 1650
Maximum Quantity and write the Ending Balance = 250
number.
Quantity Needed to Reach Max. =
1650 – 250 = 1400
H=G–D
If the Quantity Needed to Reach Max. is a
negative number, write ―0‖; no re-supply is
needed.
65
5. Quantity Supplied (I): Write in the The Quantity Supplied should be the same
quantity of products supplied to the unit. as the Quantity Needed to Reach Max.
If the Quantity Supplied is negative, write

―0‖ (zero); no re-supply is needed.
6. Update the Bin Card and the Stock See the Job Aids Recording Transactions in
Record Card for the product you have the Bin Card and Recording Transactions
issued. in the Stock Record Card.
7. Completed by/Signature/Date: The The person issuing the product should also
person issuing (completing the fill and sign Model 22.
―Completed by Health Centre‖ section)
writes his or her name and signs and
dates the form.
8. Approved by/Signature/Date: The The IFRR can be approved by Pharmacy
person approving the issue writes his or head or health facility head.
her name and signs and dates the form.
NB:
In HCMIS sites, enter DU remaining stock/Ending Balance from HPMRR, decide the amount based on
either the HCMIS recommended quantity or over ride it to adjust the quantity, and generate pick list. To
complete it follow the steps in 7 & 8.

 The re-supply quantity has been calculated and written for each product, and the products
have been given to the Health Post worker.
 The HPMRR has been signed by the person issuing the products, the person approving the
issue, and the person reporting the products.
 Other legal documents such as Model 22 has been filled and signed by the person issuing the
product.
 The Bin Cards and Stock Record Cards for the products issued have been updated.
66
VIII. RECEIVING PHARMACEUTICALS
A. Receiving pharmaceuticals from PFSA
PFSA delivers pharmaceuticals to Hospitals and Health Centers which have submitted a
completed and approved RRF on time. Hospitals and Health Centers receive pharmaceuticals
every other month. At the time of delivery, PFSA trucks will wait while products are counted
and verified, to take note of any discrepancies, to obtain proof of delivery (Model 19), to
collect signed and sealed PFSA Delivery for the pharmaceuticals shipment. All
pharmaceuticals should be received by a store manager before issued to dispensing
unites.
RDF Pharmaceuticals are delivered with two copies of PFSA Delivery Invoices (Cash sales
invoice (CSI), Credit sales invoice (CRSI) and for Program Pharmaceuticals Stock
transfer voucher (STV). But, the facility will use the RRF copy in the facility to check
if they are receiving the quantity ordered.
67
JOB AID: Receiving Pharmaceuticals
Task: Receiving Pharmaceuticals.

Completed by: Hospital or Health Centre Pharmacy Store Manager
Purpose: To inspect and account for pharmaceuticals received

To ensure that the quantity received matches the quantity
issued/delivered
To account for any other discrepancies between the documents and
drugs received
To enter newly received pharmaceuticals into inventory
When to perform: Any time pharmaceuticals are received
Materials needed: Copy of RRF, PFSA Delivery/Distribution Invoice, Stock Record

Cards and Bin Cards for all pharmaceuticals, pen, products and
documents received
Note: The same procedures that are used for routine receipt of products
should be used for receipt of emergency orders.
68
Step Action Notes
Locate the following documents If applicable, an updated PFSA product
1. that should accompany the order: price list may also be included with the
• PFSA Delivery/Distribution delivery documents (for purchased
Invoice for direct delivery pharmaceuticals).
• Model 22 along with copy of
Delivery/Distribution invoices
from WoHOs for non-direct
delivery health centres.
Conduct a visual inspection of the See the part in Visual Inspection in section
2. order: Verify that the cartons, IX.
boxes and contents are not
damaged.
Review the PFSA
3. Delivery/Distribution Invoice:
Check that the quantities received
match the quantities issued.
Quantity Received: Count the If any of the products received are
4. quantity of each usable damaged and expired only write the
pharmaceuticals received and write quantity of usable product received.
down the specific quantity received In every case where the quantity received
for each product in the appropriate is different from that issued in the invoice
row and column on the Model 19 record the discrepancies in the formats for
damaged and short received items in the
delivery invoice. Write explanation for the
discrepancies on the remark column of the
invoice.
Supplies received by/ Signature/ .

5. Date: Write your name and sign
and date both copies of the PFSA
delivery/distribution invoice.
Return one copy of the PFSA
6. delivery/distribution invoice and
one copy of Model 19 with the
PFSA driver.
Retain and file at your facility the
7. second copy of the PFSA
delivery/distribution invoice.
Mark expiry dates clearly, with
8. large, dark numbers, on each box or
carton. Place and reorganize
products on shelves by FEFO.
Enter and update all stock See Job Aids Recording Transactions in
9. information on the Stock Record the Stock Record Card and Recording
Card and the Bin Card for all Transactions in the Bin Card found in
pharmaceuticals received. Section V.
69
For HCMIS sites, pick products to be received, and properly enter, supplier, batch number,
expiry date, respective quantities of each batch and APTS code.

 A visual inspection of the products has been conducted.
 Quantities of each product have been counted.
 The usable PFSA invoice quantities verified.
 Damaged and short received items recorded with their respective remarks.
 The PFSA delivery/distribution invoice has been signed and sealed.
 A copy of the signed and sealed PFSA delivery/distribution invoice has been returned
to the PFSA truck driver.
 One copy of the signed and sealed PFSA delivery/distribution invoice has been filed at
your facility.
 Goods have been stored appropriately.
 Stock Record Cards and Bin Cards have been updated with the receipts.
 A visual inspection of the products has been conducted.
 Quantities of each product have been counted.
 The usable PFSA invoice quantities verified.
 Damaged and short received items recorded with their respective remarks.
 The PFSA delivery/distribution invoice has been signed and sealed.
 A copy of the signed and sealed PFSA delivery/distribution invoice has been returned
to the PFSA truck driver.
 One copy of the signed and sealed PFSA delivery/distribution invoice has been filed at
your facility.
 Goods have been stored appropriately.
 Stock Record Cards and Bin Cards have been updated with the receipts.
B. Distribution of formats involved during receiving

 Keeps 2 copies at PFSA :
- Original: Branch / Central Store.
- One Copy: Finance
1. PFSA uses the copy of the RRF
 Sends 2 copies to SDP with pharmaceuticals.
that it receives from the health
- One copy signed and sealed together with
facility to produce 4 copies of
the completed receipt voucher (Model 19)
Delivery/Distribution Invoice
by the receiver (SDP) and returned back to
sender (PFSA)
 Keeps 1 copy of Delivery/Distribution Invoice
and 1 copy of the facility receipt voucher (Model
19).
 Sends 1 copy of Delivery/Distribution Invoice
2. Hospital or Health Centre
and 1 copy of the facility receipt voucher (Model
completes the 2 copies of the
19) to PFSA with deliverer.
Delivery/Distribution Invoice
and 3 copies of the facility  Sends 1 copy of the facility receipt voucher
receipt voucher (Model 19). (Model 19) to Hospital or Health Centre Finance
Department.
70
There are 3 versions of Delivery Invoices used for distributing pharmaceuticals from PFSA
to SDPs based on the type of pharmaceuticals and payment modalities. Except for their
difference in their name these formats are similar in all other aspects.
1. Cash Sales invoice (CSI): Used for items issued out on cash
2. Credit sales invoice (CRSI): Used for items issued out on credit bases
3. Stock transfer voucher (STV): Used for program drugs.
C. Funding Pharmaceuticals in the IPLS
Hospitals and health centers will have either ―Revolving Drug Fund (RDF)‖ or ―Ministry
allocated budgets‖ to purchase pharmaceuticals from PFSA. Health posts do not have
separate budgets; funding for pharmaceuticals for a health post is included in the budget of
the health centre that supplies that health post. PFSA will be paid for the delivery of
pharmaceuticals with one of three different models:
1. Allocation: Pharmaceuticals budget allocations are made to PFSA on an annual

