World Health Organization · 1st edition, 2025 · 36 pages
WHO guidance on standardised core indicators and electronic systems for tracking NTD medicines from central warehouses to community distribution.
- Issuer
- World Health Organization
- Edition
- 1st edition, 2025
- Audience
- Health workers, pharmacists, logistics personnel at health facilities and districts; NTD programme managers and data managers; supply chain partners
- Evidence
- Expert consensus, best practices from field assessments and partner reviews
- Reviewed
- 15 Oct 2026 · GMJ
What this guideline says
GMJ summary
This WHO normative guidance establishes a standardised framework for logistics management information systems (LMIS) to track neglected tropical disease (NTD) medicines and health products throughout the ‘last mile’—from national warehouses to health facilities, schools, and community drug distributors. The document addresses critical gaps in supply chain visibility, including poor forecasting, wastage from expiry, stock-outs alongside overstocking, and inability to calculate remaining balances after mass drug administration campaigns.
The guidance defines 13 essential data elements (opening balance, quantities received/issued/consumed, expired/lost products, stock transfers, stock on hand, stock-out days, returns after MDA, and forecasts) and eight core indicators organised into product availability, service performance, product quality, and asset utilisation. It recommends transitioning from paper-based systems to electronic LMIS (eLMIS) with interoperability to health management information systems, GS1 barcoding for traceability, and dashboard analytics for real-time decision-making at strategic, tactical, and operational levels.
The document provides detailed best practices for inventory management using FEFO (first expired, first out), reverse logistics for unused medicines, multi-year forecasting aligned with pharmaceutical production cycles, adequate warehousing compliant with WHO good storage and distribution practices, and timely reporting cycles (monthly, quarterly, or per MDA event). A green light checklist ensures countries have customs waivers, import permits, warehouse space, and distribution funding before donated shipments proceed.
Key points
For clinicians — doses and thresholds as stated in the guideline
- Collect 13 essential data elements at each reporting cycle: opening balance, quantities received/issued/consumed, expired/lost/transferred products, physical stock count, days stocked out, MDA returns, and forecasts for next 1–3 years.
- Calculate inventory reconciliation as physical count / theoretical balance × 100; theoretical balance = opening balance + received − (number treated × average dosage) − expired/lost − transfers.
- Monitor stock-out rate as total days stocked out / days in reporting period × 100 to measure supply chain reliability.
- Track percentage of expired/discarded products as total expired or discarded / total stock × 100; implement FEFO rotation to minimise wastage.
- Assess stocked-according-to-plan for non-PC supplies as stock on hand / average monthly consumption (target: 1–3 months); for PC supplies as stock on hand / forecast for MDA × 100 (target: 90–110%).
- Measure forecast accuracy as (1 − (|forecasted consumption − actual consumption| / actual consumption)) × 100 to refine quantification models.
- Implement eLMIS with interoperability to HMIS, GS1 barcoding/serialisation for traceability from central to peripheral levels, and real-time dashboards.
- Establish reverse logistics for all unused, unopened products post-MDA; quantities returned must be recorded in stock systems and reported to national level for next forecasting cycle.
Key data elements to collect through LMIS records and reports
Table extracted from the guideline
| Data element | Levels | Definition | Data source and frequency |
|---|---|---|---|
| Opening balance | Community, Health facility, Subnational, National | Quantity of each medical product available at district/health facility at beginning of reporting period | Bin card, stock card, ledger, eLMIS, LMIS report; per reporting cycle (monthly, quarterly) or per event (MDA) |
| Quantity received | Community, Health facility, Subnational, National | Quantity of each medical product received at health facility in reporting period | Receipt vouchers, bin card, stock card, ledger, eLMIS; per reporting cycle or per MDA |
| Quantity issued | Subnational, National, Health facility | Quantity of each medical product issued to lower-level health facility/hub in reporting period | Issue vouchers, bin card, stock card, ledger, eLMIS; per reporting cycle or per MDA |
| Quantity consumed | Community, Health facility | Quantity of each medical product consumed (used) or dispensed to patient at health facility or by community health worker | Consumption records, daily activity register, MDA register; per reporting cycle or per MDA |
| Quantity expired | Community, Health facility, Subnational, National | Quantity of expired medical products during reporting period by NTD medical product, by type | Bin card, stock card, ledger, eLMIS; per reporting cycle or per MDA |
| Stock on hand (physical stock) | Community, Health facility, Subnational, National | Quantity of medical products available at health facility at end of reporting period by NTD medical product, by type | Physical count at facility or storage facility; per reporting cycle or per MDA |
| Number of days stock out | Health facility, Subnational, National | Number of days during which an item is out of stock at any time by NTD medical product | Bin card, stock card, ledger, eLMIS; per reporting cycle or per MDA |
| Quantity returned after MDA | Community, Health facility | Quantity of medical products (useable) returned after MDA by NTD medical product (PC supplies only) | Bin card, stock card, ledger, eLMIS; per MDA event |
| Stock forecast | Health facility, Subnational, National | Number of medical products required for following year (PC for community; non-PC for health facility) | NTD medical product projection based on previous consumption and planned activities; eLMIS |
Source: World Health Organization, Routine health information system and health facility and community data for neglected tropical diseases: last-mile logistics information system for medicines and health products. Reproduced in summary form.
