Record IPTp, tetanus and iron-folate against a pregnancy, send ANC medicines to the pharmacy, and correct a dose recorded in error.
The bottom of a woman’s antenatal card carries two blocks: Programme schedule, which says what the dating suggests is due, and Programme doses, the ledger of what was actually given.
The dialog says it plainly: “This records the dose against the pregnancy. It does not give the drug or draw stock.”A dose given at your hospital is given the normal way — through a screen that draws the stock and records the lot. This ledger then says which pregnancy, which programme, which position in the series and points back at that administration. A dose given somewhere else is recorded as reported, with nothing to point at.There are four ways a dose can have been given here, and all four end at the same place — a record for the ledger to point at:
The dose was
Give it on
It then appears in
A vaccine, such as tetanus toxoid
The vaccine screen
Which administration drew the stock
A drug for an admitted patient
The ward drug chart
The same list
A drug for a woman at clinic, from the antenatal room’s own stock — IPTp-SP, iron and folate
Give it now, from stock, on this block
The same list, straight away
A drug for a woman at clinic, dispensed by the pharmacy
Send to pharmacy, on this block, then the Pharmacy dispenses it
The same list, once it has been dispensed
Give it now, from stock was added because there was no way to record IPTp-SP or iron and folate as given here at all. They are not vaccines, and the woman receiving them has no bed — so neither of the other two routes fitted her, and the only remaining option said the dose came from another facility, which was not true.
Three lines, each with its own state and its own reason in plain words.
Line
States
IPTp-SP (malaria preventive treatment)
Cannot say · Not yet eligible · Not due · Due · Complete
Tetanus-toxoid-containing vaccine (TT/Td)
the same five
Iron and folic acid
Cannot say · Not started · Supplied · Resupply due
Iron and folate is supply, not a dose series. The ledger records what was issued, never what was taken — nothing in the product knows whether she swallowed them. The block says so: “Supply is what was recorded as issued, not what was taken. Advisory only.” Do not read Supplied as adherence.
Cannot say is not the same as up to date. It means the pregnancy has no usable dating, so no schedule can be derived at all — correcting the due date is what fixes it. The whole block is advisory: it is a prompt to a clinician, not a finding.
It sits at the top right of the Programme doses block, and is absent if you do not hold the permission.
2
Choose the Programme
IPTp (malaria prevention) · Tetanus toxoid · Iron and folate · ART · Infant nevirapine · Other.
3
Give its position in the series
Dose number — “Its position in the series — TT-2, IPTp-3. Leave blank if it isn’t known.” The field is not offered for Iron and folate or ART, which are issued rather than numbered.
4
Set the Date given
Today or earlier. A future date is refused.
5
Say where it was given
Where it was given offers Given at this clinic or Reported from another facility — “A dose given here must point at the administration that drew the stock.”
6
Point at the administration, if it was given here
Which administration drew the stock lists this woman’s own records — you choose one, you never type a reference. If she has none yet it reads No administration recorded for her yet, and the note below tells you what to do instead.A dose Reported from another facility is not asked for one, because it drew no stock here, and the form refuses one.
7
Select Record dose
It confirms Dose recorded — “It is linked to the administration that drew the stock”, or “Recorded as given at another facility.”
Use this for a drug you are handing to a woman at clinic — IPTp-SP, iron and folate. It draws the dose from your stock against her name, records the lot, and hands the record straight to the ledger form.
1
Select Give it now, from stock
It sits under Which administration drew the stock, and only when Given at this clinic is selected.
2
Choose the Drug and the Dose
Drug searches your active medications. Dose is how many units leave the shelf — it must be greater than zero.
3
Choose where it comes Taken from
Taken from is the storage location the stock leaves. Lot defaults to Earliest expiry first, which is what you want unless you are deliberately using a particular lot.
4
Add Route, Site and Notes if they apply
All three are optional — PO, IM, a site, or a note such as directly observed.
5
Select Give the dose
It confirms Dose given — “Stock has been drawn and the lot recorded. It is not on the pregnancy’s ledger until you select Record dose.”You are returned to the ledger form with the new record already chosen in Which administration drew the stock.The dose is charged to her bill. The confirmation ends ”… is on her bill, unpaid, in Billing.” It appears in Billing as an unpaid item at the medicine’s price times the dose given, and can be reduced or waived there like any other item. A medicine with no price is not charged — the confirmation says “Not charged: … has no price in the medicine list. Set its price so the next dose is charged.” — and nothing is added to her bill.
6
Finish with Record dose
Set the Programme and Dose number, then select Record dose.
These are two acts, and the first one cannot be undone. Once Give the dose succeeds, the stock is gone and the lot is recorded — whatever happens next. If Record dose then fails, the block keeps the record selected and shows a standing notice: “Stock has already been drawn for this dose and the lot recorded. It is not on this pregnancy’s ledger until you select Record dose. Do not give a second dose if this step fails — select Record dose again.”Select Record dose again. Do not go back and give a second dose.If the charge could not be added, the block says “This dose has been given but is not on her bill yet” with Charge it again. Use it — a dose is only ever charged once, however many times you select it.
A dose is charged once. A dose given from stock is charged when you give it, and never appears in the Pharmacy queue. A medicine sent to the pharmacy is charged when the pharmacist dispenses it, and recording the dose against it adds no second charge. Give a dose one way or the other, never both.
This needs stock set up. If your clinic has no medications or no active storage location in Inventory, the step says so plainly — “No medications are set up in this clinic’s stock, so a dose can’t be given from here” — rather than showing you an empty list. Set the item up under Inventory, or record the dose as Reported from another facility.If the list simply could not be loaded it says that instead — “The stock list could not be loaded, so it isn’t possible to say what is available” — with a Try again. An empty list and a failed read are never shown as the same thing.
Use this when the pharmacy, not the antenatal room, hands over the medicine. Everything you send for one woman at one antenatal visit reaches the Pharmacy queue as one row badged Maternity / ANC — if you send another medicine later in the same visit, it joins that row while the pharmacy has not dispensed it yet. Once the row is dispensed, a new send starts a new row. The pharmacist dispenses it and collects payment the normal way. Nothing leaves the shelf until the pharmacist dispenses it.