basis. As pharmaceuticals are ordered from and delivered by PFSA, the cost is
deducted from the account for that facility. Large hospitals will use this method of
payment
2. Cash and Carry: PFSA will be paid for the products when they are delivered to the
facility. Health centres and other hospitals will use this method of payment.
3. Credit: Health centres and hospitals whose budget is already allocated but not yet
released will use this method. Payment will be completed as soon as the budget is
released.
Program medicines will be delivered to health facilities without any payment
71
IX. STORING PHARMACEUTICALS
A. Storage and Product Shelf Life
Shelf life is the length of time a product may be stored without affecting the
usability and safety of the item, if the product is stored under the prescribed
conditions.
Pharmaceuticals have a shelf life which is specified by the manufacturer. When

pharmaceuticals reach the end of their shelf life, it has expired and should not be
distributed to patients. Some health products have short shelf lives. Because of these short
shelf lives, it is important that proper storage procedures are followed, so that the shelf life is
protected.
Always check the expiry dates before receiving, issuing or using, and do not use products
that have expired. The expiry date of the products should be indicated directly on the
product carton.
Most products have the expiration date already labeled on them. To find this important date
look in the following places:
1) On the carton in which the product is shipped

2) On the inner box, packaging of the product
3) On the product itself.
If the date is not on the outer carton look at the packaging. If it is not there, look at the
product itself. , The expiration date will be found at least in one of the three locations
mentioned above. Once the date is identified, write it in large numbers on the outer carton
with a marker for easy identification.
If the expiration date is not available, look for the manufacture date on the carton, packaging,
or product. By knowing the manufacture date and the shelf life of the product, one is able to
determine the expiration date of the product. For example, if you receive an item with a
manufacture date of February 2006, add the shelf life (for example, 18 months) to this date.
The expiry date would then be August 2007. Once the expiration date is determined, write it
in large numbers on the outer carton with a marker for easy identification. If you are unsure
72
of the shelf life of a product, make an inquiry; then determine and write the expiration date
once the manufacture date is known.
Following FEFO
FEFO means ―ﬁrst-to-expire, ﬁrst-out. Always distribute products that will expire before
other products. To apply FEFO, Store Managers and Health Facility In-Charges should:
1) Write the expiry dates on the outside of cartons.
2) Place the cartons or products so that the first to expire are stacked in front of
or on top of products that will expire later.
Never distribute any product that will expire before it can be distributed to and used by the
client.
73
B. Storage Guidelines
In general, supplies should be protected from sun, heat, and water. Follow manufacturer
recommendations for storing supplies. This information is usually printed on the product
carton and boxes. The following are general storage guidelines for pharmaceuticals.
Storage Guidelines
1. Clean the storeroom Pests are less attracted to the storeroom if it is

regularly. regularly cleaned and disinfected. If possible a
regular schedule for extermination will also help
eliminate pests. Keep food and drink out of the
storeroom.
2. Store pharmaceuticals in Extreme heat and exposure to direct sunlight can

a dry, well-lit, well- degrade drugs and other pharmaceuticals and
ventilated storeroom – dramatically shorten shelf life. Temperatures in the
out of direct sunlight. storeroom should not exceed 25oC. Direct sunlight
raises the temperature of the product and can reduce
its shelf life. Drugs should not be opened to
repackage them. Store supplies in their original
shipping cartons.
3. Protect storeroom from Water can destroy both supplies and their packaging.
water penetration. If the packaging is damaged, the product is still
unacceptable to the patient even when the
pharmaceutical is not damaged. Repair the storeroom
so that water can not enter. Stack supplies off the
floor on pallets at least 10 cm high and 30 cm away
from walls as moisture can seep through walls and
floors. ARV drugs and fluconazole are particularly
sensitive to moisture.
4. Keep fire safety Stopping a fire before it spreads can saves expensive
equipment available, supplies and the storage facility. The right equipment
accessible, and should be available; water is able to put out paper
functional, and train fires, but is ineffective on electrical and chemical
employees to use it. fires. Place well-maintained fire extinguishers at
suitable positions in the storeroom. If a fire
extinguisher is not available, keep sand or soil in a
bucket nearby. Regardless of the method used, train
the staff in the use of the available fire safety
equipment.
74
5. Store latex products Latex products can be damaged if they are directly
away from electric exposed to fluorescent lights and electric motors.
motors and fluorescent Electric motors and fluorescent lights create the
lights. chemical ozone which can rapidly deteriorate latex
products. Keep latex products in paper boxes and
cartons.
6. Maintain cold storage, Cold storage (2 to 8 degrees Celsius; 36 to 46 degrees

including a cold chain, as Fahrenheit) is essential for maintaining the shelf life
required. of certain pharmaceuticals that require it. These items
are irrevocably damaged if the cold chain is broken.
If electricity is unreliable, the use of cylindered gas
or kerosene-powered refrigeration is recommended.
Many drugs require storage below 25 oC. Some drugs
require refrigeration, that is storage between 2- 8 o C.
7. Limit storage area access To prevent theft and pilferage, lock the storeroom
to authorized personnel and/or limit access to personnel other than authorized
and lock up controlled staff, and track the movement of drugs and other
substances. pharmaceuticals. Access must not, however, prevent
appropriate distribution; a spare set of keys should be
kept in the office of the facility or pharmacy In-
Charge. Physical counts should be conducted on a
regular basis to verify inventory records.
8. Stack cartons at least 10 Pallets keep the products off of the floor so they are
cm off the floor, 30 cm less susceptible to pests, water and dirt damage.
away from the wall and Stack cartons on pallets 30 cm away from the walls
other stacks, and no and from each other to promote air circulation and to
more than 2.5m high. ease movement of stock, cleaning and inspection.
Do not stack cartons more than 2.5m high, as the

weight of the products may crush the cartons at the
bottom. This will also reduce potential injury to
warehouse personnel. If cartons are particularly
heavy, stack cartons less than 2.5m high.
At health facilities, where the use of pallets is

inappropriate, shelving should be used.
75
9. Store medical supplies Exposure to insecticides and other chemicals may
away from insecticides, affect the shelf life of pharmaceuticals. Old files and
chemicals, old files, office office supplies may get in the way and reduce space
supplies and other for medical supplies or make them less accessible.
materials. ―Dejunk‖ the storeroom regularly to make more
space for storage.
10. Store flammable Some medical procedures use flammable products,

products separately from such as alcohol, cylindered gas, or mineral spirits.
other products. Take Such products should be stored away from other
appropriate safety products and near a fire extinguisher.
precautions.
11. Store pharmaceuticals to FEFO (First Expired, First Out) is a method of

facilitate FEFO arranging drugs in a storage facility where the drugs
procedures and stock are managed by their expiry date. Drugs that will
management. expire first are issued first, regardless of when they
were received at the health facility.
12. Arrange cartons with Identification labels make it easier to follow FEFO,
arrows pointing up, and and make it easier to select the right product. Items
with identification labels, should be stored according to manufacturer‘s
expiry dates, and instructions on the cartons; this includes paying
manufacturing dates attention to the direction of the arrows.
clearly visible.
13. Separate unusable Do not dispense expired drugs to the patients.

