eLMIS Pharmaceutical Forecasting, Approval and Receipt in Relation to Stock-Outs and Availability in Kigoma, Tanzania

This study examined the associations between eLMIS-recorded pharmaceuticals forecasting, approval and receipt in relation to stock-outs and availability in Kigoma, Tanzania. A retrospective quantitative case study used 1,725 medicine-level observations from three purposively selected public healthcare facilities across reporting cycles spanning from July 2025 to July 2026. Five mixed-effects regression models examined forecasting-to-approval, approval-to-receipt, and the associations of previous-period receipts with availability, stock-out occurrence and positive stock-out duration. Overall medicine availability was 92.56%; however, availability varied across pharmaceuticals and facility types, whereas some products had availability below 80%. Also, product-specific gaps occurred between forecasted, approved and received quantities. Forecast quantity was positively associated with approved quantity (β = 0.787, p < 0.001), while previous-period approved quantity was positively associated with following receipts (β = 0.391, p < 0.001). Previous-period receipt quantity was negatively and significantly associated with lower odds of stock-out occurrence (β = -0.217, p < 0.001). The study was limited to three purposively selected public healthcare facilities and retrospective records covering approximately one year. Health facilities should track differences between forecasted, approved and received quantities to identify medicine supply gaps and address stock-outs. The study distinguishes the relationships associated with successive supply chain stages and demonstrates why forecast and approval quantities alone may not adequately indicate medicine availability. Pharmaceutical availability requires alignment between information-based planning, supply decisions, and operational fulfilment by the MSD.