A visit is the antenatal contact recorded today. If no contact has been recorded for her today, each send is its own row.
1
Select Send to pharmacy
It sits at the top right of the Programme doses block beside Record dose, and under Which administration drew the stock beside Give it now, from stock.
2
Choose the Medicine
Medicine searches your clinic’s medicine list. A medicine that has been archived is not offered.
3
Fill in Dose, Frequency, Duration and Quantity
Quantity is how many units the pharmacy hands over — a whole number of at least 1. The other three are the instructions the pharmacist sees.
4
Add another medicine if she needs more than one
Select Add another medicine for each — iron and folate and IPTp-SP, say. Remove this medicine takes a line away. They all travel as one order.
5
Select Send to pharmacy
It confirms Sent to the pharmacy — “It is one Maternity / ANC order in the Pharmacy queue. Once it has been dispensed, record the dose here against it.”
6
Record the dose once it has been dispensed
Select Record dose, choose the Programme, keep Given at this clinic, and pick the medicine from Which administration drew the stock — a dispensed line reads “dispensed by the pharmacy”. Then select Record dose.
A medicine still waiting at the pharmacy is not offered on the ledger. Only a dispensed line can be recorded as a dose — until then she has not received it. A dispensed line can be recorded once: one dispensed medicine is one dose.
Nothing here is deleted. If the dose was given from stock and its charge has not been paid, marking it in error also takes the charge off her bill. A charge that has already been paid stays — refund it from Billing.A wrong dose is marked as entered in error, keeping the row, its reason and any administration it points at — and freeing its position in the series so the correct dose can be recorded.
1
Select Mark in error on the row
The dialog is headed Mark this dose as entered in error and names the dose and its date: it “will stop counting towards the series. The record is kept, along with any administration it points at.”
2
Answer Why is this wrong?
A reason is required — the button stays disabled until you write one.
3
Select Mark in error
It confirms Marked as entered in error — “The record is kept; the dose no longer counts towards the series.”
The row stays in the ledger, struck through and badged Entered in error, and stops counting on the Programme schedule block.
This is why a struck-through row matters. A midwife reading the ledger can tell “never given” from “given and retracted” — and that difference is the difference between giving a dose and double-dosing. Deleting the row would erase it.
Choose the administration that drew the stock, or give the dose from stock here first
Given at this clinic requires a real administration behind it — the one that drew the stock and recorded the lot. Choose one from the list, use Give it now, from stock, give it on the vaccine screen or the ward drug chart, or record this one as Reported from another facility.
Not enough stock available.
Give the dose could not draw what you asked for from Taken from. Check the location and the quantity, or receive stock first.
Say who the dose is for — an admitted patient or a patient of this clinic.
The dose reached the store without a patient attached. Close the dialog, reopen the woman’s antenatal card and try again.
That patient could not be found, or you do not have access to them.
The woman named is not a patient of this clinic, or you are not permitted to see her record. Open the dose from her own antenatal card.
A dose given elsewhere drew no stock here
You chose Reported from another facility but left an administration reference in the box. Clear it.
That dose in the series is already recorded for this pregnancy.
“Mark the existing one as entered in error if it is wrong.” Two doses cannot hold the same position in a series.
That administration is already recorded against a dose. One administration is one dose.
The reference you pasted is already claimed by another ledger row. Check you copied the right one.
That administration was given to a different patient.
“A dose can only be recorded against the woman it was given to.” You are on the wrong pregnancy’s card, or you copied another patient’s reference.
That medicine has not been dispensed by the pharmacy yet.
“Record the dose once it has been dispensed.” The pharmacy has not dispensed this line yet, so she has not received it. Wait until it is dispensed, then record the dose.
That dispensed medicine is already recorded against a dose. One dispensed line is one dose.
Another ledger row already points at this dispensed medicine. Send another supply to the pharmacy if she needs a second dose.
One of these medicines has been archived and can no longer be prescribed.
“Remove it and choose another.” The medicine was archived in your medicine list after you opened Send to pharmacy. Remove that line and pick an active one.
This pregnancy is no longer active, so medicines can't be sent against it.
The pregnancy record has been closed. Medicines can only be sent while it is open.
A dose can't be dated in the future.
Set Date given to today or earlier.
This pregnancy record is delivered, so no further doses can be recorded against it.
The record has been closed. Doses can only be added while it is open.
Record dose never does. Give it now, from stock does — that is the whole difference between the two, and it is why they are separate steps with separate confirmations. The ledger points at a stock movement; it never causes one.
Is a dose given from stock charged?
Yes. Give the dose adds it to her bill as an unpaid item at the medicine’s price times the dose given, in Billing, where it can be reduced or waived. A medicine with no price in the medicine list is not charged, and the confirmation says so. A dose reported from another facility is never charged, and doses given before this change are not charged afterwards.
Is tetanus toxoid charged?
Tetanus toxoid is given on Inventory → Vaccines, so it is charged only if your hospital has turned on Charge patients for vaccines given from stock in Settings → Facility. If that dose is later marked in error here before it is paid, the charge is taken off her bill.
I gave the dose but Record dose failed. Should I give it again?
No. The stock has already been drawn and the lot recorded — giving it again would give a second dose and draw a second one. The block keeps the record selected and says so; select Record dose again.
Why is Give it now, from stock missing?
It appears only when Given at this clinic is selected, and only where the pregnancy record could name the woman. If it is absent, give the dose on the vaccine screen or the ward drug chart and choose it from Which administration drew the stock.
When do I use Send to pharmacy instead of Give it now, from stock?
Use Give it now, from stock when the antenatal room hands the medicine over from its own stock. Use Send to pharmacy when the pharmacy hands it over — the pharmacist dispenses it, draws the stock and collects payment. Never both for the same dose.
Why is there no Dose number for iron and folate?
Because it is supplied rather than given as a numbered series, and a position in a series would be a false precision. The same applies to ART.
Can I record ART or infant nevirapine?
They are in the Programme list and can be recorded on the ledger. The Programme schedule block derives IPTp, tetanus and iron-folate only, so those two carry no due state — and neither is printed on the downloadable antenatal card, which a woman carries to another facility.