pharmaceuticals from Designate a separate part of the storeroom for
usable pharmaceuticals damaged and expired goods. See Section G below
and dispose of damaged for instructions on handling damaged or expired
or expired products, pharmaceuticals.
Remove them from
inventory immediately
and dispose of them using
established procedures.
76
C. Conducting Visual Inspection
To ensure the quality of pharmaceuticals, it is important to Visual inspection is the

conduct visual inspections of the products. A visual process of examining
products and their
inspection should be completed each time products are packaging by eye to
look for problems in
handled: when receiving, issuing or dispensing
product quality.
pharmaceuticals, or when conducting a physical count.
When conducting a visual inspection, be sure to check the following:
Package and product integrity: check for damage to packaging (tears,

perforations, water or oil) and products (unexpected odor, caking on bottles,
change in color, broken bottles).
Manufacturing defects: incomplete set, missing or illegible identification information.
Labeling: Make sure that products are labeled with the date of manufacture or expiration,
lot number and manufacturer‘s name. For products coming in individual patient kit form like
TB kit, check if the labeling includes Batch No and Expiry Date of each product with in the
Kit.
For vaccines, check:
• VVM (vaccine vial monitors)
• Freeze indicator
VVM is a chemical indicator label attached to the vaccine container (vial, ampoule or
dropper) by the vaccine manufacturer. As the container moves through supply chain, the
VVM records its cumulative heat exposure through a gradual change in color. If the color of
the inner square is in the same color or darker than the outer circle, the vaccine has been
exposed to too much heat and should be discarded.
Freeze indicator is an electronic device to monitor vaccines exposed to less than 0°
77
D. De junking and Organizing storage spaces
I. Logical organization of pharmaceuticals in the store
• Organize the storage area into zones as needed: a cold storage area for
vaccines and other supplies requiring cold storage; a secure area or locked
cage for narcotics and controlled substances; a zone in which to store
flammable materials, ideally in a separate building or room.
• Organize pharmaceuticals on their shelves according to FEFO, first-to-expire,
first-out. Put supplies that will expire sooner in front of or on top of
pharmaceuticals that will expire later.
• Organize the storage area in an orderly manner so health supplies can be found
easily and re-stocked easily.
• Designate a specific space for temporary storage of unusable items before
their disposal.
II. Steps in De junking
De junking means getting rid of the ―junk‖ in a storage facility, including DEPS
(Damaged and Expired Products) and any other items that do not belong in storage
facility for health products. (These items can include old furniture, outdated forms,
fuel barrels, vehicle parts, etc.) De junking is also a time for reorganizing a storage
facility and getting bin cards and stock record cards up to date. De junking can
greatly increase storage space.
Ethiopia has had major success in de junking in some facilities. This had been
increased storage space by 100%.
1. Assign ―De junking Team‖

2. Gather materials & equipment for de junking (boxes for collecting unusable
items, push carts, etc).
3. Separate unusable items from usable items.
4. Update Bin Cards and Stock Record Cards if loss not previously recorded.
78
5. Sort unusable items by final disposition:
 Sell/auction
 Repair & Use
 Recycle
 Destroy.
6. Dispose of unusable items per final disposition.
7. Prepare report of de junking activity.
8. Deposit income from sale of unusable items into facility account.
9. Clean storage facility and adjust shelving as needed.
10. Reorganize storage facility taking advantage of reclaimed space.
11. Assign staff responsible for routine disposal of unusable items.
12. Establish routine schedule of disposal of unusable items.
13. Monitor implementation for routine disposal.
E. Product arrangement in the pharmacy store
To improve pharmaceuticals management efficiency (storage, recording, reporting and

resupply) store arrangement in the pharmacy store should match the pre printed list in the
facility RRF as follows:
Drugs Supplies and Diagnostics
• Free drugs will be grouped • Free supplies and diagnostics will

Free/Program according to their program be grouped according to their
category, e.g. Tb, Malaria... program category, e.g. Tb,
• Each program category will then Malaria....
further be arranged alphabetically • Each program category will then
and dosage form further be arranged alphabetically.
• Purchased drugs will be grouped • Purchased supplies and diagnostics

Purchased following FMHACA‘s will be grouped according to their
Pharmacotherapeutic type
categorization, e.g. CNS drugs, • Each group will then further be
Antinfectives..... arranged alphabetically
• Each Pharmacotherapeutic
category will then further be
arranged alphabetically and
dosage form
79
F. Conducting a Physical Count
A physical count (also called Physical Inventory) is an actual count of the quantity of each
pharmaceutical at any given time. It is one of the most frequent pharmaceuticals management
activities in health facilities.
A physical count of pharmaceuticals in the storeroom should be conducted

cyclically or annually and the Bin Cards and Stock Record Cards should be
updated.
A physical count of the products in the storeroom is done to verify that the stock balance
found on the Bin Card and the Stock Record Card shows the correct number of usable
pharmaceuticals that are available in the storeroom. If the quantity on the Bin Card or the
Stock Record Card does not match the quantity on the shelf, the Bin Card and the Stock
Record Card should be updated and an adjustment should be entered.
Instructions on how to complete a physical count of the storeroom and make adjustments to
the Bin Card and the Stock Record Card are provided in the Job Aid below.
80
JOB AID: Conducting a Physical Count
Task: Conducting a Physical Count

Completed by: Pharmacist or Pharmacy Technician
Purpose: To verify the stock level of pharmaceuticals in the store at the time
of physical count
To detect errors in drug management records
To detect drug loss in the store
When to perform: At least every quarter at the Health Post level
At least every 6 months at the Health Centre/Hospital level
Any time you suspect that products have been lost
Materials needed: Bin Cards, Stock Record Cards, calculator, pen
81
Prior to a Physical Count, these tasks should be completed:
 Set a date for the physical count. Select the physical count team. Participants should be
selected from the facility. The pharmacist, pharmacy technician and/or health technician
should be members of the team. store manager should also be part of the team.
 Do not issue pharmaceuticals during the physical count or count receipts on the day of the
physical count, except in an emergency. Receipts during the physical count will be
recorded on the Bin Cards and the Stock Record Cards the following day and counted in
the next physical count.
 Make sure that the Bin Cards and the Stock Record Cards for the health supplies are
updated to the day of the physical count. If the Bin Cards and the Stock Record Cards are
not completed, complete them.
 Prepare the store, making sure all cartons are neatly stacked and partial cartons are clearly
visible.
 Reorganize products by FEFO before counting. Mark expiry dates clearly, with large, dark
numbers, on each box or carton. This step should have been taken during routine receipt
and management of supplies.
 Visually inspect pharmaceuticals as you organize them for counting. See Section F below
on Visual Inspection for more information.
 Separate any expired or damaged supplies.
 Be sure to have the Bin Cards and the Stock Record Cards for the pharmaceuticals to be
counted.
THE STORE IS NOW READY FOR THE PHYSICAL COUNT.
82
Conducting a Physical Count Table should be corrected
Step Action Notes

