Assessment of Constraints in the HIV Input Supply Chain in N’Djamena, Chad

Introduction: Continuous access to HIV inputs, particularly Antiretrovirals (ARVs), diagnostic tests, and cotrimoxazole, is essential for quality care of people living with HIV (PLHIV). However, stock-outs persist in health facilities (FOSA) in N’Djamena, Chad. This study aims to assess the availability of these inputs in care centers in the Chadian capital. Material and Methods: A comprehensive prospective descriptive study was conducted from July to August 2021 on the 16 FOSA providing care for PLHIV in N’Djamena. Data was collected from stock cards, registers, order forms, inventories, and semi-structured interviews with stock managers at FOSA, and at central and provincial warehouses. A standardized stock-out monitoring form and checklist were used to document stock-outs and assess storage conditions. Results: On the day of the survey, 91.7% of FOSA (11 out of 12 responding) experienced a stock-out of at least one ARV. Stock-outs of adult ARVs affected 75% of facilities, and pediatric ARVs 66.7%. Cotrimoxazole was unavailable in 58.3% of FOSA, and HIV tests in 33.3%. The most frequently out-of-stock adult ARVs included: Efavirenz 600 mg (71.4%), DTG/3TC/TDF (40%), ABC/3TC 600/300 mg (22.2%), AZT/3TC 300/150 mg (37.5%) and AZT/3TC/NVP 300/150/200 mg (18.2%). Pediatric ARVs most frequently unavailable included: Efavirenz 200 mg (62.5%), ABC/3TC 60/30 mg (55.6%), Nevirapine syrup 50 mg (40%), and LPV/r 100/25 mg (33.3%). Conclusion: FOSA in N’Djamena faces frequent HIV input stock-outs, compromising treatment continuity and patient retention. Strengthening logistics systems, planning, and stock monitoring is needed to secure the supply chain.