Does Supplied mean she is taking her iron?
No. It means a supply was issued and recorded. Adherence is not something the product can know, and it never claims to.
Can I edit a dose instead of marking it in error?
No. Mark it in error with the reason, then record the correct one — the series position is freed as soon as you do.
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li>a{padding-top:0.45rem;padding-bottom:0.45rem}}"}],"page":{"pagePath":"hospital/maternity/programme-doses","slug":"/hospital/maternity/programme-doses","pageMetadata":{"title":"Programme doses","description":"Record IPTp, tetanus and iron-folate against a pregnancy, send ANC medicines to the pharmacy, and correct a dose recorded in error.","icon":"/images/icons/syringe.svg","href":"/hospital/maternity/programme-doses"},"description":{"compiledSource":"\"use strict\";\nconst {jsx: _jsx} = arguments[0];\nconst {useMDXComponents: _provideComponents} = arguments[0];\nfunction _createMdxContent(props) {\n const _components = {\n p: \"p\",\n ..._provideComponents(),\n ...props.components\n };\n return _jsx(_components.p, {\n children: \"Record IPTp, tetanus and iron-folate against a pregnancy, send ANC medicines to the pharmacy, and correct a dose recorded in error.\"\n });\n}\nfunction MDXContent(props = {}) {\n const {wrapper: MDXLayout} = {\n ..._provideComponents(),\n 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It does not give the drug or draw stock.”`}),`\n`,_jsxs(_components.p,{children:[`A dose given at your hospital is given the normal way — through a screen that draws the stock and records the lot. This ledger then says `,_jsx(_components.em,{children:`which pregnancy, which programme, which position in the series`}),` and points back at that administration. A dose given somewhere else is recorded as reported, with nothing to point at.`]}),`\n`,_jsx(_components.p,{children:`There are four ways a dose can have been given here, and all four end at the same place — a record for the ledger to point at:`}),`\n`,_jsxs(Table,{children:[_jsx(_components.thead,{children:_jsxs(_components.tr,{children:[_jsx(_components.th,{children:`The dose was`}),_jsx(_components.th,{children:`Give it on`}),_jsx(_components.th,{children:`It then appears in`})]})}),_jsxs(_components.tbody,{children:[_jsxs(_components.tr,{children:[_jsx(_components.td,{children:`A vaccine, such as tetanus toxoid`}),_jsx(_components.td,{children:`The vaccine screen`}),_jsx(_components.td,{children:_jsx(_components.strong,{children:`Which administration drew the stock`})})]}),_jsxs(_components.tr,{children:[_jsx(_components.td,{children:`A drug for an admitted patient`}),_jsx(_components.td,{children:`The ward drug chart`}),_jsx(_components.td,{children:`The same list`})]}),_jsxs(_components.tr,{children:[_jsx(_components.td,{children:`A drug for a woman at clinic, from the antenatal room’s own stock — IPTp-SP, iron and folate`}),_jsxs(_components.td,{children:[_jsx(_components.strong,{children:`Give it now, from stock`}),`, on this block`]}),_jsx(_components.td,{children:`The same list, straight away`})]}),_jsxs(_components.tr,{children:[_jsx(_components.td,{children:`A drug for a woman at clinic, dispensed by the pharmacy`}),_jsxs(_components.td,{children:[_jsx(_components.strong,{children:`Send to pharmacy`}),`, on this block, then the Pharmacy dispenses it`]}),_jsx(_components.td,{children:`The same list, once it has been dispensed`})]})]})]}),`\n`,_jsx(Note,{children:_jsxs(_components.p,{children:[_jsx(_components.strong,{children:`Give it now, from stock`}),` was added because there was no way to record IPTp-SP or iron and folate as given here at all. They are not vaccines, and the woman receiving them has no bed — so neither of the other two routes fitted her, and the only remaining option said the dose came from another facility, which was not true.`]})}),`\n`,_jsx(Heading,{level:`2`,id:`read-the-programme-schedule`,children:`Read the Programme schedule`}),`\n`,_jsx(_components.p,{children:`Three lines, each with its own state and its own reason in plain words.`}),`\n`,_jsxs(Table,{children:[_jsx(_components.thead,{children:_jsxs(_components.tr,{children:[_jsx(_components.th,{children:`Line`}),_jsx(_components.th,{children:`States`})]})}),_jsxs(_components.tbody,{children:[_jsxs(_components.tr,{children:[_jsx(_components.td,{children:_jsx(_components.strong,{children:`IPTp-SP (malaria preventive treatment)`})}),_jsxs(_components.td,{children:[_jsx(_components.strong,{children:`Cannot say`}),` · `,_jsx(_components.strong,{children:`Not yet eligible`}),` · `,_jsx(_components.strong,{children:`Not due`}),` · `,_jsx(_components.strong,{children:`Due`}),` · `,_jsx(_components.strong,{children:`Complete`})]})]}),_jsxs(_components.tr,{children:[_jsx(_components.td,{children:_jsx(_components.strong,{children:`Tetanus-toxoid-containing vaccine (TT/Td)`})}),_jsx(_components.td,{children:`the same five`})]}),_jsxs(_components.tr,{children:[_jsx(_components.td,{children:_jsx(_components.strong,{children:`Iron and folic acid`})}),_jsxs(_components.td,{children:[_jsx(_components.strong,{children:`Cannot say`}),` · `,_jsx(_components.strong,{children:`Not started`}),` · `,_jsx(_components.strong,{children:`Supplied`}),` · `,_jsx(_components.strong,{children:`Resupply due`})]})]})]})]}),`\n`,_jsx(Warning,{children:_jsxs(_components.p,{children:[_jsx(_components.strong,{children:`Iron and folate is supply, not a dose series.`}),` The ledger records what was `,_jsx(_components.strong,{children:`issued`}),`, never what was taken — nothing in the product knows whether she swallowed them. The block says so: “Supply is what was recorded as issued, not what was taken. Advisory only.” Do not read `,_jsx(_components.strong,{children:`Supplied`}),` as adherence.