Count the pharmaceuticals in Make sure that you count units that have the
1. the storage area. same name, same dosage, same formulation,
and same pack size.
For each pharmaceutical…

Example:
I have 4 unopened cartons with each one
A. Count unopened/complete containing 1000 tests.
cartons first. Multiply the 4 x 1000 = 4000 total tests in the unopened
number of cartons by the cartons
number of units (bottles) in the
carton. This will give you the
total number of u n i t s / bottles in the I also have 1 opened carton with 10
unopened carton. boxes inside. Each unopened box contains 10
tests.
10 x 10 = 100 total tests in the unopened boxes.
B. Next count the boxes inside the
open cartons. If an open carton
contains unopened boxes, 4000 tests from unopened cartons
count the boxes and multiply +100 tests from unopened boxes
the number by the number of
units/bottles in a box. This will give 4100 total tests = Actual Quantity on
Hand. you the total number of the
bottles in the unopened boxes.
Do not count any pharmaceuticals in the
smallest packing unit if that unit has been
C. Add up the total units from the opened. For example, do not count open
unopened cartons and u n i t s / bottles, individual gloves, and individual
unopened boxes. vacutainers.
Update the Bin Card and the Stock Record Use a red pen when completing these steps.
Card by completing the following actions:
83
Step Action Notes
Circle the last calculated Balance. Example: Circle ―500‖, which is the previous,
2. If this is the first entry on the Bin calculated Balance.
Card/Stock Record Card, skip to
Step 5.
Draw a line under the row that This will highlight the physical count
3. shows the last calculated balance. information from the rest of the information on
the Bin Card/Stock Record Card.
Date: Write the date of the
4. physical count.
Document No. (Receiving or
5. Issuing): Write ―Physical Count‖.
Received From or Issued to /
6. Quantity Received / Quantity
Issued: Leave these columns
blank.
Loss/Adj.: Leave this column Any losses and adjustments will be recorded
7. blank until after you complete Step after the physical quantity has been recorded.
12 below.
Quantity/Balance: Write the This is the actual quantity of unopened
8. result of the physical count in red packages of drugs/products on hand in the
pen. storeroom.
Batch No.: (Bin Card only)
9. Leave this column blank.
Price/Unit Price: (Stock Record

Card Only) Leave this column
blank.
Expiry Date: Leave this column
10. blank.
Remarks: Leave this column
11. blank until after you complete Step
14 below.
84
Step Action Notes
Compare the previously
12. recorded stock balance that you
just circled in the previous row
to the Physical Count balance.
If the previously recorded stock

balance (circled in the line above)
matches the physical count, skip
to Step 16 below.
If the previously recorded stock

balance (circled in the line above)
does not match the physical
count, continue with Step 13
below.
Determine your Loss or Example calculation:
13. Adjustment. Subtract the
calculated Stock Balance
(previously circled) from the 869 Actual Quantity on Hand
Actual Quantity on Hand. - 875 Calculated Stock Balance
-6 Difference (Loss of 6 bottles)
 If your result is a negative

quantity you have suffered a loss.
 If your result is a positive

quantity, you have more units in stock than
you had recorded on the Bin Card/Stock
Record Card.
Sometimes the difference is due to a mistake

while counting during the physical count or due
to a mathematical error in the Bin Card/Stock
Record Card. Repeat the physical count if you
believe there was a mistake in the counting, and
check for mathematical errors on the Bin
Card/Stock Record Card. Correct the mistake
through an adjustment on the Bin Card/Stock
Record Card.
85
Step Action Notes
Record the Loss or Adjustment. Example;
14. In the Losses/Adjustments Losses/Adjustments – 6
column, write the answer that was
calculated in Step 13. The
loss/adjustment is documented in If the adjustment is positive, write a plus (+)
the same row as the transaction of sign next to the number. Example: +3
the physical count. Write the
quantity of the loss/adjustment.
If the adjustment is negative, write a negative
(–) sign next to the number, example – 3
All Losses/Adjustments should be documented,

and the difference in stock explained in the
Remarks column
Remarks: Write any comments Examples:
15. related to losses/adjustments noted
during the physical count.
Negative adjustments (losses): expiry, damage,
not found at physical count.
Positive adjustments: found at physical count.

Draw a line under the row of the This will complete the differentiation between
16. Bin Card/Stock Record Card the physical count information and the rest of
where you recorded the physical the information on the card.
count.
Make sure the stocks are arranged
17. back in their appropriate place
according to FEFO.
Keep each Bin Card with its
18. matching product in the storeroom.
Return all Stock Record Cards to

the place where they are kept in
the pharmacy manager‘s office
NB: In HCMIS sites, annual physical count should be done and entered in to the system for every
batch, from Hamle 1 to Hamle 30.
This task is complete when:

 The actual quantity on hand in units has been counted and recorded in the Balance column
on the Bin Card/Stock Record Card.
 Losses /Adjustments, if any, have been calculated and recorded in the Losses/Adjustments
column on the Bin Card/Stock Record Card.
 Losses/Adjustments, if any, have been explained in the Remarks column.
86
G. Handling Damaged or Expired Stocks
Logistics systems try to minimize the amount of damaged or expired stocks. However, if
expired or damaged stocks are found at any time during a visual inspection or physical count,
these stocks should be immediately removed from the inventory and be moved to a separate
place, so that they cannot be dispensed or used. Later, they can be disposed of according to
the established guidelines.
Expired or damaged products that are discovered upon receipt of a consignment should not be
accepted, but rather returned to the supplier for replacement.
The following Job Aid explains how to handle damaged or expired products.
JOB AID: Handling of Damaged or Expired Products at Health Post or

Dispensing Units
Task: Handling of damaged or expired products
1.
Completed by: Health Extension Worker, Dispensing Unit Personnel
Purpose: To remove unusable pharmaceuticals from storage so they are not

distributed to clients
To return unusable commodities to the supplying Health Centre
When to perform: Whenever damaged or expired products are known or discovered
Materials needed: Corresponding Bin Cards for damaged or expired products, blank
Record for Returning Unusable Commodities
Step Action Notes

1. Stack damaged or expired products separately
from usable stocks; keep them in an unused box
or on an unused shelf.
2. Write Damaged or Expired Stock on the box or
shelf.
3. Record the quantity of expired or damaged stock
as a loss on the appropriate Bin Card/ Stock
Record Card and, subtracts the quantity from
the Quantity/Balance column.
4. Return the unusable products to your supplying
Health Centre/Hospital pharmacy store the next
time you go for re-supply.
87
 Damaged or expired stock has been separated from usable stock.
 The Bin Card has been updated.
 The Record for Returning Unusable Commodities has been completed.
 The products have been returned to the Health Centre/Hospital pharmacy store.
JOB AID: Handling of Damaged or Expired Products at Health Centre /

Hospital
Task: Handling of damaged or expired products
Completed by: Pharmacist or Pharmacy Technician
Purpose: To remove unusable products from storage so they are not

distributed to clients
When to perform: Whenever damaged or expired products are known or discovered

Whenever we plan to dispose pharmaceuticals
Materials needed: Corresponding Bin Cards and/or Stock Record Cards for damaged
or expired products.
Step Action Notes

