Background Children in resource-limited countries are more likely to die from treatable conditions than those in higher resource settings due to a lack of the right essential medicine at the right time. Globally millions of children die every year from conditions that could be treatable with existing medicines before they reach their fifth birthday. This study aimed in assessing the availability and affordability of essential medicine for children in selected health facilities of southern nations, nationalities, and peoples’ regions (SNNPR), Ethiopia. Method A medicine outlets-based cross-sectional study was conducted to assess the availability, affordability, and prices of the 30 selected essential medicines (EMs) for children in 30 public and 30 private medicine outlets in SNNPR from March 29 to May 5, 2019, applying WHO and Health Action International (HAI) tools. Availability was expressed as the percentage of sampled medicine outlets per sector that the surveyed medicine was found on the day of data collection. The amount of daily wages required for the lowest-paid government unskilled worker (LPGW) to buy one standard treatment of an acute condition or treatment for a chronic condition for a month was used to measure affordability and median price ratio for the price of EMs. The results Availability varied by sector, type of medication, and level of health facilities. The average availability of EM was 57.67% for the public sector and 53.67% for the private sector. Ceftriaxone, SOR, zinc sulfate, and cotrimoxazole were the most widely available types of medications in the two sectors. The median price ratios (MPR) for the cheapest drugs LP were 1.26 and 2.24 times higher than their International Reference Price (IRP) in the public and private sectors respectively. Eighty-two percent of LP medicines in the public and 91 % of LP medicines in the private sectors used in the treatments of prevalent common conditions in the region were unaffordable as they cost a day’s or more wages for the LPGW. Conclusion Availability, affordability, and price are determinant pre-requisite for EMs access. According to the current work, although fair availability was achieved, the observed high price affected affordability and hence access to EMs.
Background Inventory management is the heart of the supply system in improving availability of medicines, reducing the cost, and improving patient care quality. However, in the government facilities’ supply system, inventory management is poor. So, the purpose of this research is to assess inventory management performance for family planning, maternal and child health medicines in public health facilities of West Wollega zone, Oromia region, Ethiopia. Method Facility-based descriptive cross-sectional quantitative study was conducted using checklist, structured and semi-structured questionnaire, and triangulated with qualitative method. Quantitative data were coded and analyzed using SPSS Version 20 and Microsoft excel spreadsheet. Qualitative data were analyzed manually, using thematic analysis technique. Different indicators were used to measure variables. Results Among 23 health facilities assessed, availability of family planning/maternal and child health medicines ranged from 0 to 100%. Average availability of medicines was 14 (61.30%) with mean stock-out duration of 70.71 days. Bin cards were available for 559 (78.40%) of medicines, and 374 (52.45%) bin cards were accurate. Report submission rate was 116 (84.06%), with 47 (40.52%) report and resupply forms reported on time, 73 (62.93%) of them were complete and 69 (59.48%) were accurate. Supplier-related problem, lack of human resource, administrative problem, and lack of computer infrastructure were inventory management challenges identified. Conclusion Inventory management performance for Family planning/maternal and child health medicines was poor as indicated by low availability, high stock-out duration, and poor LMIS performance. Efforts should be undertaken by concerned bodies to improve it.
Background: Auditable pharmaceuticals service and transaction system (APTS) is unique in its systems strengthening approach. It is a data-driven package of interventions designed to establish accountable, transparent, and responsible pharmacy practice. The objective of this study was to assess the outcome performance of pharmaceuticals services among selected hospitals with and without the APTS system in SNNPR, Ethiopia. Methods: A cross-sectional comparative facility-based study was conducted at public hospitals by using an intervention and control approach to estimate the significance of the difference between average performances of APTS and non-APTS hospitals. A case-tocontrol ratio was applied to decide the number of sites and a simple random lottery sampling technique was employed to select control sites. The sample size formula was used to determine the proposed population for patient care indicator assessment. Epidata version 3.1 and SPSS version 23 were used for analysis. The study was conducted from March 1 to 30, 2019. Results: APTS implemented hospitals attained 92.3% patient satisfaction on the overall pharmacy services compared to 47.5% for non-APTS hospitals. They have improved essential drugs (EDs) availability, minimum stock-outs, and reduced wastage rates, unlike control groups. They undertook workload analysis to assess human power sufficiency; generate reliable information from accurate recording culture for decision making; practiced transparency and accountability through conducting physical inventory and daily sales tracking/ management system; and made budget utilization rationale applying ABC analysis, VEN analysis, ABC/VEN reconciliation, and stock status analysis (SSA) that non-APTS hospitals did less/not. Conclusion: In general, higher performances were observed in APTS implemented hospitals than non-APTS hospitals regarding patient knowledge, satisfaction, and medicine availability at stores. In all cases, it needs improvement to achieve target values.
