The procurement and supply chain strengthening project: Improving public health supply chains for better access to HIV medicines, Uganda 2011-2016 (original) (raw)
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Integrated Pharmacy Research and Practice, 2020
BackgroundHealth facilities (HFs) need an extensive range of antiretroviral (ARV) drugs and related HIV/AIDS commodities for diagnosis, prevention, and treatment of HIV/AIDS. This study was aimed to assess supply chain management performance from the perspective of achieving 90-90-90 treatment strategy at HFs of Southern Nations, Nationalities and People’s Regional State (SNNPRS), Ethiopia.MethodsFacilities based cross sectional study design in 30 HFs (9 hospitals and 21 health centers) and five pharmaceuticals fund and supply agencies (PFSAs) was conducted. The HFs were selected randomly. Semi-structured questionnaires and observation checklists with logistic indicators assessment tools (LIATs) were used to collect data for HIV/AIDS related services from November 2016 to May 2017. In addition, we used in-depth face to face interview and thematic approach. Quantitative data were entered into Epi-Data version 3.1 and transported to SPSS version 20 to analyze the result. Qualitative data were analyzed using thematic approach.ResultsOnly 9 (30%) HFs had received their orders from PFSA on time from date of report. Average lead time for ARV drugs was 46.4 days in hospitals and 59.2 days in health centers (HCs). Sixteen (60.7%) HFs reported their completed report and requisition format (RRF). From this, 53.3% HFs order was refilled correctly in quantity from that they need. Inventory accuracy rate was 77%. Major HFs, 20 (66.7%) faced at least one-time emergency order for ARV drugs, HIV test kits and viral load (VL) supplies. Whereas, 9 (30%) hospitals and 5 (16.67%) HCs were out of stock two and three times respectively. Sixteen (53.3%) commodities stocked out at least once in six months. Nevirapine (NVP) 10 mg/5 mL in 240 mL was the most stocked out (13 times) for an average 22 days. Uni gold was stocked out (16 times) with average of 34.5 days. Wastage rate was 2.5%. Twenty-five (83.3%) facilities had good storage conditions (>80% to the standard).ConclusionUnsatisfactory data records, stock-outs, interrupted reports, inaccurate inventory and wastage rates were indicators for defective supply chain management of HIV/AIDS commodities. Respective organizations should improve their responsible activities to secure commodities availability.
Health supply chain system in Uganda: assessment of status and of performance of health facilities
Journal of Pharmaceutical Policy and Practice
Background Health supply chain systems are essential for effective and efficient healthcare system by ensuring availability of quality essential medicines and health supplies. While several interventions have been made to ensure the availability of quality essential medicines and health supplies, health facilities continue to report stockouts in Uganda. Objectives This study aimed to assess the status and performance of the supply chain system across all levels of care in health facilities in Uganda. Methods This was a cross-sectional study conducted in 128 public and private-not-for-profit health facilities across 48 districts in Uganda. These facilities included all levels of care from Health Centres II, III, IV, general and referral hospitals, and national referral hospitals. Data were collected using desk reviews, health facility surveys, and key informant interviews with key personnel. Stock registers were reviewed to assess the availability of a basket of essential medicines b...
2019
Ethiopia is on the way to achieve the three nineties. However, HIV testing has decreased by 8% (Oromia by 7%) in 2009 EFY (2016/17)when compared to performance of preceding year by major reason related to shortage/poor distribution of diagnostic test kits (FMOH, 2017). This study aimed to assess the supply chain management practices and challenges of HIV rapid test kits in selected public Hospitals and Health Centers in Oromia region, focusing on ten HIV hot spot towns. The study is descriptive and causal study design, employing cross sectional data and using quantitative and qualitative data collection techniques to gather the required data at certain point in time. Sample size determined as per the basis of LIAT for Antiretroviral drugs (USAID|DELIVER PROJECT, Task Order 1, 2009) using extreme or deviant case sampling, 25 public health facilities selected. Data was collected from a total of 120 staffs working at Voluntary Counseling and Testing, Prevention of Mother to Child Trans...