1. Stack damaged or expired products separately from
usable stocks; keep them in an unused box or on an
unused shelf.
2. Write Damaged or Expired Stock on the box or shelf.
3. IF ⇒ THEN
Damaged or expired • Record the quantity of xpired or damaged
products were found stock as a loss on the appropriate Bin
during a visual inspection Card/Stock Record Card and subtract the
or routine physical count quantity from the quntity/ Balance column.
Damaged or expired • Do not accept the products at your facility;

products were found upon return them with the driver. Note the
receipt of a consignment information on the shipping/receipt
documentation.
Unusable products were • Record and dispose along with other HC

returned to you from a pharmaceuticals to be disposed if it is expired
Health Posts or Dispensing
Units.
88
Disposal steps
4. Segregate and sort products according to medicine waste Controlled
management and disposal directive. Sort products by drugs,antineoplastics,ra
dosage form and type ( example: Solids,liquids, aerosol diopharmaceuticals,antii
canisters) nfectives,antiseptics and
disinfectants be sorted
separetly as per the
directive
5. Submit list of products to be disposed for responsible Use annex -- to register
organizations as per the directive products and apply for
disposal
6. Establish disposal committee including relevant bodies
according to the directive.
7. Dispose the separated products according to the According to the
directive. directive it is
recommended to
dispose twice a year or
every six month.
8. Report list of the disposed products and minute to all
responsible organizations
9. Receive disposal certification within a week
NB: In HCMIS sites, expired and damaged products should be recorded as loss/adjustment so they will be
deducted from the usable stock.

 Damaged or expired stock has been separated from usable stock.
 The Bin Cards and Stock Record Cards have been updated.
 The damaged or expired stock has been disposed properly
PFSA promotes and encourages facilities to communicate with each other so that unusable stock,
products which are going to expire before use and overstocks can be transferred between facilities.
But in special conditions where transfer of products between facilities is not feasible products could be
returned to PFSA. This action is important to reduce the wastage of pharmaceuticals at different level of
the supply chain system.
92
IX. Summary of Activities by Function
Activities by Facilities
Function Health Post Health Centre/Hospital
• Products will stored in the lockable cabinet • The pharmaceutical store will have two big
• Logical arrangement of products within the sections (Drug section and
lockable cabinet, that is: supply/diagnostics section) within it.
- Matching it with the arrangement of • The drug section will have two sub sections
the list in HPMR (Free and purchased drug section).
- Arrangement by type (Supplies, • The supply/diagnostics section will have two
Storage Syrups, Tablets….) sub sections (Free and purchased
• Storage following the 13 storage guidelines supply/diagnostics section).
and principles as it was translated to the HP. • Logical arrangement of products within each
sections and subsections:
- Matching product arrangement with the
pre printed list in the RRF(following the
categorization criteria in the level
specific RRF in the respective sections
and sub sections
- Zoning and other logical arrangements
• Storage following the 13 storage guidelines
• BCs will be used to account for products in • BCs will be used to account for products in
the lockable cabinet. That is, BCs should be the store. That is, BCs should be updated
updated when: when:
- Products are received from the Health - Products are received from the PFSA or
Centre or any other source (received any other source (received column
column mentioning the source) mentioning the source)
- Products are issued out to the dispensary - Products are issued out to the dispensing
area from the lockable cabinet (issued units from the pharmacy store(issued
column mentioning the place : column mentioning the place : name of
Dispensary area) the DU)
Recording - Products are issued out to the CHW/V - Products are issued out to affiliated HPs
from the lockable cabinet (issued column from the Health Centre‘s pharmacy store
mentioning the place : CHW/V) (issued column mentioning the name of
- There is loss/adjustment due to damage, the HP)
theft, expiry and stock transfer - There is loss/adjustment due to damage,
(Loss/Adjustment column mentioning theft, expiry and stock transfer
the reason in the remark column). (Loss/Adjustment column mentioning
- Calculate the balance after every the reason in the remark column).
transaction (receipt, issue and - Calculate the balance after every
loss/adjustment) transaction (receipt, issue and
loss/adjustment)
93
Activities by Facilities
Function
Health Post Health Centre/Hospital
Level specific RRF for ―purchased

• Complete the ―Completed by Health Post‖ pharmaceuticals‖ by the facility
section of the HPMR every month. • Report and requisition every other month
following PFSA‘s delivery schedule
• The pharmacy store manger calculates the • Cost analysis worksheet will help in deciding
resupply quantity according to the job aid and the total quantity after prioritizing according to
resupply accordingly. need when there is budget limitation at the
facility.
• ‖Quantity needed to reach Max‖ may or may
not be equal to ―Quantity Ordered‖ according
to the availability of budget.
Level specific RRF for ―free pharmaceuticals‖

by the facility
• Report and requisition every other month
following PFSA‘s delivery schedule
• Quantity needed to reach Max‖ will be equal
to ―Quantity Ordered‖
Report and
Requisition
System Training Training

implementation • OJT through Health Centre store manager • Formal training to relevant professionals
using standardized and simple graphic job aids (Pharmacy Head and Store Manager)
(for HPs to use) • IPLS Orientation and SS training for relevant
• OJT curriculum for the pharmacy head or store management units in the
manager for HP resupply and Internal report RHB/ZHO/WoHO/SDPs
and resupply system.
Implementation follow up
Implementation follow up • Intensive SS and implementation follow up by
• Onsite and offsite (when HEWs come to the the hub based teams by making use of
HC for resupply) SS and implementation standardized tools.
follow up activities by the HEW supervisor
and store manager by making use of
standardized tools.
94
REFERENCE
1. USAID | DELIVER PROJECT. The Logistics Handbook: A Practical Guide for the Supply
Chain Management of Health Commodities. Second Edition. Arlington; 2011.
2. Drug fund and Pharmaceuticals Supply Establishment. Proclamation. No, 553/2007. Addis
Abeba, Federal Negarit Gazeta; 2007
3. Management Sciences for Health. Managing Drug Supply: The Selection, Procurement,
Distribution, and Use of Pharmaceuticals. Revised second edition. Arlington, Kumarian
press;1997
4. Food, medicine and healthcare administration and control authority of Ethiopia.
“Medicines Waste Management and Disposal Directive No. 2/2011”. 2011.
5. Pharmaceuticals Fund and Supply Agency. Business Process Reengineering,
Pharmaceuticals Supply Core Process. Addis Abeba, 2008.
95
X. ANNEXES
1. Formats
A. Bin Card (BC)

B. Stock Record Card (SRC)
C. Health Post Monthly Report and Re-supply Form (HPMRR)
D. Internal Facility Report and Resupply Form (IFRR)
E. Report and Requisition Form (RRF) for Program Drugs
F. Report and Requisition Form (RRF) for RDF Drugs
G. Cost Analysis Worksheet for RRF
H. Record for Returning Unusable Pharmaceuticals to Health Centres/Hospital
pharmacy store
I. Aggregated Report (WoHO and RHB/ZHD)
J. Drug Issue Voucher of PFSA
K. Routine Feedback Reporting Format
L. List of Medicines Waste to Be Disposed M.
Annual quantification template
N. ABC Analysis of Pharmaceuticals
O . Vaccine Request Form (VRF)
96
A. BIN CARD
Name of Health Facility:
Product Name, Strength and Dosage Form
Unit of Issue:
Maximum Stock Level: Emergency Order Point:
Average Monthly Consumption (AMC):
Doc. No. Received Quantity Expiry

Date (Receiving from or Batch No. Remarks
or Issuing) Date
Issued to
Received Issued Loss/Adj Balance
97
B. STOCK RECORD CARD
Name of Health Facility:
Product Name, Strength and Dosage Form:
Unit of Issue: Location:
Maximum Stock Level: Emergency Order Point:
Average Monthly Consumption (AMC):

