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The short expiry drugs are the drugs which are left with a short shelf-life and need to be utilised immediately to avoid their expiry. 

The principle of First-Expired, First-Out (FEFO) means that the drugs which are due to expire first, are to be issued first. 

The FEFO principle ensures that the product with the shortest expiry date is utilised at the earliest within its shelf-life. 

Following the FEFO principles, the stocks need to be placed/ arranged/ stacked in a sequential manner. 

Steps Followed for Implementing FEFO

Minimum Stock

 A minimum stock level is a threshold value that indicates the level below which actual medicine stock should not normally be allowed to fall.

In other words, a minimum stock level is a minimum quantity of a particular drug/ medicine that must be kept at all times.

The main factors to consider when fixing the minimum stock level are:

Various stocks are maintained at different levels. To facilitate the monitoring of the quantity of these stocks, these are classified as follows:

• Good quality sputum collection is of paramount importance in tuberculosis diagnosis.
• Once a person is identified as presumptive TB, s/he is referred to the Designated Microscopy Centre (DMC) for sputum collection.
• For TB diagnosis two sputum samples are collected - one is the supervised ‘spot’ sample collected at the DMC (labelled Specimen A) and the other is the early morning sample collected by patient themselves at his/her home (labelled Specimen B).

Sputum smear microscopy is an integral part of the National TB Elimination Programme's (NTEP’s) diagnostic services and can majorly impact the success of the programme.

It is essential to have a credible and well-established quality assurance system to assess the performance of the microscopy service.

NTEP has implemented a multi-level quality assurance network system of sputum smear microscopy in the country consisting of: 

1. Internal Quality Control (IQC)
2. External Quality Assessment (EQA)
3. Quality Improvement (QI)

• Designated Microscopy Centres (DMCs) are the most peripheral laboratory under the National TB Elimination Programme (NTEP) network. Therefore, it is very important for the DMCs to maintain an adequate stock of all consumables.
• A paper-based stock register is maintained at the DMC and submitted as a part of the ‘Monthly report on programme management, logistics and microscopy’.

The monthly abstract is a recording format filled and printed in the Designated Microscopy Centre (DMC) Tuberculosis (TB) laboratory register. Every month after the last day, the laboratory technician (LT) summarizes the information on sputum smear examinations done during that month, using the monthly abstract format.

• Designated Microscopy Centres (DMCs) are the most peripheral laboratory under the National TB Elimination Programme (NTEP) network.
• Any person identified to be a presumptive TB patient is first referred to the nearest DMC for sputum examination or their sputum specimens are collected and transported to the DMC. Therefore, it is very important for the DMCs to maintain an adequate stock of reagents and other consumables.
• The Medical Officer (MO) of DMC is responsible for determining the number of reagents and other materials the DMC needs every month.