Bulletin of the World Health Organization

Expiry of medicines in supply outlets in Uganda

Josephine Katabaazi Nakyanzi, Freddy Eric Kitutu, Hussein Oria & Pakoyo Fadhiru Kamba

Volume 88, Number 2, February 2010, 154-158

Table 1. Perceived factors contributing to expiry of medicines at key stages of the supply chain

Contributing factor Type of medicineoutleta No. Public Private Total (%)b
Minimum shelf life not specified in orders P 38 0 9 23.7
Profit margin determines size of purchase Q 32 N/A 22 68.8
Procurement done irrespective of present stock Q 35 1 0 2.9
Medicines dumped by manufacturers P 32 N/A 6 18.8
No advice from expert clinicians on medicines forecasts Q 3 3 N/A 100
Standard treatment guidelines violated in forecasts Q 3 1 N/A 33.3
Irrational prescribing causes underuse of certain medicines U 3 1 N/A 33.3
Donations received irrespective of need P 5 1 N/A 20
No accurate data available to facilitate quantification Q 28 2 0 7.1
Obsolete medicines are sometimes procured P 33 0 7 21.2
Some medicines are quantified by vertical programmes Q 5 2 N/A 40
Seller’s incentives influence quantification Q 36 0 10 27.7
Overstocking is common Q 37 0 12 32.4
Use neither FIFO nor FEFO in stock management IM 38 0 2 5.3
Not knowledgeable about FEFO IM IM 38 2 13 38
Not knowledgeable about FIFO IM IM 38 0 8 21.1
Expired medicines not isolated into secure areas IM 37 0 2 5.4
No timetable for regular inventory level analysis IM 37 2 9 29.7
Filing and records are poorly maintained IM 38 0 2 5.3
Inventory levels not regularly monitored IM 37 4 24 75.7
No specific personnel for inventory management IM 38 0 7 18.4

FEFO, first expiry first out; FIFO, first in first out; IM, inventory management; N/A, not applicable to that category of medicine outlet; P, procurement; Q, quantification; U, use.
a Some contributing factors are specific to a type of medicine outlet.
b Overall proportion of medicine outlets with that contributing factor.