Price
Doc. No. Received Quantity Expiry
Date (Receiving from or Remarks
or Issuing
Unit Price Date
Issued to
Received Issued Loss/Adj Balance Birr Cent
98
C. Health Post Monthly Report and Re-supply Form
Name of the Health Post: Health Post ID Code:

Supplying Health Centre: Health Center ID Code:
Reporting Period From: (month/day/year) To: (month/day/year) Maximum Level: 2 months of stock
COMPLETED BY HEALTH POST COMPLETED BY HEALTH CENTRE
Quantity Calculated Quantity
Calculated Maximum
Beginning Received Loss / Ending Consumption Needed to Quantity to be
Ser. Product Code/Product Adjustment Balance
Consumptio Quantity
Balance this month Reach Max. Supplied
No. Name/Unit UNIT OF E = A+B+/-C-D
n last month G=E+F
H=G–D
ISSUE
A B C D E F G H I
1 Product description (pre-printed)
Remarks:
Completed by (Name, Date and Signature) : Completed by (Name, Date and Signature) :
Approved by (Name, Date and Signature) :
99
D. Internal Facility Report and Resupply Form
Name of Dispensing Unit: Reporting Period From: To:

Maximum Level (ML):
COMPLETED BY UNIT COMPLETED BY STORE
Quantity
Calculated Maximum
Ser. Beginning Loss/ Ending
Consumption Quantity
Needed to Quantity to be
Item Balance Adjustment Balance Reach Max. Supplied
No. Quantity E = A+B+/-C-D F =E * 2
Received G=F–C
Unit of
issue A B C D E F G H
8
Remarks :
Completed by (Name, Date and Signature) : Completed by (Name, Date and Signature) :
Approved by (Name, Date and Signature) :
100
E. Report and Requisition Form for Program Drugs
Region: Zone:
Health Facility:
Woreda:
Supplying Branch: Maximum Stock Level = 4 Months of Stock
Reporting Period: From: To: Emergency Order Point = 0.5 Months of Stock
Report Part
Requisition Part
Unit of Ending Balance Days Maximum
SN Product Description Beginning Quantity Losses/ Calculated
Out of Stock
Quantity
Issue Balance Received Adjustments Consumption Ordered
DU Stock Quantity Quantity Needed
Store
to Reach Max
F
G H
A B C D E = A + B +/- C – = (120*F)
D –E /(60 – G)
I= H-D-E
2
3
Products with shelf life < 6 months (S/No, Quantity and Expiry date): Remarks:
Completed by:_ Signature:_ Date:_
Verified by:_ Signature:_ Date:_
Approved by:__ Signature:_ Date:_
101
F. Report and Requisition Form for RDF Drugs
Health Facility: Region: Zone: Woreda:
Supplying Branch:_ Maximum Stock Level = 4 Months of Stock
Reporting Period:
Emergency Order Point = 0.5 Months of Stock
From:_ To:
Report Part
Requisition Part
Ending Balance in
Unit of Beginning Quantity Losses/ Calculated
Days
Maximum Quantity
SN Product Description Out of
Issue Balance Received Adjustments Consumption Stock Quantity Quantity Ordered
Stock Needed to
DU Store
Reach Max
G H I= H-D-E
F
=
A B C D E = A + B +/- C
F*2*RP*30/
– D-E
((RP*30)-G)
1
2
3
Products with shelf life < 6 months (S/No, Quantity and Expiry date): Remarks:
Completed by:_ Signature:_ Date:_
Verified by:_ Signature:_ Date:_
Approved by:_ Signature:_ Date:_
102
G. Cost Analysis Worksheet
Original Request Adjustment
Unit of Issue VEN Group Unit Price

Ser.
Product Code/Product Name/Unit
No. Quantity Total
Quantity needed to reach Max Total Price
Ordered Price
A B C (A*B) D E (A*D)
103
H. Record of returning unusable pharmaceuticals to Hospital/Health Centre pharmacy store
Name of the Health post/Dispensing Unit:

Woreda: Zone: Region:
Sr no Product Description Quantity to be Remark

returned
Name/Date/Signature of DU or HP staff (Returning) :

Name/Date/Signature of the store manager in the Hospital/Health Centre (Receiving) :
104
I. Aggregated Report (WoHO and RHB/ZHD)
Region: Woreda:
Reporting Period: From: To:

(month and year) (month and year)
Beginning Losses/ Ending Calculated

Qty Received
S/ Product Unit of Balance Adjustments Balance Consumption
Product
No. Code Issue
A B C D E
11
Remarks:
Completed by: Printed Name Signature Date
Head of Institution: Printed Name Signature Date
105
J. PHARMACEUTICALS FUND AND SUPPLY AGENCY DELIVERY INVOICES
Cash Sales invoice (CSI)*

CSI no. xxxxxx
Date:
Name of Central Store/Branch
Name of Store
Customer name
Customer Address: Region Zone Woreda CIV No.
Requisition No.:
s.no Item code Item name Unit Qty Unit price Total price Manufacturer Batch Expiry
no. date
Sender store: name & sig Checked by Carrier/Driver: name and sig.
For damaged and short received items
s.no Item code Item name Unit Damaged Short Unit price Total price Manufacturer Remark on damage
qty received and missing
qty
(missing)
I have received the above goods with the remarks there of in good condition
Received by: name and sig.
Distribution: Original: Receiver branch/central store, Copies to: Finance, Document follow up, Store, one copy signed and sealed by receiver and returned to
sender.
* Credit Sales Invoice (CRSI), Stock Transfer Voucher (STV)
106
K. Routine Feedback Reporting Format
S/No List of possible feed backs Need of the Remarks and specific recommendations if C is yes (D)
(A) (B) feedback
(Y/N)
1 Report even if you are not Write your specific feedback mentioning the significance or
requesting (even if you have importance of completing report and requisition for all products
sufficient stocks in your in the list if ―column C‖ is yes (e.g. PFSA needs the data for
facility) decision making)
2. Timely reporting Write your specific feedback mentioning the significance or