Globalization and Health, 2011
Background: Strengthened national health systems are necessary for effective and sustained expansion of antiretroviral therapy (ART). ART and its supply chain management in Uganda are largely based on parallel and externally supported efforts. The question arises whether systems are being strengthened to sustain access to ART. This study applies systems thinking to assess supply chain management, the role of external support and whether investments create the needed synergies to strengthen health systems. Methods: This study uses the WHO health systems framework and examines the issues of governance, financing, information, human resources and service delivery in relation to supply chain management of medicines and the technologies. It looks at links and causal chains between supply chain management for ART and the national supply system for essential drugs. It combines data from the literature and key informant interviews with observations at health service delivery level in a study district. Results: Current drug supply chain management in Uganda is characterized by parallel processes and information systems that result in poor quality and inefficiencies. Less than expected health system performance, stock outs and other shortages affect ART and primary care in general. Poor performance of supply chain management is amplified by weak conditions at all levels of the health system, including the areas of financing, governance, human resources and information. Governance issues include the lack to follow up initial policy intentions and a focus on narrow, short-term approaches. Conclusion: The opportunity and need to use ART investments for an essential supply chain management and strengthened health system has not been exploited. By applying a systems perspective this work indicates the seriousness of missing system prerequisites. The findings suggest that root causes and capacities across the system have to be addressed synergistically to enable systems that can match and accommodate investments in diseasespecific interventions. The multiplicity and complexity of existing challenges require a long-term and systems perspective essentially in contrast to the current short term and program-specific nature of external assistance.
Background: A wide range of pharmaceutical products are needed for diagnosis, treatment, and prevention of HIV/AIDS. However, interrupted supplies and stock-outs are the major challenges in the supply chain of ARV medicines and related commodities. The aim of this study was to assess the supply chain management of HIV/AIDS related commodities in public health facilities of Addis Ababa, Ethiopia. Methods: A descriptive cross-sectional survey complemented by qualitative method was conducted in 24 public health facilities (4 hospitals and 20 health centers). A semi-structured questionnaire and observation check list were used to collect data on HIV/AIDS related service, reporting and ordering; receiving, transportation and storage condition of ARV medicines and test kits; and supportive supervision and logistics management information system. In addition, in-depth interview with flexible probing techniques was used to complement the quantitative data with emphasis to the storage condition of ARV medicines and test kits. Quantitative data was analyzed using SPSS version-20. Analysis of qualitative data involved rigorous reading of transcripts in order to identify key themes and data was analyzed using thematic approach.
Tanzania journal of health research, 2018
Background: Reliable supply of laboratory supportive services contributes significantly to the quality of HIV diagnostic services. This study assessed the status of supply chain management of laboratory supportive services and its potential implications on the quality of HIV diagnostic services in selected districts of Tanzania. Methods: The study was conducted in 39 health facilities (HFs) from eight districts in four regions of Tanzania, namely Iringa, Mtwara, Tabora and Tanga. Facilities with care and treatment centres for HIV/AIDS patients were purposively selected for the study. The study utilized a quantitative method of data collection. A questionnaire was administered to heads of laboratories to obtain information on laboratory supply chain management. Results: A total of 39 health facilities (HF) were included in the study. This included 23 public and 16 private facilities. In 82% of the HFs, ordering of supplies was performed by the laboratory departments. The information commonly used to forecast requirements of the laboratories included the number of tests done (74.4%; n=29), current stock levels (69.2%; n=27), average monthly consumption (64.1%, n=25) and minimum and maximum stock levels (10.2%, n=4). Emergency orders were significantly common in public than private facilities (73.9% vs. 56.3%, p=0.004). Delivery of ordered supplies took 1 to 180 days with a significantly longer mean period for public than private facilities (32.5 vs. 13.1 days, p=0.044). Most of the public HFs ordered supplies from diverse sources compared to private facilities (68.2% vs. 31.8%). Conclusion: There was a weak inventory management system and delays in delivery of supplies in the majority of HFs, which are likely to impede quality of HIV care and treatment. Strengthening capacity for data management and ensure constant supply will potentially improve the quality of HIV diagnostic services.