`]})}),`\n`,_jsxs(_components.p,{children:[_jsx(_components.strong,{children:`Cannot say`}),` is not the same as up to date. It means the pregnancy has no usable dating, so no schedule can be derived at all — correcting the due date is what fixes it. The whole block is advisory: it is a prompt to a clinician, not a finding.`]}),`\n`,_jsx(Heading,{level:`2`,id:`record-a-dose`,children:`Record a dose`}),`\n`,_jsxs(Steps,{children:[_jsx(Step,{title:`Select Record dose`,children:_jsxs(_components.p,{children:[`It sits at the top right of the `,_jsx(_components.strong,{children:`Programme doses`}),` block, and is absent if you do not hold the permission.`]})}),_jsx(Step,{title:`Choose the Programme`,children:_jsxs(_components.p,{children:[_jsx(_components.strong,{children:`IPTp (malaria prevention)`}),` · `,_jsx(_components.strong,{children:`Tetanus toxoid`}),` · `,_jsx(_components.strong,{children:`Iron and folate`}),` · `,_jsx(_components.strong,{children:`ART`}),` · `,_jsx(_components.strong,{children:`Infant nevirapine`}),` · `,_jsx(_components.strong,{children:`Other`}),`.`]})}),_jsx(Step,{title:`Give its position in the series`,children:_jsxs(_components.p,{children:[_jsx(_components.strong,{children:`Dose number`}),` — “Its position in the series — TT-2, IPTp-3. Leave blank if it isn’t known.” The field is not offered for `,_jsx(_components.strong,{children:`Iron and folate`}),` or `,_jsx(_components.strong,{children:`ART`}),`, which are issued rather than numbered.`]})}),_jsx(Step,{title:`Set the Date given`,children:_jsx(_components.p,{children:`Today or earlier. A future date is refused.`})}),_jsx(Step,{title:`Say where it was given`,children:_jsxs(_components.p,{children:[_jsx(_components.strong,{children:`Where it was given`}),` offers `,_jsx(_components.strong,{children:`Given at this clinic`}),` or `,_jsx(_components.strong,{children:`Reported from another facility`}),` — “A dose given here must point at the administration that drew the stock.”`]})}),_jsxs(Step,{title:`Point at the administration, if it was given here`,children:[_jsxs(_components.p,{children:[_jsx(_components.strong,{children:`Which administration drew the stock`}),` lists this woman’s own records — you choose one, you never type a reference. If she has none yet it reads `,_jsx(_components.strong,{children:`No administration recorded for her yet`}),`, and the note below tells you what to do instead.`]}),_jsxs(_components.p,{children:[`A dose `,_jsx(_components.strong,{children:`Reported from another facility`}),` is not asked for one, because it drew no stock here, and the form refuses one.`]})]}),_jsx(Step,{title:`Select Record dose`,children:_jsxs(_components.p,{children:[`It confirms `,_jsx(_components.strong,{children:`Dose recorded`}),` — “It is linked to the administration that drew the stock”, or “Recorded as given at another facility.”`]})})]}),`\n`,_jsx(Heading,{level:`2`,id:`give-the-dose-from-stock-here`,children:`Give the dose from stock, here`}),`\n`,_jsx(_components.p,{children:`Use this for a drug you are handing to a woman at clinic — IPTp-SP, iron and folate. It draws the dose from your stock against her name, records the lot, and hands the record straight to the ledger form.`}),`\n`,_jsxs(Steps,{children:[_jsx(Step,{title:`Select Give it now, from stock`,children:_jsxs(_components.p,{children:[`It sits under `,_jsx(_components.strong,{children:`Which administration drew the stock`}),`, and only when `,_jsx(_components.strong,{children:`Given at this clinic`}),` is selected.`]})}),_jsx(Step,{title:`Choose the Drug and the Dose`,children:_jsxs(_components.p,{children:[_jsx(_components.strong,{children:`Drug`}),` searches your active medications. `,_jsx(_components.strong,{children:`Dose`}),` is how many units leave the shelf — it must be greater than zero.`]})}),_jsx(Step,{title:`Choose where it comes Taken from`,children:_jsxs(_components.p,{children:[_jsx(_components.strong,{children:`Taken from`}),` is the storage location the stock leaves. `,_jsx(_components.strong,{children:`Lot`}),` defaults to `,_jsx(_components.strong,{children:`Earliest expiry first`}),`, which is what you want unless you are deliberately using a particular lot.`]})}),_jsx(Step,{title:`Add Route, Site and Notes if they apply`,children:_jsxs(_components.p,{children:[`All three are optional — `,_jsx(_components.strong,{children:`PO`}),`, `,_jsx(_components.strong,{children:`IM`}),`, a site, or a note such as directly observed.`]})}),_jsxs(Step,{title:`Select Give the dose`,children:[_jsxs(_components.p,{children:[`It confirms `,_jsx(_components.strong,{children:`Dose given`}),` — “Stock has been drawn and the lot recorded. It is not on the pregnancy’s ledger until you select Record dose.”`]}),_jsxs(_components.p,{children:[`You are returned to the ledger form with the new record already chosen in `,_jsx(_components.strong,{children:`Which administration drew the stock`}),`.`]}),_jsxs(_components.p,{children:[_jsx(_components.strong,{children:`The dose is charged to her bill.`}),` The confirmation ends ”… is on her bill, unpaid, in Billing.” It appears in `,_jsx(_components.strong,{children:`Billing`}),` as an unpaid item at the medicine’s price times the dose given, and can be reduced or waived there like any other item. A medicine with no price is not charged — the confirmation says “Not charged: … has no price in the medicine list. Set its price so the next dose is charged.” — and nothing is added to her bill.`]})]}),_jsx(Step,{title:`Finish with Record dose`,children:_jsxs(_components.p,{children:[`Set the `,_jsx(_components.strong,{children:`Programme`}),` and `,_jsx(_components.strong,{children:`Dose number`}),`, then select `,_jsx(_components.strong,{children:`Record dose`}),`.`]})})]}),`\n`,_jsxs(Warning,{children:[_jsxs(_components.p,{children:[_jsx(_components.strong,{children:`These are two acts, and the first one cannot be undone.