> ## Documentation Index
> Fetch the complete documentation index at: https://help.clinikehr.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Programme doses

> Record IPTp, tetanus and iron-folate against a pregnancy, read what the schedule says is due, and correct a dose recorded in error.

export const AuditNote = ({action = 'This action'}) => <div className="ck-callout ck-callout--info" role="note">
    <p className="ck-callout__body">
      {action} is written to your workspace's audit log with your name, the
      record touched and the time — a HIPAA requirement, and one you can review
      yourself under <strong>Audit Log</strong>. See{' '}
      <a href="/platform/security/audit-log">Audit log</a>.
    </p>
  </div>;

export const StillStuck = ({topic}) => <div className="ck-callout ck-callout--note" role="note">
    <p className="ck-callout__body">
      <strong>Still stuck{topic ? ` with ${topic}` : ''}?</strong>{' '}
      Check <a href="/platform/help/troubleshooting">Troubleshooting</a> first —
      it covers the failures we see most often. If that does not resolve it,{' '}
      <a href="/platform/help/contact-support">contact support</a> and include
      your workspace name and the time the problem happened, so we can find the
      matching entry in your audit log.
    </p>
  </div>;

export const TaskHeader = ({before, time, after}) => <div className="ck-task">
    {before ? <div className="ck-task__cell">
        <div className="ck-task__title">Before you start</div>
        <p className="ck-task__body">{before}</p>
      </div> : null}

    {time ? <div className="ck-task__cell">
        <div className="ck-task__title">Takes about</div>
        <p className="ck-task__body">{time}</p>
      </div> : null}

    {after ? <div className="ck-task__cell">
        <div className="ck-task__title">When you're done</div>
        <p className="ck-task__body">{after}</p>
      </div> : null}
  </div>;

export const Path = ({steps = []}) => <span className="ck-path">
    {steps.map((s, i) => <span key={i} className="ck-path__step">
        {i > 0 ? <span className="ck-path__sep" aria-hidden="true">
            ›
          </span> : null}
        {s}
      </span>)}
  </span>;

export const Availability = ({editions = ['all'], plans, roles, note}) => {
  const list = editions.includes('all') ? ['clinic', 'pharmacy', 'lims'] : editions;
  return <div className="ck-avail" role="note" aria-label="Feature availability">
      <span className="ck-avail__label">Available in</span>

      {list.map(e => <span key={e} className={`ck-pill ck-pill--${e}`}>
          {EDITION_LABELS[e] || e}
        </span>)}

      {plans ? <span className="ck-avail__label">Plan</span> : null}
      {plans ? <span className="ck-pill ck-pill--plan">{plans}</span> : null}

      {roles ? <span className="ck-avail__label">Who</span> : null}
      {roles ? <span className="ck-pill ck-pill--role">{roles}</span> : null}

      {note ? <span className="ck-avail__note">{note}</span> : null}
    </div>;
};

<Availability editions={['clinic']} plans="Enterprise" roles="Anyone with Record a programme dose" note="Needs the Maternity care area" />

The bottom of a woman's [antenatal card](/hospital/maternity/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.

<Path steps={['Sidebar', 'Maternity', 'Antenatal', "Today's Clinic", "the patient's name"]} />

<TaskHeader before="An open pregnancy record — and, if the dose was given here, either an existing administration to point at or stock to give it from" time="Under a minute" after="A dose on the pregnancy's ledger, counting towards its series" />

## This records a dose; it does not give one

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 three ways a dose can have been given here, and all three 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 — IPTp-SP, iron and folate | **Give it now, from stock**, on this block | The same list, straight away            |

<Note>
  **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.
</Note>

## Read the Programme schedule

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**           |

<Warning>
  **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.
</Warning>

**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.

## Record a dose

<Steps>
  <Step title="Select Record dose">
    It sits at the top right of the **Programme doses** block, and is absent if you do not hold the permission.
  </Step>

  <Step title="Choose the Programme">
    **IPTp (malaria prevention)** · **Tetanus toxoid** · **Iron and folate** · **ART** · **Infant nevirapine** · **Other**.
  </Step>

  <Step title="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.
  </Step>

  <Step title="Set the Date given">
    Today or earlier. A future date is refused.
  </Step>

  <Step title="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."
  </Step>

  <Step title="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.
  </Step>

  <Step title="Select Record dose">
    It confirms **Dose recorded** — "It is linked to the administration that drew the stock", or "Recorded as given at another facility."
  </Step>
</Steps>

## Give the dose from stock, here

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.