importance of timely completion of report and requisition if
―Column C‖ is yes
3. Report Quality
3a. Completeness Write your specific feedback mentioning the significance or
importance of completeness if
―Column C‖ is yes
3b. Accuracy (calculation errors Write your specific feedback with formula and practical
: CC, Max and Qty Ordered) example ―Column C‖ is yes.
3c. Validity (Beginning balance Write your specific feedback with formula and practical
is not equal to ending example if ―Column C‖ is yes.
4. ―Quantity Ordered ― is not Write the specific reason for the difference if
equal to ―Column C‖ is yes. e.g.
―Quantity Supplied‖ 1. Logical rounding due to package size
2. Calculation error (be specific)
108
L. List of Medicines Waste to Be Disposed
Description of
Reason for
Medicines
Disposal
Wastes (generic Unit Type Batch Expiry Manufacturer/ Country of Purchase
No. Quantity (expired,
& brand name, and Size Number Date Supplier origin Value
damaged,
strength and
spilled, etc)
dosage form)
109
M. አመታዊ የመድሀኒትና የህክምና መገልገያዎች ፍላጎት ማቅረቢያ ቅጽ (ሀ)
የጤና ጣቢያው ስም የ በጀት ዓመት
አመታዊ የመድኒት ጥያቄ አመታዊ የመድሀኒትና የህክምና መገልገያዎች በጀት በብር
ተ.ቁ. ዋጋ (Price)
የመድሀኒትና የህክምና መገልገያዎች አይነት መለኪያ መጠን
ያንዱ ዋጋ (unit ጠቅላላ ዋጋ (Total ማብራሪያ (Remark)
S.N. (Name, Strength & dosage form of items) (Unit) (Quantity)
price) Price)
A: Medicines
1 Amoxacillin 500mg Capsule 50X10 10 284.15 2,841.50 ለምሳሌ የቀረበ
2
3
.
B: Medical Supplies
1 Adhesive Plaster Zinc Oxide Size 7.5cmx10m Roll 30 24.93 997.20 ለምሳሌ የቀረበ
2
3
.
C: Laboratory Chemicals & reagents
1 Alanine Aminotransferase SGPT(ALT) 350 test 600 149.60 89,760.00 ለምሳሌ የቀረበ
2
3
.
D: Medical Instrument
1 Sphygmomanometer Each 20 110.38 2,207.60 ለምሳሌ የቀረበ
2
ለመድሃኒትና የህክምና መገልገያዎች የሚያስፈልግ ጠቅላላ በጀት (በብር)
ማስታወሻ፡
1. እያንዳንዱ ጤና ጣቢያ ለአመት የሚያስፈልጉትን መድሃኒትና የህክምና መገልገያዎች በሰንጠረዥ ላይ በምሳሌ በቀረበው መልኩ በመግለጽና ከበጀቱ ጋር በማጣጣም ለወረዳ ጤና ጽ/ቤት ማቅረብ አለበት፡፡
2. አመታዊ ጥያቄው በሚዘጋጅበት ወቅት በመጀመሪያ በጤና ጣቢያው የሚፈለጉ መድሃኒቶች (Medicines) በእንግሊዘኛ ፊደል ቅደም ተከተላቸው (A to Z) ከተዘረዘሩ በኋላ የህክምና
መገልገያዎች (Med supplies)፣ የላቦራቶሪ ሪኤጀንቶችና ኬሚካሎች (Laboratory Reagents & Chemicals) እንዲሁም የህክምና መሳሪያዎች (Medical equipments) በተመሳሳይ መልኩ
መገለጽ አለባቸው፡
110
አመታዊ የመድሀኒትና የህክምና መገልገያዎች ፍላጎት ማቅረቢያ ቅጽ (ለ)
የወረዳ ጤና ጽ/ቤት ስም የ በጀት ዓመት አመታዊ የመድሃኒት ጥያቄ በወረዳ ጤና ጽ/ቤት ስር ያሉ ጤና ጣቢያዎች ብዛት
አመታዊ የመድሃኒት በጀት (የሁሉም ጤና ጣቢያ•ች ድምር) በብር
የመድሀኒትና የህክምና መገልገያዎች አይነት መጠን ዋጋ (Price) ማብራሪያ
ተ.ቁ. (Name, Strength & dosage form of items) መለኪያ (Quantity) ያንዱ ዋጋ (unit ጠቅላላ ዋጋ (Total (Remark)
A: Medicines
1 Amoxacillin 500mg Capsule 50X10 60 284.15 17,049.00 ለምሳሌ የቀረበ
2
3
.
B: Medical Supplies
1 Adhesive Plaster Zinc Oxide Size 7.5cmx10m Roll 300 24.93 9972.00 ለምሳሌ የቀረበ
2
3
C: Laboratory Chemicals & reagents

1 Alanine Aminotransferase SGPT(ALT) 350 test 2500 149.60 374,000.00 ለምሳሌ የቀረበ
2
3
.
D: Medical equipments
1 Sphygmomanometer Each 60 110.38 6,622.80 ለምሳሌ የቀረበ
2
3
ለመድሃኒትና የህክምና መገልገያዎች የሚያስፈልግ ጠቅላላ በጀት (በብር)
ማስታወሻ፡
1. በወረዳው ስር ያሉ ጤና ጣቢያዎች እያንዳንዳቸው ለአመት የሚያስፈልጋቸውን መድሀኒትና የህክምና መገልገያዎች በሰንጠረዥ ላይ በምሳሌ በቀረበው መልኩ በመግለጽና ከበጀታቸው ጋር በማጣጣም
ለወረዳ ጤና ጽ/ቤት ማቅ አለባቸው፡፡
2. የወረዳ ጤና ጽ/ቤቱ በስሩ ካሉ ጤና ጣቢያዎች በቅጽ ሀ የቀረበውን ጥያቄ በአንድ ላይ በማጠናቀር በሸኚ ደብዳቤ በአቅራቢያው ለሚገኝ የመድሃኒት ፈንድና አቅርቦት ኤጀንሲ ቅርንጫፍ ያቀርባል፡፡
111
N. ABC Analysis of Pharmaceuticals
Vilfredo Pareto, (born July 15, 1848, Paris, France—died August 19, 1923, Geneva,
Switzerland), Italian economist and sociologist who is known for his theory on mass and elite
interaction as well as for his application of mathematics to economic analysis.
V. Pareto created a mathematical formula to describe the unequal distribution of wealth in his
country, observing that twenty percent of the people owned eighty percent of the wealth.
In pharmaceutical analysis, ABC has been used to identify the vital few from the trivial
many.
ABC needs reconciliation with VEN of the health facility. If once reconciled with VEN of the
facility and proved to be consumed according to the standard treatment guidelines, then the
vital few 20% in pharmaceutical order will be the real 80% consumption in value as follows.
Category Percentage of Budget Percentage of Pharmaceuticals Orders

―A‖ Pharmaceuticals 70-80% 10-20%
―B‖ Pharmaceuticals 15-20% 10-20%
―C‖ Pharmaceuticals 5-10% 60-80%
“A” pharmaceuticals:

High percentage of funds spent on large-volume or high-cost items

Greatest potential for savings

Greatest potential for identifying expensive pharmaceuticals that are
overused
“B” pharmaceuticals:
• Moderate cost and moderate number of items; important items
“C” pharmaceuticals:
• Small amount of funds spent on the majority of the inventory
Applications of ABC analysis:

 Measures the degree to which actual consumption reflects public health needs and
morbidity when reconciled with VEN and hence improve rational use of
pharmaceuticals.
 Provides information for choosing the most cost-effective alternatives and finding
opportunities for therapeutic substitution.
JOB AID: ABC Analysis
Task: Conduct ABC Analysis
Completed by: DTC Committee
Purpose: To sort pharmaceuticals as A,B and C
When To Perform: Annual
Materials Needed: Report and Requisition Form, Bin cards, Stock Record card, Model
19,Model 22
Step Action Notes

1. List of pharmaceuticals (A): List all Use the standard pharmaceutical list
pharmaceuticals used by the facility. (formulary) of the facility
2. Quantity consumed (B): Write the

quantity of each pharmaceutical
consumed/purchased under the period
of analysis.
3. Unit Price (C) :Enter the unit price of Take the latest price information for each
each of the product purchased pharmaceutical.
4. Total value (D): Multiply the unit cost with

quantity consumed.
D= B*C
5. Grand Total Value (∑Dis): Add the total value

of all items at the bottom of the column.
6. Percentage value represented by each item (E):