`}),` Once `,_jsx(_components.strong,{children:`Give the dose`}),` succeeds, the stock is gone and the lot is recorded — whatever happens next. If `,_jsx(_components.strong,{children:`Record dose`}),` then fails, the block keeps the record selected and shows a standing notice: “Stock has already been drawn for this dose and the lot recorded. It is `,_jsx(_components.strong,{children:`not`}),` on this pregnancy’s ledger until you select `,_jsx(_components.strong,{children:`Record dose`}),`. Do not give a second dose if this step fails — select `,_jsx(_components.strong,{children:`Record dose`}),` again.”`]}),_jsxs(_components.p,{children:[`Select `,_jsx(_components.strong,{children:`Record dose`}),` again. Do not go back and give a second dose.`]}),_jsxs(_components.p,{children:[`If the charge could not be added, the block says “This dose has been given but is `,_jsx(_components.strong,{children:`not on her bill yet`}),`” with `,_jsx(_components.strong,{children:`Charge it again`}),`. Use it — a dose is only ever charged once, however many times you select it.`]})]}),`\n`,_jsx(Note,{children:_jsxs(_components.p,{children:[_jsx(_components.strong,{children:`A dose is charged once.`}),` A dose given from stock is charged when you give it, and never appears in the `,_jsx(_components.strong,{children:`Pharmacy`}),` queue. A medicine sent to the pharmacy is charged when the pharmacist dispenses it, and recording the dose against it adds no second charge. Give a dose one way or the other, never both.`]})}),`\n`,_jsxs(Note,{children:[_jsxs(_components.p,{children:[_jsx(_components.strong,{children:`This needs stock set up.`}),` If your clinic has no medications or no active storage location in `,_jsx(_components.strong,{children:`Inventory`}),`, the step says so plainly — “No medications are set up in this clinic’s stock, so a dose can’t be given from here” — rather than showing you an empty list. Set the item up under `,_jsx(_components.strong,{children:`Inventory`}),`, or record the dose as `,_jsx(_components.strong,{children:`Reported from another facility`}),`.`]}),_jsxs(_components.p,{children:[`If the list simply could not be loaded it says that instead — “The stock list could not be loaded, so it isn’t possible to say what is available” — with a `,_jsx(_components.strong,{children:`Try again`}),`. An empty list and a failed read are never shown as the same thing.`]})]}),`\n`,_jsx(Heading,{level:`2`,id:`send-it-to-the-pharmacy`,children:`Send it to the pharmacy`}),`\n`,_jsxs(_components.p,{children:[`Use this when the pharmacy, not the antenatal room, hands over the medicine. Everything you send for one woman at one antenatal visit reaches the `,_jsx(_components.strong,{children:`Pharmacy`}),` queue as one row badged `,_jsx(_components.strong,{children:`Maternity / ANC`}),` — if you send another medicine later in the same visit, it joins that row while the pharmacy has not dispensed it yet. Once the row is dispensed, a new send starts a new row. The pharmacist dispenses it and collects payment the normal way. Nothing leaves the shelf until the pharmacist dispenses it.`]}),`\n`,_jsx(Note,{children:_jsxs(_components.p,{children:[_jsx(_components.strong,{children:`A visit is the antenatal contact recorded today.`}),` If no contact has been recorded for her today, each send is its own row.`]})}),`\n`,_jsxs(Steps,{children:[_jsx(Step,{title:`Select Send to pharmacy`,children:_jsxs(_components.p,{children:[`It sits at the top right of the `,_jsx(_components.strong,{children:`Programme doses`}),` block beside `,_jsx(_components.strong,{children:`Record dose`}),`, and under `,_jsx(_components.strong,{children:`Which administration drew the stock`}),` beside `,_jsx(_components.strong,{children:`Give it now, from stock`}),`.`]})}),_jsx(Step,{title:`Choose the Medicine`,children:_jsxs(_components.p,{children:[_jsx(_components.strong,{children:`Medicine`}),` searches your clinic’s medicine list. A medicine that has been archived is not offered.`]})}),_jsx(Step,{title:`Fill in Dose, Frequency, Duration and Quantity`,children:_jsxs(_components.p,{children:[_jsx(_components.strong,{children:`Quantity`}),` is how many units the pharmacy hands over — a whole number of at least 1. The other three are the instructions the pharmacist sees.`]})}),_jsx(Step,{title:`Add another medicine if she needs more than one`,children:_jsxs(_components.p,{children:[`Select `,_jsx(_components.strong,{children:`Add another medicine`}),` for each — iron and folate and IPTp-SP, say. `,_jsx(_components.strong,{children:`Remove this medicine`}),` takes a line away. They all travel as one order.`]})}),_jsx(Step,{title:`Select Send to pharmacy`,children:_jsxs(_components.p,{children:[`It confirms `,_jsx(_components.strong,{children:`Sent to the pharmacy`}),` — “It is one Maternity / ANC order in the Pharmacy queue. Once it has been dispensed, record the dose here against it.”`]})}),_jsx(Step,{title:`Record the dose once it has been dispensed`,children:_jsxs(_components.p,{children:[`Select `,_jsx(_components.strong,{children:`Record dose`}),`, choose the `,_jsx(_components.strong,{children:`Programme`}),`, keep `,_jsx(_components.strong,{children:`Given at this clinic`}),`, and pick the medicine from `,_jsx(_components.strong,{children:`Which administration drew the stock`}),` — a dispensed line reads “dispensed by the pharmacy”. Then select `,_jsx(_components.strong,{children:`Record dose`}),`.`]})})]}),`\n`,_jsx(Note,{children:_jsxs(_components.p,{children:[_jsx(_components.strong,{children:`A medicine still waiting at the pharmacy is not offered on the ledger.`}),` Only a dispensed line can be recorded as a dose — until then she has not received it. A dispensed line can be recorded once: one dispensed medicine is one dose.`]})}),`\n`,_jsx(Heading,{level:`2`,id:`correct-a-dose-recorded-in-error`,children:`Correct a dose recorded in error`}),`\n`,_jsxs(_components.p,{children:[`Nothing here is deleted. If the dose was given from stock and its charge has not been paid, marking it in error also takes the charge off her bill. A charge that has already been paid stays — refund it from `,_jsx(_components.strong,{children:`Billing`}),`.