From the guideline
Verbatim
“Effective supply chains rely on end-to-end visibility, where the right data, of the right quality, reach the right people at the right time and place, enabling informed decisions and prompt actions.”
Editor’s perspective
Why this matters for Georgia and the region
Prof. Giorgi Pkhakadze, MD, MPH, PhD
Editor-in-Chief, Georgian Medical Journal · Chair, Public Health Institute of Georgia · WHO consultant, health and migration
As WHO consultant on health and migration, I recognise this guidance provides a critical framework for strengthening pharmaceutical supply chains beyond NTDs—applicable to Georgia's vertical disease programmes including our hepatitis C elimination effort and tuberculosis control. The standardised 13 data elements and eight core indicators offer immediate value for integrating logistics visibility across our National Centre for Disease Control warehouse systems and the established electronic prescription infrastructure. I would stress to Georgian colleagues the inventory reconciliation formula (physical count versus theoretical balance based on treatment records) as a powerful accountability tool, particularly for high-value medicines in our UHC programme. The realistic implementation caveat is that achieving true LMIS-HMIS interoperability requires resolving organisational boundaries between our pharmaceutical supply management units and clinical information system teams—a structural challenge the document acknowledges but underestimates in resource-constrained settings where dedicated logistics personnel at peripheral levels remain limited.
ORCID 0000-0001-7609-4515 · Perspective written for the GMJ Guidelines Library, 15 Oct 2026
Applicability
Georgia and the South Caucasus
Georgia’s neglected tropical disease burden is relatively low compared to tropical regions, but the standardised LMIS framework is directly applicable to strengthening supply chain management for national disease elimination programmes (e.g., hepatitis C, tuberculosis, HIV) and immunisation logistics. The country’s established digital health infrastructure—including the national electronic health record system and pharmacy information systems—provides a foundation for implementing interoperable eLMIS. National NTD programmes would need to adapt the 13 data elements and eight core indicators to locally relevant disease portfolios, ensure alignment with existing warehouse management systems at the National Centre for Disease Control and Public Health, and integrate with Georgian Medicines and Medical Devices Agency regulatory frameworks. The guidance on reverse logistics, FEFO inventory rotation, and green light checklists for imported products aligns with existing pharmaceutical import procedures and could strengthen management of donated or centrally procured medicines across vertical disease programmes.
Questions this guideline answers
Quick answers
What is the difference between LMIS and HMIS?
LMIS tracks commodity data (quantities issued, dispensed, used, received, lost, damaged, ordered) collected by warehouse users and used daily to assess stock status and determine resupply quantities. HMIS tracks patient health conditions and health services rendered, collected by healthcare workers and used periodically to determine disease patterns and plan resources. Both systems should be interoperable to correlate stock levels with disease burden.
How do I calculate theoretical balance for inventory reconciliation?
Theoretical balance = opening balance + quantity received − (number of treated people × average dosage) − reported expired/lost quantity − peer transfer quantity (if any). Then calculate inventory reconciliation as (physical count / theoretical balance) × 100. Discrepancies indicate issues with stock keeping or reporting that require investigation.
What is the target range for 'stocked according to plan'?
For non-preventive chemotherapy (PC) medical supplies at health facilities, maintain stock on hand equivalent to 1–3 months of average monthly consumption. For PC medical supplies used in mass drug administration, maintain stock on hand at 90–110% of the forecasted need for the planned MDA campaign.
What should be included in the green light checklist before accepting donated NTD medicines?
Confirm: (1) customs office is aware of shipment quantity; (2) customs duty waiver will be prepared before arrival; (3) import permit is available (if required); (4) central medical store warehouse has space and personnel to receive and offload containers; (5) country is prepared to distribute medicines with secured funding; (6) all other requirements are met. Only proceed with shipment when all items are confirmed.
Related on GMJ
Interconnected resources
Dictionary of Public Health
Drugs A–Z
Conditions A–Z
GMJ News coverage
Quality & accreditation
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- Issuer
- World Health Organization
- Type
- Guidance (normative)
- Edition
- 1st edition, 2025
- Status
- Current
- Published
- 2025-08-05
- Languages
- English
- Scope
- Last-mile logistics (national warehouse to community distribution) for NTD medicines and health products
- Audience
- Health workers, pharmacists, logistics personnel at health facilities and districts; NTD programme managers and data managers; supply chain partners
- Pages
- 36
- Licence
- CC BY-NC-SA 3.0 IGO
- ISBN
- 978-92-4-011158-5
- Evidence
- Expert consensus, best practices from field assessments and partner reviews
- Record history
- Created 15 Oct 2026 · updated 15 Oct 2026 · next check Apr 2027
World Health Organization. Routine health information system and health facility and community data for neglected tropical diseases: last-mile logistics information system for medicines and health products. Geneva: World Health Organization; 2025. Licence: CC BY-NC-SA 3.0 IGO.GMJ Guidelines Library records are original summaries written by the GMJ editorial team from the issuer’s published document and reviewed by a physician. They do not replace the full guideline. The document is the copyright of its issuer and is linked, not hosted. Spotted an error or a newer edition? Tell the Guidelines Desk.
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