Pharmacists play a crucial role in the provision of medical abortion services by ensuring that safe and effective medications are available for women and girls seeking abortion services. Forecasting and quantification of medical abortion drugs is essential to ensure that enough stock is available to meet the needs of patients, and that supplies are not wasted or expired.

Pharmacists are responsible for procurement, storage, and distribution of medications, for instance, medical abortion drugs, such as mifepristone and misoprostol. They work closely with Comprehensive Abortion Care (CAC) providers, who are responsible for coordinating the provision of abortion services, including counseling, treatment, and follow up care.

Together, the two types of health cadres, in an ideal situation expected to work hand-in-hand to forecast the demand for medical abortion drugs, taking into account factors such as the number of patients seeking the service, available drug quantity in stock, and overall uptake of the service. Forecasting helps to ensure that an adequate supply of medications is available, and that stock-outs are minimized.

In addition to forecasting, pharmacists also play a key role in quantifying the amount of medication needed for each patient. This involves accurately calculating the dosage of mifepristone and misoprostol, for example – based on the gestation age of the pregnancy, and ensuring that patients receive the correct amount of medication for a safe and effective abortion care. They also work to monitor drug availability, expiry dates, and storage conditions to ensure that medications remain safe and effective.

It is against this backdrop that ZAGO conducted training for pharmacists on drug quantification and forecasting. The meeting involved 14 pharmacists from all the 10 districts, and 3 CAC coordinators from the three provinces in which self-managed abortion care project is being implemented. The training was facilitated by three senior pharmacists from the Ministry of Health, and one senior manager from the Zambia Medicines and Medical Supplies Agency (ZAMMSA) and one ZAGO member.

 The main goal of the training was to equip senior, middle level and supply chain pharmacists with the necessary knowledge, skills and attitudes to enable them to effectively quantify and forecast Medical Abortion (MA) drugs for their respective health facilities. Although, ZAMMSA indicated that MA drugs were available, and that health facilities were to blame for not ordering, the training identified a number of challenges impeding pharmacists to effectively forecast, quantify and order the drugs. Among the challenges include:

1. Inconsistent supply of MA drugs to facilities due to non-order fulfilment by ZAMMSA
2. Inadequate supply of MA drugs in facilities
3. Parallel supply chain of MA drugs directly to facilities/ providers by the partners
4. Poor coordination between pharmacy and service providers
5. Lack of  quality data from facilities without pharmacy staff
6. Pharmacy staff not involved in planning, monitoring and evaluation of CAC services (including training)
7. Lack of dedicated transport leading to delayed distribution of CAC commodities

After a comprehensive discussion of the problem of lack of MA drugs availability in health facilities, participants identified the following interventions:

1. That ZAGO should to apply to the Ministry of Health for ZAMMSA to consider the association as one of the clients within the drug distribution chain. This will enable ZAGO to order  drugs on behalf of the health facilities implementing SMMA project
2. ZAMMSA to start honouring/ fulfilling orders for MA drugs
3. Facilities to order MA drugs & other medical commodities through their districts
4. Ministry of Health, Pharmacy Unit, to continue with ongoing orientation to facilities with pharmacy staff
5. The Pharmacy staff and CAC providers to work together in ensuring drug availability
6. Engage partners to support in MA drug distribution

By accurately forecasting and quantifying the demand for medication, pharmacists will ensure that women have access to safe and effective abortion care whenever they need it. The problems of lack of MA drug availability in health facilities could be reduced, and service delivery enhanced.