`]}),`\n`,_jsx(_components.p,{children:`A wrong dose is marked as entered in error, keeping the row, its reason and any administration it points at — and freeing its position in the series so the correct dose can be recorded.`}),`\n`,_jsxs(Steps,{children:[_jsx(Step,{title:`Select Mark in error on the row`,children:_jsxs(_components.p,{children:[`The dialog is headed `,_jsx(_components.strong,{children:`Mark this dose as entered in error`}),` and names the dose and its date: it “will stop counting towards the series. The record is kept, along with any administration it points at.”`]})}),_jsx(Step,{title:`Answer Why is this wrong?`,children:_jsx(_components.p,{children:`A reason is required — the button stays disabled until you write one.`})}),_jsx(Step,{title:`Select Mark in error`,children:_jsxs(_components.p,{children:[`It confirms `,_jsx(_components.strong,{children:`Marked as entered in error`}),` — “The record is kept; the dose no longer counts towards the series.”`]})})]}),`\n`,_jsxs(_components.p,{children:[`The row stays in the ledger, struck through and badged `,_jsx(_components.strong,{children:`Entered in error`}),`, and stops counting on the `,_jsx(_components.strong,{children:`Programme schedule`}),` block.`]}),`\n`,_jsx(Note,{children:_jsxs(_components.p,{children:[_jsx(_components.strong,{children:`This is why a struck-through row matters.`}),` A midwife reading the ledger can tell “never given” from “given and retracted” — and that difference is the difference between giving a dose and double-dosing. Deleting the row would erase it.`]})}),`\n`,_jsx(_MdxComponentBoundary,{name:`AuditNote`,children:_jsx(AuditNote,{action:`Recording or correcting a programme dose`})}),`\n`,_jsx(Heading,{level:`2`,id:`what-the-ledger-shows`,children:`What the ledger shows`}),`\n`,_jsxs(Table,{children:[_jsx(_components.thead,{children:_jsxs(_components.tr,{children:[_jsx(_components.th,{children:`Column`}),_jsx(_components.th,{children:`Shows`})]})}),_jsxs(_components.tbody,{children:[_jsxs(_components.tr,{children:[_jsx(_components.td,{children:_jsx(_components.strong,{children:`Dose`})}),_jsxs(_components.td,{children:[`The programme and its number — `,_jsx(_components.strong,{children:`IPTp 2`}),`, `,_jsx(_components.strong,{children:`Tetanus toxoid 3`}),` — with an `,_jsx(_components.strong,{children:`Entered in error`}),` badge where one applies`]})]}),_jsxs(_components.tr,{children:[_jsx(_components.td,{children:_jsx(_components.strong,{children:`Given`})}),_jsx(_components.td,{children:`The date it was given`})]}),_jsxs(_components.tr,{children:[_jsx(_components.td,{children:_jsx(_components.strong,{children:`Source`})}),_jsxs(_components.td,{children:[_jsx(_components.strong,{children:`Given here`}),` or `,_jsx(_components.strong,{children:`Reported elsewhere`}),`, and `,_jsx(_components.strong,{children:`Dispensed by the pharmacy`}),` when the dose was recorded against a medicine the pharmacy dispensed`]})]})]})]}),`\n`,_jsxs(_components.p,{children:[`With nothing recorded it reads `,_jsx(_components.strong,{children:`No programme doses recorded for this pregnancy.`})]}),`\n`,_jsx(Heading,{level:`2`,id:`who-can-do-this`,children:`Who can do this`}),`\n`,_jsxs(Table,{children:[_jsx(_components.thead,{children:_jsxs(_components.tr,{children:[_jsx(_components.th,{children:`Action`}),_jsx(_components.th,{children:`Who by default`}),_jsx(_components.th,{children:`Permission`})]})}),_jsxs(_components.tbody,{children:[_jsxs(_components.tr,{children:[_jsx(_components.td,{children:`Read the ledger and the schedule`}),_jsx(_components.td,{children:`Anyone who can open the antenatal card`}),_jsx(_components.td,{children:`Nothing`})]}),_jsxs(_components.tr,{children:[_jsx(_components.td,{children:`Record a dose`}),_jsx(_components.td,{children:`Anyone not yet governed; otherwise only if switched on`}),_jsx(_components.td,{children:_jsx(_components.strong,{children:`Record a programme dose`})})]}),_jsxs(_components.tr,{children:[_jsx(_components.td,{children:`Give a dose from stock, here`}),_jsxs(_components.td,{children:[`The same — it opens from inside `,_jsx(_components.strong,{children:`Record dose`})]}),_jsx(_components.td,{children:_jsx(_components.strong,{children:`Record a programme dose`})})]}),_jsxs(_components.tr,{children:[_jsx(_components.td,{children:`Send medicines to the pharmacy`}),_jsx(_components.td,{children:`The same`}),_jsx(_components.td,{children:_jsx(_components.strong,{children:`Record a programme dose`})})]}),_jsxs(_components.tr,{children:[_jsx(_components.td,{children:`Mark a dose as entered in error`}),_jsx(_components.td,{children:`The same`}),_jsx(_components.td,{children:_jsx(_components.strong,{children:`Record a programme dose`})})]})]})]}),`\n`,_jsx(_components.p,{children:`Recording and correcting share one permission on purpose: whoever may assert that a dose happened may assert that it did not.`}),`\n`,_jsx(Heading,{level:`2`,id:`check-it-worked`,children:`Check it worked`}),`\n`,_jsxs(_components.ul,{children:[`\n`,_jsx(_components.li,{children:`The dose is a row in the ledger with the right date and source.`}),`\n`,_jsxs(_components.li,{children:[`The matching line on `,_jsx(_components.strong,{children:`Programme schedule`}),` moves — its count rises, and `,_jsx(_components.strong,{children:`Due`}),` becomes `,_jsx(_components.strong,{children:`Not due`}),` or `,_jsx(_components.strong,{children:`Complete`}),`.`]}),`\n`,_jsx(_components.li,{children:`A dose you marked in error is struck through, badged, and no longer counted.