A recent performance review meeting of the Maternal and Child Health (MCH) Technical Working Group (TWG) on July 18, 2025, shed light on the varying stock levels of essential Reproductive, Maternal, Newborn, Child, and Adolescent Health (RMNCAH) commodities across Uganda.
While some vital supplies are robustly stocked, concerns remain over critical shortfalls in certain areas and a pervasive issue of overstocking at health facilities.
The Department of Pharmaceuticals and Natural Medicines (DPNM) presented a detailed stock status update, highlighting trends from January to June 2025 from both the National Medical Stores (NMS) and Joint Medical Stores (JMS).
Family Planning Commodities: A Tale of Two Halves
For injectables and long-acting reversible contraceptives (LARCs), commodities like Medroxyprogesterone Acetate (Depo-Provera, both 150 mg/ml and 104 mg Sayana Press) and Etonogestrel 68 mg/rod Implant (Implanon NXT) generally maintained more than six months of stock throughout Q3 and Q4, with notable increases in April and June 2025.
However, Hormonal IUDs showed significant fluctuation, with zero stock at JMS and very low levels (3.2 months) at NMS as of July 1, 2025, although a pipeline is expected from UNFPA in September 2025. Copper IUDs also experienced fluctuations, often below six months of stock.
Regarding other family planning commodities, Cycle beads, female condoms, male condoms, and Emergency Contraceptive Pills (ECPs) were well-stocked, consistently above seven months of supply for the two quarters reviewed.
Conversely, Combined Oral Contraceptives (COCs) and Levonorgestrel 30 mcg (Microlut) experienced significant stock drops in May 2025, though some improvement was seen in June.
As of July 1, 2025, Microlut had a critically low stock level of 0.3 months at NMS, with COCs completely stocked out. Plans for inter-warehouse transfers from JMS to NMS are in place to address these low stock levels.
At the health facility level, the availability of male condoms and Implanon NXT has been persistently low, averaging 52%, despite a slight increase in Q4 compared to Q3.
Maternal Health Essentials: Amoxicillin a Key Concern
The report indicated a general drop in stock levels for maternal items during Q4. A particularly alarming finding was the status of Amoxicillin 250mg capsules, which were only stocked at NMS in January 2025 with about nine months of supply, but remained stocked out for the rest of the months in both quarters.
This suggests potential challenges in the sourcing of this crucial antibiotic by the central warehouse. Other maternal commodities like Calcium Gluconate, Ferrous Sulphate + Folic Acid, and Folic Acid were also tracked, though specific details on their stock levels were not as prominently highlighted as Amoxicillin’s scarcity.
Maternal & Child Health Commodities: Low Stocks for Mama Kits and Micronutrients
For broader Maternal & Child Health (MCH) supplies, Oxytocin and Misoprostol maintained good stock levels, consistently above three months throughout the two quarters.
However, Maama Kits (Safe Maternity Kits) recorded very low stock levels, remaining below three months of supply, though availability did show improvement in Q4 compared to Q3. Chlorhexidine availability also saw better performance in Q4.
Overall, while the majority of MCH commodities are reported as well-stocked, Iron/Folic acid supplements and Pyrimethamine+Sulphadoxine (SP) were identified as having low stock levels, with a pipeline of these commodities expected from the Government of Uganda (GOU).
Key Challenges and Way Forward
A significant concern highlighted in the report is the “overstock of Key RMNCAH commodities still significant at the health facilities (over 30% of HFs)”. This suggests inefficiencies in the supply chain or distribution that lead to some facilities holding excess stock while others face shortages.
In response to these findings, the MCH TWG has emphasized several key actions:
• Support for Redistribution: Implementing Partners (IPs) in the health sector are urged to support the redistribution of RMNCAH commodities to optimize availability at health facilities.
• Order Placement: IPs also need to support districts in placing orders for RMNCAH commodities, particularly for family planning supplies, at the health facilities.
• Procurement Updates: Orders for MCH and FP commodities for Funding Year 2025 under UNFPA have been placed, with expected delivery dates pending. The distribution of GOU FP commodities via JMS by the Medical Stores Unit (MSU) is also commencing.
• Accountability and Mentorship: Product supply management (PSM) mentorships, health product reconciliations, and accountability activities are being conducted on a bi-annual basis to improve supply chain efficiency.
The report underscores the complex nature of managing health commodity supplies, calling for continued collaboration and strategic interventions to ensure that essential RMNCAH services are not hindered by stockouts or poor distribution.