Divide the value of each item by the grand total
value.
E=Di/∑Dis, i=1, 2, 3…
Step Action Notes
7. Rearrange the list: Rank the items in descending Sort out again in descending
order by percentage value (E). manner so that the largest
amount being on the top and
decreasing down.
8. Cumulative percentage value of the total value
(F): Calculate the cumulative percentage value of
the total value for each item; beginning with the
first (top) item, add its percentage to that of the
item below it in the list.
9. Choose cut-off points for A, B and C
pharmaceuticals: A, those few items accounting
for 70-80% of total value
B, those items which take up the next 15-20% C,
the bulk of items which only account for the
remaining 5-10% of value.
10. Crosschecking of pharmaceutical order system
with cost percentage system:
Percentage of pharmaceuticals order can be taken
as 10-20%, 10-20%, 60-80% as a cut point as
shown below.
Category Percentage of Budget

Percentage of
Pharmaceuticals Orders
―A‖ Pharmaceuticals 70-80%
10-20%
―B‖ Pharmaceuticals 15-20%
10-20%
―C‖ Pharmaceuticals 5-10%
60-80%
11. Validation:
• Validate the value of A B C by reconciling
with VEN
• Subject the result to DTC for discussion to
check whether pharmaceuticals in this
class reflects public health problem of the
facility.
O. Vaccine Request Form
Vaccine Request Form
Federal Ministry of Health
Region/Zone/Woreda Amhara Level of cold chain Date of request: 28/01/08
Name of cold store Bahir Dar PFSA Cold Room No. of months to supply (S): 3
Responsible Person Biruh Tesfaye For population catchment served
Contact Address [email protected] Births (BI): 430,408
Telephone Number(s): 913992077 Surviving Infants (SI): 397,201
Used or
Waste factor
Balance at dispatched to Doses Requirement Vaccinations
Antigen
coverage
beginning of Received lower level Discarded Current for the next Requested given since
Target
Doses
last supply during the last during last (Provide reason Balance supply Amount Quantity last supply
period supply period supply period in remarks) (E + F − G-H) period* (J − I) released (all doses) Remarks
A B C D E F G H I J K L M N
BCG + Diluent 1 2.5 100% 94880 174640 222,440 0.00 47080 336,256 289,176
Excluding the amount of

Polio Doses for Two
Campaignes under metekel
zone and 70000 dose
unusable due to unfit
OPV + Droppers 4 1.11 100% 249440 91230 329,430 0 11240.00 551,116 539,876 Dropper )
DPT-Hib-Hep (Pentavalent) 3 1.05 100% 169899 187834 304,280 0 53453 390,995 337,542
Measles + Diluent 1 1.75 100% 45110 110220 130,280 0 25050 217219 192,169
PneumoccoalVaccine (PCV10) 3 1.11 100% 1576826 143999 298,893 0 1421932 413337 0.00
Rotavirus vaccine (PV) 2 1.05 100% 64492 339950 216,358 0 188084 260,663.16 72,579
Tetanus Toxiod (TT) 3 1.11 100% 57030 279997 278,310 0 58720 447,893 389,173
Syringe, A-D, 0.5ml 10 1.11 100% 55400 1979200 1,326,300 0 708300 1,377,791 669,491
Syringe, A-D, 0.05ml 1 2.5 100% 96200 169622 153,900 0 111900 336,256 224,356
Mixing syringe (BCG) 1 1.11 100% 14500 300 8,100 0 6500 16,813 10,313
*Stock Under
Mixing syringe (Measles) 1 1.11 100% 384100 0 30,896 0 820400 21,722 0 PROGRAMME STORE used
Stock Under PROGRAMME

STORE is used thoug small
Safety Box Pcs 2750 0 7,750 0 13300 17,526 4226 amount from Vaccine .
* Surviving Infants (Births for BCG) × B x C x D × S (Months to Supply) ÷ 12 × 1.25 (Buffer)
N.B.. all figures are indicated as doses, pieces; supply requirement includes requirement for number of months indicated at target coverage PLUS 25% buffer (min. stock) LESS current stock
Equipment monitoring No. of units No. Temperature excursions Remarks
Type of fridge F NF FT* < 0˚C > 8˚C Requested by: Biruh Tesfaye
Cold rooms 2 0
Refrigerators 2 2 Approved by: Abdissa Mengesha
Freezers 2 4
*Functional (F); Non-
functional (NF); Fridges tag
(FT) in use

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Standard Operating Procedures (SOP) Manual for

the Integrated Pharmaceuticals Logistics System

Addis Ababa, Ethiopia

Therefore, the implementation of the SOP manual needs to be re-enforced by management

Pharmaceuticals Fund and Supply Agency

AIDS Acquired Immune Deficiency Syndrome

• Recording and reporting on stock levels and usage of pharmaceuticals.

Overview of Pharmaceuticals and Information flow in IPLS

IPLS implementation requires collaborative efforts of different officials and professionals

1. Federal Ministry of Health (FMOH)

Table 1: Roles and responsibilities of FMOH

As an agency with a prime responsibility of managing the pharmaceutical logistics system

Table 2: Roles and responsibilities of PFSA

1 Forecast national pharmaceuticals need based on the demand of Health Facilities.

10 Develop data recording, requisition and reporting formats.

3. Regional Health Bureaus/Zonal Health Department

1. Provide technical assistance and supervision in logistics management including

2. Monitor pharmaceutical budget and pharmaceutical availability

5. Provide and develop guidelines to facilities when necessary

6. Enforce policies as related to pharmaceutical logistics management

7. Monitor and oversee annual pharmaceutical quantification of Woreda health offices

4. Woreda Health Offices

Table 4: Roles and responsibilities of WoHOs

7. Monitor pharmaceutical budget and pharmaceutical availability

Table 5: Roles and responsibilities of hospitals

Pharmacy case team

16. Conducts budget utilization studies and analysis.

Coordinate and participate in the annual quantification of RDF pharmaceuticals.(Head of the

6. Approves the RRF at the end of each reporting period

8. Follow and enforce timely reporting and data quality of RRF

3. Coordinate and participate in the annual quantification of RDF pharmaceuticals.

1. Store pharmaceuticals using appropriate storage procedures

A. Logistics Management Information System (LMIS) in IPLS.

The purpose of a Logistics Management Information System (LMIS) is to

1. Stock on Hand: Quantities of usable stock available at a particular point in time.

Table 8: Records and reports used at different level

Table 9: Reporting frequency at different level of health facilities

C. Storage of Pharmaceuticals in the IPLS

A. Maintaining the Bin Card

Task: Recording Transactions in the Bin Card

Completed by: Health staff in charge of pharmaceuticals (Health Extension Worker,

Purpose: To record pharmaceuticals received

When To Perform: When pharmaceuticals are received or issued

Materials Needed: Bin Cards, pen, pencil (for AMC only)

Steps 3 – 10: Opening a NEW Bin Card

RHZE/RH - (150mg +75mg + 275mg

For Dispensing Unit : 2 x reporting interval

For Health Post : Leave it empty

• If this is the first line of a new Bin Card

12. Document No. (Receiving or Issuing): Example: 736529

Stock transferred from one facility to

At the health post, write the total quantity of

At the health centre and hospital, write the

At the dispensing units

• Write the quantity of the product in the

Adjustments may also be made to correct

For TB kits at TB clinic - Newly

If issuing products: Subtract the ―Quantity

If recording a loss or adjustment: Add (if

MOS= SOH/(AMCLSI): 16/(400.66)=0.61.