`}),`\n`]}),`\n`,_jsx(Heading,{level:`2`,id:`if-something-goes-wrong`,children:`If something goes wrong`}),`\n`,_jsxs(AccordionGroup,{children:[_jsx(Accordion,{title:`Choose the administration that drew the stock, or give the dose from stock here first`,id:`choose-the-administration-that-drew-the-stock-or-give-the-dose-from-stock-here-first`,children:_jsxs(_components.p,{children:[_jsx(_components.strong,{children:`Given at this clinic`}),` requires a real administration behind it — the one that drew the stock and recorded the lot. Choose one from the list, use `,_jsx(_components.strong,{children:`Give it now, from stock`}),`, give it on the vaccine screen or the ward drug chart, or record this one as `,_jsx(_components.strong,{children:`Reported from another facility`}),`.`]})}),_jsx(Accordion,{title:`Not enough stock available.`,id:`not-enough-stock-available`,children:_jsxs(_components.p,{children:[_jsx(_components.strong,{children:`Give the dose`}),` could not draw what you asked for from `,_jsx(_components.strong,{children:`Taken from`}),`. Check the location and the quantity, or receive stock first.`]})}),_jsx(Accordion,{title:`Say who the dose is for — an admitted patient or a patient of this clinic.`,id:`say-who-the-dose-is-for-an-admitted-patient-or-a-patient-of-this-clinic`,children:_jsx(_components.p,{children:`The dose reached the store without a patient attached. Close the dialog, reopen the woman’s antenatal card and try again.`})}),_jsx(Accordion,{title:`That patient could not be found, or you do not have access to them.`,id:`that-patient-could-not-be-found-or-you-do-not-have-access-to-them`,children:_jsx(_components.p,{children:`The woman named is not a patient of this clinic, or you are not permitted to see her record. Open the dose from her own antenatal card.`})}),_jsx(Accordion,{title:`A dose given elsewhere drew no stock here`,id:`a-dose-given-elsewhere-drew-no-stock-here`,children:_jsxs(_components.p,{children:[`You chose `,_jsx(_components.strong,{children:`Reported from another facility`}),` but left an administration reference in the box. Clear it.`]})}),_jsx(Accordion,{title:`That dose in the series is already recorded for this pregnancy.`,id:`that-dose-in-the-series-is-already-recorded-for-this-pregnancy`,children:_jsx(_components.p,{children:`“Mark the existing one as entered in error if it is wrong.” Two doses cannot hold the same position in a series.`})}),_jsx(Accordion,{title:`That administration is already recorded against a dose. One administration is one dose.`,id:`that-administration-is-already-recorded-against-a-dose-one-administration-is-one-dose`,children:_jsx(_components.p,{children:`The reference you pasted is already claimed by another ledger row. Check you copied the right one.`})}),_jsx(Accordion,{title:`That administration was given to a different patient.`,id:`that-administration-was-given-to-a-different-patient`,children:_jsx(_components.p,{children:`“A dose can only be recorded against the woman it was given to.” You are on the wrong pregnancy’s card, or you copied another patient’s reference.`})}),_jsx(Accordion,{title:`That medicine has not been dispensed by the pharmacy yet.`,id:`that-medicine-has-not-been-dispensed-by-the-pharmacy-yet`,children:_jsx(_components.p,{children:`“Record the dose once it has been dispensed.” The pharmacy has not dispensed this line yet, so she has not received it. Wait until it is dispensed, then record the dose.`})}),_jsx(Accordion,{title:`That dispensed medicine is already recorded against a dose. One dispensed line is one dose.`,id:`that-dispensed-medicine-is-already-recorded-against-a-dose-one-dispensed-line-is-one-dose`,children:_jsx(_components.p,{children:`Another ledger row already points at this dispensed medicine. Send another supply to the pharmacy if she needs a second dose.`})}),_jsx(Accordion,{title:`One of these medicines has been archived and can no longer be prescribed.`,id:`one-of-these-medicines-has-been-archived-and-can-no-longer-be-prescribed`,children:_jsxs(_components.p,{children:[`“Remove it and choose another.” The medicine was archived in your medicine list after you opened `,_jsx(_components.strong,{children:`Send to pharmacy`}),`. Remove that line and pick an active one.`]})}),_jsx(Accordion,{title:`This pregnancy is no longer active, so medicines can't be sent against it.`,id:`this-pregnancy-is-no-longer-active-so-medicines-cant-be-sent-against-it`,children:_jsx(_components.p,{children:`The pregnancy record has been closed. Medicines can only be sent while it is open.`})}),_jsx(Accordion,{title:`A dose can't be dated in the future.`,id:`a-dose-cant-be-dated-in-the-future`,children:_jsxs(_components.p,{children:[`Set `,_jsx(_components.strong,{children:`Date given`}),` to today or earlier.`]})}),_jsx(Accordion,{title:`This pregnancy record is delivered, so no further doses can be recorded against it.`,id:`this-pregnancy-record-is-delivered-so-no-further-doses-can-be-recorded-against-it`,children:_jsx(_components.p,{children:`The record has been closed. Doses can only be added while it is open.`})})]}),`\n`,_jsx(Heading,{level:`2`,id:`faq`,children:`FAQ`}),`\n`,_jsxs(AccordionGroup,{children:[_jsx(Accordion,{title:`Does recording a dose here take it out of stock?`,id:`does-recording-a-dose-here-take-it-out-of-stock`,children:_jsxs(_components.p,{children:[_jsx(_components.strong,{children:`Record dose`}),` never does. `,_jsx(_components.strong,{children:`Give it now, from stock`}),` does — that is the whole difference between the two, and it is why they are separate steps with separate confirmations. The ledger points at a stock movement; it never causes one.`]})}),_jsx(Accordion,{title:`Is a dose given from stock charged?`,id:`is-a-dose-given-from-stock-charged`,children:_jsxs(_components.p,{children:[`Yes. `,_jsx(_components.strong,{children:`Give the dose`}),` adds it to her bill as an unpaid item at the medicine’s price times the dose given, in `,_jsx(_components.strong,{children:`Billing`}),`, where it can be reduced or waived. A medicine with no price in the medicine list is not charged, and the confirmation says so. A dose reported from another facility is never charged, and doses given before this change are not charged afterwards.