TU/PHI drug stores

Tuberculosis Unit (TU) is the administrative unit under the National Tuberculosis Elimination Programme (NTEP) which is responsible for conducting activities at the sub-district/ block level. 

Peripheral Health Institution (PHI) is the most peripheral health facility under the NTEP which is responsible for providing anti-TB care to the underserved/ hard-to-reach populations.

Structure and Human Resources

The Medical Officers (MO) at the TB Unit (TU) and the PHI level are responsible for the activities and reporting of the respective TU and PHI drug stores.

Staff available at TU drug store/ PHI are:

• One pharmacist

• In case the pharmacist is not available, the Senior Treatment Supervisor (STS) is required to handle the TU drug store activities. 

As it is not a stocking point, the PHI drug store does not require a pharmacist/ storekeeper. It is handled directly by the MO in charge of the PHI who issues drugs to the patients.

Function of TU and PHI Drug Stores

• The TU drug stores function as both consumption and stocking points for drugs and are responsible for the supply of drugs to the PHI.

• The PHI drug stores serve only as a consumption point where the drugs are issued to the patients.

Infrastructure Required for the TU/ PHI Drug Stores

Storage space: There should be sufficient space available to stock the supplies required for the maximum number of TB patients to be initiated on treatment under that facility. Should have a lockable door, at least one window with a grill, a ceiling height of at least 3 metres, and 'pukka' flooring with plastered walls and ceiling. Windows should be open to allow air circulation, screens/ wire mesh should be installed on the windows to keep out insects and birds.

Shelves, racks & storage arrangements: Shelves should be made of 40 mm. bore medium quality mild steel pipes with sufficient ‘gap’ between cartons from the ceiling, floor and walls, facilitating ventilation and avoiding seepage from the walls into the boxes.

Stacking arrangements: Drugs should be stacked as per the First Expiry First Out (FEFO) principle, i.e., the boxes expiring earlier should be stored at ground level and those expiring later should be on a higher level.

Control of humidity and temperature: Humidity levels should be kept below 60% and the drugs should not be exposed to direct sunlight to maintain their efficacy. Hydrothermometers, cooling facilities (coolers and ceiling fans) and dehumidifiers may be installed at the TU drug stores as the need may be.

Regular power supply: Regular power supply should be available, especially in drug stores where humidity and temperature control devices have been installed.

Resources

• Standard Operating Procedure Manual Procurement & Supply Chain Management, CTD, MoHFW, India, 2018.

• Procurement, Supply Chain Management & Preventive Maintenance, Module 6, CTD, MoHFW, India.

• Guidelines for Storage of Second-line Anti-TB Drugs for Revised National TB Control Programme (RNTCP).

Assessment

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