LHW Systems Review - Oxford Policy Management

Logistics management systemTable 6.3Comparison of procuring a bundle of medicines in accordancewith the PC-1, and in accordance with the LHW dispensing rateName of ItemParacetamoltabletsParacetamolsyrupChloroquinetabletsChloroquinesyrupFerrousfumarate+ folic acidtabletsCotrimoxazolesyrupVitamin Bcomplex syrupBenzyl benzoatelotionMebendazoletabletsPiperazine syrupOral rehydrationsaltsAccountingunitProcured in2007/08 atRs. per unitMonthlyrequirement(PC-1)Actualmonthlydispensingrateby accounttingunit(1)Differencebetweenmonthlyrequirementsin PC-1 and actualdispen-singMonthlycost ifdispensingasper PC-1(Rs.)Monthlycost usingactualdispensingrate(Rs.)Pack of 200tablets, instrip/blister 47.37 1 0.75 0.25 47.37 35.53Bottle of 60ml,with carton 8.49 10 15.17 -5.17 84.9 128.79Pack of 100tablets, instrip/blister 56 1 0.34 0.66 84.9 19.04Bottle of 60ml,with carton 7.22 5 5.63 -0.63 84.9 40.65Pack of 1,000tablets, instrip/blister132.75 1 0.44 0.56 84.9 58.41Bottle of 50ml,with carton 7.99 5 5.81 -0.81 84.9 46.42Bottle of120ml, withcarton 6.89 7 10.80 -3.8 84.9 74.41Bottle of 60ml,with carton 6.66 2 5.53 -3.53 84.9 36.83Pack of 100tablets, instrip/blister 42.3 1.5 0.29 1.21 84.9 12.27Bottle of 30ml,with carton 37.18 5 7.01 -2.01 84.9 260.63Pack of 20sachets 124.44 1 0.67 0.33 84.90 83.37Total cost 832.41 796.36Source: PC-1 (2003–08); and OPM LHWP 4th Independent Evaluation, Quantitative Survey data, 2008.Low dispensing rates by LHWThe Quantitative Survey reported the amount of medicines the LHW had dispensed in theprevious week if the item were in stock. Compared with 2000, the average amountdispensed by LHWs has increased substantially for many items. While the dispensing rateprovides some information on the demand for LHW medicines, it is not possible, given thelevel of medicines procured over the five years, for this rate to have been constant. It is morelikely that LHWs make a judgement on what the risk of stock-outs are and modifies herdispensing patterns accordingly.The monthly cost of a bundle of 11 medicines in 2007/08, if purchased in accordance withthe monthly requirements specified in the PC-1, would have cost Rs. 832.41 per LHW. Thecost of the same bundle of 11 medicines, in accordance with the dispensing rate identified inthe survey and using the 2007/08 prices paid by the LHWP, was Rs. 484.30 (Table 6.3).LHWs are not dispensing at the rate forecast in the PC-1.37