`]})}),_jsx(Accordion,{title:`Is tetanus toxoid charged?`,id:`is-tetanus-toxoid-charged`,children:_jsxs(_components.p,{children:[`Tetanus toxoid is given on `,_jsx(_components.strong,{children:`Inventory → Vaccines`}),`, so it is charged only if your hospital has turned on `,_jsx(_components.strong,{children:`Charge patients for vaccines given from stock`}),` in Settings → `,_jsx(_components.a,{href:`/hospital/settings/facility`,children:`Facility`}),`. If that dose is later marked in error here before it is paid, the charge is taken off her bill.`]})}),_jsx(Accordion,{title:`I gave the dose but Record dose failed. Should I give it again?`,id:`i-gave-the-dose-but-record-dose-failed-should-i-give-it-again`,children:_jsxs(_components.p,{children:[`No. The stock has already been drawn and the lot recorded — giving it again would give a second dose and draw a second one. The block keeps the record selected and says so; select `,_jsx(_components.strong,{children:`Record dose`}),` again.`]})}),_jsx(Accordion,{title:`Why is Give it now, from stock missing?`,id:`why-is-give-it-now-from-stock-missing`,children:_jsxs(_components.p,{children:[`It appears only when `,_jsx(_components.strong,{children:`Given at this clinic`}),` is selected, and only where the pregnancy record could name the woman. If it is absent, give the dose on the vaccine screen or the ward drug chart and choose it from `,_jsx(_components.strong,{children:`Which administration drew the stock`}),`.`]})}),_jsx(Accordion,{title:`When do I use Send to pharmacy instead of Give it now, from stock?`,id:`when-do-i-use-send-to-pharmacy-instead-of-give-it-now-from-stock`,children:_jsxs(_components.p,{children:[`Use `,_jsx(_components.strong,{children:`Give it now, from stock`}),` when the antenatal room hands the medicine over from its own stock. Use `,_jsx(_components.strong,{children:`Send to pharmacy`}),` when the pharmacy hands it over — the pharmacist dispenses it, draws the stock and collects payment. Never both for the same dose.`]})}),_jsx(Accordion,{title:`Why is there no Dose number for iron and folate?`,id:`why-is-there-no-dose-number-for-iron-and-folate`,children:_jsx(_components.p,{children:`Because it is supplied rather than given as a numbered series, and a position in a series would be a false precision. The same applies to ART.`})}),_jsx(Accordion,{title:`Can I record ART or infant nevirapine?`,id:`can-i-record-art-or-infant-nevirapine`,children:_jsxs(_components.p,{children:[`They are in the `,_jsx(_components.strong,{children:`Programme`}),` list and can be recorded on the ledger. The `,_jsx(_components.strong,{children:`Programme schedule`}),` block derives IPTp, tetanus and iron-folate only, so those two carry no due state — and neither is printed on the `,_jsx(_components.a,{href:`/hospital/maternity/antenatal-card`,children:`downloadable antenatal card`}),`, which a woman carries to another facility.`]})}),_jsx(Accordion,{title:`Does Supplied mean she is taking her iron?`,id:`does-supplied-mean-she-is-taking-her-iron`,children:_jsx(_components.p,{children:`No. It means a supply was issued and recorded. Adherence is not something the product can know, and it never claims to.`})}),_jsx(Accordion,{title:`Can I edit a dose instead of marking it in error?`,id:`can-i-edit-a-dose-instead-of-marking-it-in-error`,children:_jsx(_components.p,{children:`No. Mark it in error with the reason, then record the correct one — the series position is freed as soon as you do.`})})]}),`\n`,_jsx(_MdxComponentBoundary,{name:`StillStuck`,children:_jsx(StillStuck,{topic:`programme doses`})})]})}function MDXContent(props={}){const{wrapper:MDXLayout}={..._provideComponents(),...props.components};return MDXLayout?_jsx(MDXLayout,{...props,children:_jsx(_createMdxContent,{...props})}):_createMdxContent(props)}return{AuditNote,StillStuck,TaskHeader,Path,__snippet_EDITION_LABELS_uyx1hn,Availability,default:MDXContent};function _missingMdxReference(id,component){throw new Error(`Expected `+(component?`component`:`object`)+\" `\"+id+\"` to be defined: you likely forgot to import, pass, or provide it.\")}","frontmatter":{},"scope":{"codeStyling":"system","config":{},"pageMetadata":{"title":"Programme doses","description":"Record IPTp, tetanus and iron-folate against a pregnancy, send ANC medicines to the pharmacy, and correct a dose recorded in error.","icon":"/images/icons/syringe.svg","href":"/hospital/maternity/programme-doses"}}},"mdxSourceWithNoJs":null,"noJsSplices":[[145,3101,")=>null;const StillStuck=()=>null;const TaskHeader=()=>null;const Path=()=>null;const __snippet_EDITION_LABELS_uyx1hn=undefined;const Availability=()=>null;func"]]},"mdxExtracts":{"tableOfContents":[{"title":"This records a dose; it does not give one","slug":"this-records-a-dose-it-does-not-give-one","depth":2,"children":[]},{"title":"Read the Programme schedule","slug":"read-the-programme-schedule","depth":2,"children":[]},{"title":"Record a dose","slug":"record-a-dose","depth":2,"children":[]},{"title":"Give the dose from stock, here","slug":"give-the-dose-from-stock-here","depth":2,"children":[]},{"title":"Send it to the pharmacy","slug":"send-it-to-the-pharmacy","depth":2,"children":[]},{"title":"Correct a dose recorded in error","slug":"correct-a-dose-recorded-in-error","depth":2,"children":[]},{"title":"What the ledger shows","slug":"what-the-ledger-shows","depth":2,"children":[]},{"title":"Who can do this","slug":"who-can-do-this","depth":2,"children":[]},{"title":"Check it worked","slug":"check-it-worked","depth":2,"children":[]},{"title":"If something goes wrong","slug":"if-something-goes-wrong","depth":2,"children":[]},{"title":"FAQ","slug":"faq","depth":2,"children":[]}],"codeExamples":{}},"jsLinks":[],"subdomain":"clinikehr","siteName":"ClinikEHR Help Center","title":"Programme doses - 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