His research interest is in the area of integrating developing countries into the global public procurement framework. Kambaza Stephen Faculty of education is a lecturer in Kyambogo University in the Fcaulity of Psychology(psychometry) His interests are Psychometric assessment: Values, beliefs, attitude measurement, Influence of values and beliefs on life perceptions and orientation, Development of materialism, consumer psychology. ABSTRACT. Recent empirical studies point to structural supply chain constraints in the supply of essential drugs in developing countries, hence calling for interventions and policy direction. Despite Uganda's commitment to improve drug access and availability, actual realization remains low and structural bottlenecks in the chain have not been identified and documented. A cross sectional survey was conducted on 240 respondents in four malaria prone districts. Structural bottlenecks at each stage of the supply chain have been systematically identified and documented as a starting point. Findings indicated hospitals were mainly affected by lack of credible and accessible drug consumption information, poor planning, forecasting and logistics. Health centre IVs mainly faced inadequate procurement skills and consumption information. Health centre IIIs encountered poor procurement practices and logistics. Health centre IIs faced poor procurement practices, collaborative linkages and logistics. These findings add to the literature of the increasingly complex drugs supply chains in developing countries. The paper concluded that access and availability of essential drugs remains sub-optimal. Recommendations are drawn towards policy interventions aimed at strengthening programmes at local governments, investing resources in collaborative services, training staff in procurement best practices, and logistical management.
Public Health Supply Chain Performance of Primary Health Care Units, Gamo zone, SNNPR, Ethiopia
Research Square (Research Square), 2022
A convergent parallel mixed-method was adopted. Quantitative data were collected from 46 primary healthcare units between April 01 and May 30, 2021. The study employed strati ed simple random sampling method. It was due to variation in LMIS reporting schedule; number and types of tracer drugs being handled; and pharmaceutical storage capacity among levels of primary healthcare units. Logistics records and reports, service registers, physical observation, and interview of key informants were sources of data. The data were analyzed by using SPSS version 20. The result was presented in mean, percentage, and standard deviation. Qualitative data on public health supply chain challenges were collected from key informants using a semi-structured interview guide. The data were analyzed manually using inductive thematic approach and the result was narrated. Results The study revealed that public health supply chain performance of primary health care unit in Gamo zone was low. Inventory management KPIs, LMIS report KPIs, and storage condition KPIs were below the national standard. Means of availability (64.8%±14.8%), stocked according to plan (16.5%±9.5%), inventory accuracy rate (65%±17.2%), and stock out rate (64.9%±9.8%) of tracer drugs in primary health care units deviate from ideal. Likewise, means of LMIS report accuracy rate (64%± 13.6%) and LMIS report completeness (80%±15) for primary healthcare units were lower than the standard. Only 81% of assessed primary health care units adhere to good storage practices. In general, public health supply chain performance decreases across the levels of primary health care units in Gamo zone. LMIS report quality; pharmaceutical distribution; storage condition; public transportation access; supply chain workforce training and motivation; budgeting and nance for logistics activity; and low management support were reported as prevailing challenges. Conclusion Inventory management, LMIS reporting, and storage practices are areas where public health supply chain performance gaps identi ed. These lead to wastage and interruption of essential medicines, affecting the quality of healthcare delivery at each level of primary healthcare unit. Background Public health supply chain is the channel through which health commodities are distributed from the central medical store (CMS) to the service delivery points (SDPs) (1). Public health SCM functions that are tailored to CMS at Federal level are selection, quanti cation, and procurement (2). SDPs are not
2018
Back ground: pharmaceutical Supply chain management is the backbone of healthcare delivery. It arises from the fact that health care is dependent on the availability of drugs and other medical supplies at the right time and in the right quantities for the management of patients. Public health facilities are facing challenges in assuring uninterrupted pharmaceuticals that are efficacious and have good quality, physically and financially accessible and used rationally. Developing a framework for assessing the performance of the supply chain requires certain assumptions, including the ones related the areas of its measurement. Several types of indicators have been developed to measure many supply chain and logistics activities. Objective: study aimed at analysis of the performance of pharmaceutical supply chain management practices and the strength and weakness at public health facilities in Addis Ababa Methodology: a quantitative and qualitative study approaches were employed to analy...
International Journal of Supply Chain Management
The COVID-19 pandemic and its induced lockdown resulted in huge disruptions that affected access to and availability of healthcare commodities at different levels of the supply chain system. An understanding of the pandemic impact in different areas will help in designing strategies to mitigate future disruptions. This study was designed to evaluate the supply chain performance of HIV/AIDS commodities through the review of key performance indicators in health facilities in Anambra State, Nigeria, during the COVID-19 pandemic lockdown. A facility-based cross- sectional study was conducted across 27 selected health facilities in the state. Facilities were selected using a stratified random sampling technique. Data was collected using a combination of a semi-structured questionnaire and observational checklists adapted from a previous study and the Logistics Indicators Assessment Tool (LIAT). Data obtained were analyzed using SPSS software (version 23). A total number of 44 focal perso...