<Steps>
  <Step title="Select Give it now, from stock">
    It sits under **Which administration drew the stock**, and only when **Given at this clinic** is selected.
  </Step>

  <Step title="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.
  </Step>

  <Step title="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.
  </Step>

  <Step title="Add Route, Site and Notes if they apply">
    All three are optional — **PO**, **IM**, a site, or a note such as directly observed.
  </Step>

  <Step title="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**.
  </Step>

  <Step title="Finish with Record dose">
    Set the **Programme** and **Dose number**, then select **Record dose**.
  </Step>
</Steps>

<Warning>
  **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.
</Warning>

<Note>
  **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.
</Note>

## Correct a dose recorded in error

Nothing here is deleted. 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.

<Steps>
  <Step title="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."
  </Step>

  <Step title="Answer Why is this wrong?">
    A reason is required — the button stays disabled until you write one.
  </Step>

  <Step title="Select Mark in error">
    It confirms **Marked as entered in error** — "The record is kept; the dose no longer counts towards the series."
  </Step>
</Steps>

The row stays in the ledger, struck through and badged **Entered in error**, and stops counting on the **Programme schedule** block.

<Note>
  **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.
</Note>

<AuditNote action="Recording or correcting a programme dose" />

## What the ledger shows

| Column     | Shows                                                                                                                  |
| ---------- | ---------------------------------------------------------------------------------------------------------------------- |
| **Dose**   | The programme and its number — **IPTp 2**, **Tetanus toxoid 3** — with an **Entered in error** badge where one applies |
| **Given**  | The date it was given                                                                                                  |
| **Source** | **Given here** or **Reported elsewhere**                                                                               |

With nothing recorded it reads **No programme doses recorded for this pregnancy.**

## Who can do this

| Action                           | Who by default                                         | Permission                  |
| -------------------------------- | ------------------------------------------------------ | --------------------------- |
| Read the ledger and the schedule | Anyone who can open the antenatal card                 | Nothing                     |
| Record a dose                    | Anyone not yet governed; otherwise only if switched on | **Record a programme dose** |
| Give a dose from stock, here     | The same — it opens from inside **Record dose**        | **Record a programme dose** |
| Mark a dose as entered in error  | The same                                               | **Record a programme dose** |

Recording and correcting share one permission on purpose: whoever may assert that a dose happened may assert that it did not.

## Check it worked

* The dose is a row in the ledger with the right date and source.
* The matching line on **Programme schedule** moves — its count rises, and **Due** becomes **Not due** or **Complete**.
* A dose you marked in error is struck through, badged, and no longer counted.

## If something goes wrong

<AccordionGroup>
  <Accordion title="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**.
  </Accordion>

  <Accordion title="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.
  </Accordion>

  <Accordion title="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.
  </Accordion>

  <Accordion title="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.
  </Accordion>

  <Accordion title="A dose given elsewhere drew no stock here">
    You chose **Reported from another facility** but left an administration reference in the box. Clear it.
  </Accordion>

  <Accordion title="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.
  </Accordion>

  <Accordion title="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.
  </Accordion>

  <Accordion title="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.
  </Accordion>

  <Accordion title="A dose can't be dated in the future.">
    Set **Date given** to today or earlier.
  </Accordion>

  <Accordion title="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.
  </Accordion>
</AccordionGroup>

## FAQ

<AccordionGroup>
  <Accordion title="Does recording a dose here take it out of stock?">
    **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.
  </Accordion>

  <Accordion title="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.
  </Accordion>

  <Accordion title="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**.
  </Accordion>

  <Accordion title="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.
  </Accordion>

  <Accordion title="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](/hospital/maternity/antenatal-card), which a woman carries to another facility.
  </Accordion>

  <Accordion title="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.
  </Accordion>

  <Accordion title="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.
  </Accordion>
</AccordionGroup>

<StillStuck topic="programme doses" />