Compliance of Public Health Facilities with Essential Medicines and Health Supplies Redistribution Guidelines in Mbale District, Eastern Uganda: A mixed-methods study

Abstract

Introduction Redistribution of essential medicines and health supplies (EMHS) is a mechanism to address supply chain uncertainty by moving excess stock of health commodities from health facilities that are overstocked to health facilities with shortages where it is most needed. It prevents the wastage of scarce resources and improves efficiency within a health supply chain system. Many public health facilities in Uganda experience stock-outs, overstocking, and expiry of essential medicines. This study assessed the compliance of public health facilities with the Uganda Ministry of Health redistribution strategy for EMHS in Mbale district, Eastern Uganda. Methods A mixed-methods study was conducted among 55 respondents at public health facility level and five key informants at the district level. Audio-recorded data were transcribed and coded to develop themes. Thematic analysis was performed using ATLAS.ti Version 8.5. Quantitative data were analysed using IBM SPSS Version 24.0. Results About a third (33%) of the surveyed health facilities complied with EMHS redistribution guidelines. Respondents agreed that EMHS redistribution had helped reduce health commodity expiries and stock-outs in health facilities. Respondents who did not know about the timely release of funds for redistribution were 68% less likely to comply, and those who said the guidelines were never shared were 88% less likely to comply with the guidelines. Conclusions Compliance with the EMHS redistribution guidelines was low and associated with failure to share the guidelines with staff and inadequate awareness about release funds for EMHS redistribution. The district local government should allocate more funds to the EMHS redistribution.

Evaluation of pharmaceutical inventory management challenges at public healthcare facilities in King Cetshwayo District, KwaZulu-Natal, South Africa

“…Redistribution not only reduces wastage but also ensures the availability of medicines when and where they are needed. Lessons can be drawn from successful implementation of redistribution strategies in countries like Uganda, where it has been a national strategy since 2012, supported by dedicated budgets and guidelines to improve medicine circulation and accessibility 5 . A study conducted in Saudi Arabia also recommended adopting a centralized inventory management approach to promote equitable distribution of medicines and enhance accessibility 12 .…”

“…The country continues to experience national medicine stockouts, posing a threat to the quality of healthcare services provided 3,4 . Such stockouts are a common occurrence within the pharmaceutical supply chain system and are worsened by issues such as overstocking and wastage due to medicine expiry at healthcare facilities 3,[5][6][7][8] . These prolonged stockouts erode public trust in the healthcare system 8 , leading to decreased con dence in primary healthcare facilities, as evidenced by a survey conducted in the Eastern Cape province in 2014 2 .…”

“…Redistributing medicines between healthcare facilities has been proposed as an initial step in addressing inventory management challenges 12 . In Uganda, redistribution has been implemented since 2012 as a national strategy to tackle overstocking, wastage, and stockouts 5 .…”