Figure 1

Morphine supply and blockages within the Ugandan regulatory framework. Blockages in morphine flow: key.
District Hospital has to obtain permission from MOH for every order and take this to JMS.
National Medical Stores currently re-structuring and lacks capacity and drug inspectors.
Mission hospitals and NGOs have to obtain morphine via District Hospital pharmacy and depend on the co-operation of the pharmacist/dispenser.
Pharmacy may be slow in re-ordering.
Local health centre/hospice level, drug cupboard may not be adequate, record books may be missing, there may be staff turn over resulting in loss of know-how.