Reading a stock-out before it happens

Long before a patient arrives to find a shelf empty, a stock-out usually leaves a paper record of its own approach. Facility dispensary logs, when kept accurately, show a slow decline in quantities before the final line runs to zero. We spent five weeks reading these logs across four facilities in Plateau and Bauchi states to understand how predictable these gaps actually are.

The pattern was consistent enough to be useful. In three of the four facilities, essential medicines such as oral rehydration salts and basic antimalarials showed a downward trend visible at least three weeks before the recorded stock-out date. The fourth facility kept its logs inconsistently enough that no reliable trend could be drawn, which is itself a finding worth noting.

What the numbers show and what they don't

None of this points to a single cause. Supply chain delays, unpredictable patient volumes, and reporting gaps at the local government level all contribute in ways that are difficult to separate from facility records alone. What the dispensary logs do show clearly is that the information needed to anticipate a shortage often already exists — it simply isn't reviewed with enough regularity to act on it.

• Facilities reviewing dispensary logs weekly caught declining stock earlier than those reviewing monthly.
• Facilities with a designated pharmacy technician kept more consistent records than those without one.
• None of the four facilities had a formal early-warning threshold written into their procedures.

A quieter kind of shortage

Staff we spoke with, all interviewed with informed consent and offered anonymity, described the experience of a stock-out less as a single event and more as a slow erosion of confidence — both their own and their patients'. One pharmacy technician described adjusting dosing conversations with patients weeks before a shortfall, simply because she could see it coming in the numbers.

Our facility record cards for this piece note precisely which stock figures were confirmed by physical count during our visits and which were drawn solely from facility logbooks. That distinction is small on the page but matters for anyone using this reporting to plan a response.