Background Keeping proper storage conditions at health facilities is vital to reduce pharmaceutical wastage caused by environmental factors. The expiration of medicines at the health facilities could lead to wastage of potentially life-saving drugs and unnecessary expenditure on the disposal of those expired medicines. Therefore, the aim of this study was to assess pharmaceutical stores and wastage of reproductive health medicines due to expiration in the west Wollega zone of Ethiopia. Method We conducted a facility-based cross-sectional study from 15th to 31st July 2019 using quantitative and qualitative data from West Wollega Zone of Ethiopia. Results Among 23 health facilities assessed, 17 (73.91%) (4(100%) hospitals and 13(68.42%) health centers) fulfilled desirable storage conditions. Hospitals’ stores had equipment and furniture, fulfilled desirable storage conditions, whereas, a significant number of the health centers’ stores did not comply with desirable storage conditions. Challenges of store management identified were poor store infrastructure and shortage of manpower. The total value of reproductive health medicines wasted due to expire in surveyed facilities was 357,920.52 ETB (12,323.81 US dollars) and the Percentage of Stock Wasted due to Expiration was 8.04%. Levonorgestrel 0.75 mg tablet is the highest in the percentage of stock wasted due to expiry. Factors contributing to wastage due to expiration were supply and demand imbalance. Conclusion Reproductive health medicines wasted due to expiration is high compared to the government of Ethiopia’s plan for the year 2018/19. This might imply that the monitoring of this plan is poor. Even though hospitals store management is good, there is a weakness in store management in health centers. This could be due to poor attention given to health centers. Therefore, west Wollega zonal health department should appropriately monitor the wastage of Reproductive health medicines and enforce health centers to follow appropriate storage guidelines. Hospitals and health centers should not accept medicines beyond their need to reduce expiry.
Background Satisfaction with pharmacy services has many implications, including the degree of interaction with health care providers, the type and quality of service provided, and the extent to which needs and desires are met. This study aimed to identify the dimensions of pharmacy services and quantify client satisfaction with them. Methods A quantitative cross-sectional study was employed to guide this study. Data were entered into Epi Data, exported to SPSS 26.0, and analyzed using exploratory factor analysis to identify the underlying dimensions of pharmacy service. The study was conducted between 14th August 2020 and 28th December 2020. For standardization and comparison purposes, items loaded onto each dimension were computed and rescaled, and descriptive statistics were used to summarize the results. Stepwise linear regression was performed to quantify the contribution of each dimension to overall satisfaction and to identify determinant variables for overall satisfaction. A 95% CI, and a P-value of < 0.05 were used for the declaration of statistical significance. Results The mean overall satisfaction with pharmacy service was found to be (21.62±6.74)/30. There were eight dimensions of pharmacy service identified, and poor customer satisfaction was recorded for the premises and supply dimensions, with mean satisfaction of (12.08±8.49)/30 and (13.66±10.06)/30, respectively. The highest mean satisfaction was recorded with waiting time (24.24±6.54). Of the emergent dimensions, only four (supply, compassion and care, privacy, and premises) were predictors of overall satisfaction (P<0.05). The supply component was the strongest predictor of overall satisfaction, accounting for 20% of the variance in overall satisfaction. The number of prescribed and dispensed pharmaceuticals, marital status, and gender of participants also predicted overall satisfaction (P<0.05). Conclusion The survey uncovered eight underlying aspects of pharmacy services that influence client satisfaction. A significant gap was recorded with premises and supply chain-related components. These dimensions’ contributions to total satisfaction were substantial in terms of practical relevance. As a result, improving the availability of pharmaceuticals and the infrastructure surrounding pharmacy services may enhance consumer satisfaction considerably. Stakeholders must work on addressing supply related and premises difficulties to increase client satisfaction.
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