Having this commodity on hand, and in a state that is effective when used, can be the difference between life and death for a mother. The USAID Global Health Supply Chain Program-Procurement and Supply Management (GHSC-PSM) project works with governments to ensure this commodity is available and kept in sufficiently cold conditions during transportation and storage so that it is effective when used.
GHSC-PSM recently coordinated the transfer of a large stock of oxytocin between the governments of Madagascar and Malawi, where health facilities had been stocked out of the drug at a high rate. This transfer limited wastage of the commodity and helped ensure its availability at 381 facilities across 28 health districts in Malawi. Using its cold chain knowledge and network of logistics providers, GHSC-PSM was able to ensure the drug was kept sufficiently cold throughout the process.
Midwives, doctors, and other skilled providers use oxytocin to prevent and lessen bleeding during childbirth.
National governments use stock tracking tools and consumption trends to forecast patient needs, so that health facilities are not vulnerable to running out of critical commodities. These tools allow countries to adjust stock levels as needed and identify early when there is a risk of over or under stock. Prior to the transfer, the government of Madagascar received a shipment of oxytocin which they determined would not be used in the public health system before its expiration date.
Starting in early 2020, GHSC-PSM worked with the Government of Madagascar to find a nearby national public health system that needed oxytocin. Using its network of staff and partners across the region, GHSC-PSM determined that the government of Malawi had the greatest need and was willing to accept the donation. GHSC-PSM worked with governments, implementing partners, and third-party logistics providers (3PLs) to secure quality assurance approvals, import waivers, appropriate packaging, international shipping, and distribution to health facilities upon delivery to Malawi. A critical consideration during the transfer was ensuring cold chain integrity between the various touch points across Madagascar and Malawi. GHSC-PSM secured logistics providers that could ensure cold storage and icing along the way.
Using data from their logistics management information system, Malawi’s Ministry of Health (MOH) and GHSC-PSM in Malawi determined that health facilities were experiencing a 17-18% stockout rate of oxytocin in November 2020. Its national target for stockouts is less than 5%. As such, the MOH readily accepted Madagascar’s donation of 260,000 ampoules of oxytocin. Once the stock arrived in Malawi, GHSC-PSM worked with the MOH to:
- Ensure the stock was secured in cold storage
- Begin distribution through a cold chain fleet to 381 facilities with low stock on hand of oxytocin
- Issue a notice to health facilities on the pending expiration dates of the stock
- Track commodities in the national LMIS so that stock levels could be properly monitored
Following the distribution of the commodities in January and February 2021, stockout rates decreased significantly, from 17-18% to approximately 9% once the deliveries completed in February.
Malawian government officials have commended the Government of Madagascar, USAID and the GHSC-PSM project for their dedication in delivering these lifesaving commodities. The cross-government coordination has unquestionably reduced the risks mothers face as they give birth.
