LHW Systems Review - Oxford Policy Management

LHWP – Systems Review6.4 System performance6.4.1 Performance indicatorsOut of stockThere were stock-outs on all items. The Programme standard is that no more than 10percent of LHWs should be out of stock of an item for more than two months. This standardwas not met for 11 items (Table 6.1). Expired stock was not a problem.Table 6.1Percentage of LHWs who have been out of stock for more thantwo monthsItem% of LHWscurrently with itemout of stock% of LHW out ofstock for more thantwo monthsParacetamol tablets 32 5Paracetamol syrup 45 13Chloroquine tablets 56 22Chloroquine syrup 58 24Mebendazole tablets 62 28Piperazine syrup 50 16Oral rehydration salts 41 11Eye ointment 59 13Cotrimoxazole syrup 69 21Vitamin B complex syrup 40 5Ferrous fumarate + folic acid tablets 34 16Antiseptic lotion 60 14Benzyl benzoate 53 9Bandages (cotton) 42 10Condoms 34 4Injectable contraceptives 76 22Oral contraceptive pills 22 2Source: OPM LHWP 4th Independent Evaluation, Quantitative Survey data, 2008.The results from the District Survey show that almost three quarters of the districts hadreceived their most recent delivery of supplies from the PPIU in July, August and September2008. Delivery of medicines and contraceptives to facilities between July and October 2008was reported by 90 percent of districts. Accounts Supervisors reported that normally theDPIU would distribute medicines and contraceptives within seven days of their receipt.However, only one fifth of the districts reported submitting requests for replenishment ofsupplies. In many instances, they would already be out of stock prior to the request andthere was no guarantee that this request would be filled.Follow-up interviews were conducted with a sample of districts whose facilities werereporting stock-outs of items that were available at the provincial level and with other districtsin the province. Reasons given by the management of these districts were: a shortage ofPOL (and, therefore, inability to send the supplies to the facilities); not using thereplenishment system and, instead, dispensing stock on arrival on a per-LHW basis,resulting in shortages to particular health facilities; and lack of competence by the previousDistrict Coordinator.34