Innovative use of supply chain data to strengthen HIV commodities management in Apac district of northern Uganda

BACKGROUND: Antiretroviral (ARV) commodities supply chain management ensures optimal and uninterrupted supply of quality medicines to implement HIV care and treatment. The implementation core players include the facility staff, medicines management supervisors, the District Health Team, central warehouse and the Ministry of Health. The efforts to achieve a resilient supply chain system in the Lango sub-region of northern Uganda were affected by COVID-19 pandemic, inadequate funding, poor order fulfillment rates, poor logistics management by facilities and inadequate data use for decision making.
DESCRIPTION: The major interventions supported by the JSI-led USAID Regional Health Integration to Enhance Services - North, Lango (RHITES-N, Lango) project include annual procurement planning, ordering and reporting for resupply, rational medicines use, stock status monitoring, and data use to inform timely decisions. Despite the support, between January 2020 to January 2022, Apac district experienced stock-outs of ARVs among other commodities. To address this, RHITES-N, Lango supported the district to undertake the following activities and approaches:

• Review of all vital commodity data, including consumption, days stock out, losses and adjustments, stock balances, months of stock available, quantities to order, and order fulfillment rates from sources like HMIS 105, order reports, weekly real-time ARV stock status and monthly stock evaluation
• Monthly commodity meetings to review progress, challenges and actions
• Intensify use of data to inform actions that included redistribution, emergency orders, targeted capacity building mentorship.

As a result, there was stabilized stock availability during the period of review. All five ART sites in the Apac maintained optimal stock level for all key commodities like ARVs, TB medicines, laboratory and other commodities.
LESSONS LEARNED: Data ownership enables use for decision making. Furthermore, the DHO's commitment and stewardship optimizes responses by all key players of commodity management.
CONCLUSIONS: ARV Stock stability is a critical prerequisite to successful HIV prevention, treatment and achieving the 95-95-95 target. The best practices from Apac will be cascaded to other districts in the Lango sub-region to ensure sustained stock stability.

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