Custom therapeutic regimens

Mozambique has a MMIA form which tracks usage and patient groups of HIV products. System admins and warehouse managers configure the default regimens on the web portal which all users can see and use. However, because of stock outs of certain drugs, the actual regimens a facility prescribes could be different. Therefore, health workers need to be able to add their custom regimens to the MMIA form.

Multiple-program in requisitions

Mozambique has forms which include products from various programs. Also, the stock cards in pharmacies are not categorized by programs, but only by products currently. During a requisition period, the generated forms need to include all products that belong to the programs for that form.

For example, a facility carries the following drugs that have different programs configured:

Drug A - Malaria

Drug B - Essential Medicine, TB

Drug C - Essential Medicine, PTV

Drug D - TARV

Of these programs, Malaria, Essential Medicine and TB are part of VIA form; PTV and TARV are part of MMIA form.

So the two forms will be:

VIA form - Drug A, Drug B, Drug C

MMIA form - Drug C, Drug D (the actual MMIA form is a report that has a list of mandatory products to report on, but we'll not discuss it here)

Even though Drug B belongs to both Essential Medicine and TB, it will only show in the VIA form once because the stock card does not distinguish programs (hence no way to separate the quantities for each program). The form also does not categorize products by program.

Stock card AMC (aka CMM) formula

AMC = Consumption / months (3) without any stock outs

where consumption is the total issued quantities, month is the scheduled requisition period, and stock out is when stock on hand is 0

Example 1

Period 1: Issues of 400: CMM IS BLANK

Period 2: Issues of 100: CMM IS BLANK

Period 3: Issues of 600 AND stock out: CMM IS BLANK

Period 4: Issues of 1000: CMM IS BLANK

Period 5: (in progress): CMM = (400+100+1000)/3 = 500

Example 2

Period 1: Issues of 400: CMM IS BLANK

Period 2: Issues of 100: CMM IS BLANK

Period 3: Issues of 600 AND stock out: CMM IS BLANK

Period 4: Issues of 1000: CMM IS BLANK

Period 5: Issues of 2000: CMM = (400+100+1000)/3 = 500 (during period)

Period 6: (in progress): CMM = (100+1000+2000)/3 = 1,033

Requisition period example

The policy in Mozambique is, the scheduled requisition period is always 21st to 20th. In reality, the pharmacists have a time window to do their monthly inventory and complete the forms, which is from 18th to 25th.

For example:

If -

Scheduled requisition period: Sep 21 - Oct 20

Facility A previously submitted requisition actual period: Aug 20 - Sep 23

Then -

Current actual period start: Sep 24

Earliest date pharmacists can create a requisition: Oct 18

Dates pharmacists can choose as requisition actual end date (inventory date): Oct 18 - Oct 25

Case 1:

On Oct 23, pharmacist does an inventory count.

On Oct 24, pharmacist does another inventory count.

On Oct 24th, she creates a requisition. She can use Oct 23 or Oct 24 to be her inventory date. If she chooses Oct 24, then the actual requisition period is Sep 24 - Oct 24.

This requisition is Normal.

Case 2:

Pharmacist forgets to do inventory count during Oct 18 - Oct 25.

On Oct 31, pharmacist wants to create a requisition for this missed period. She can choose any date between Oct 18 and Oct 25 as their inventory date for the missed period, and the EOD stock on hand quantities for that date would be used as the inventory. She should not change the requested or approved quantities on the form (should use theoretically calculated quantities).

This requisition is Late.

Case 3:

User forgets to do requisitions for Sep - Oct period and now it's at the Oct - Nov requisition period window.

User needs to follow the same procedure as in Case 2 to do the Sep - Oct requisition first and submit, and then they can do Oct - Nov requisition.