Public Health Facility Pharmacy
Facility #____ (1-30)

Facility _______________________

Date ________________________

Location ______________________

Investigator __________________

Key drugs [A]

No. of days out of stock [B]

No. of days covered by the review [C]

Equivalent no. of days/year
[D]=[B] x 365/[C]

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

[A¹] = Total no. of key drugs =(sum of A) =

[D¹]=Sum of D[E] = Average no. of stock out days = [D¹/A¹]

[D¹]=
[E]=

Notes:

[A]

List of 20 key drugs previously identified must already be printed in [A] (see p42). Review the stock cards of the key essential drugs listed.

[B]

Go through the stock cards covering the review period. Add the number of days that each of the key essential drugs are not available or marked “0” on the stock card. A drug is considered in stock if it or its equivalent is available in either generic or branded form. Indicate in [B] the total number of days each drug is out of stock.

[C]

The review should cover a 6-12 months period. If this is not possible then indicate the number of days covered by the review.

Key drugs [A]

No. of days out of stock [B]

Number of days covered by the review [C]

Equivalent no. of days/year
[B] x 365/[C]=[D]

Amoxicillin

58

120 days

58 x 365/120= 176

Cotrimoxazole

90

6 months

90x 365/180=182

Paracetamol

30

1 year

30 x 365/365=30

[A¹]= Total no. of key drugs = (sum of A) = 3

[E] = Average no. of stock out days = [D¹/A¹]

[E] = 129 days