Medicine Supply Chain Management Practice by Health Extension Workers, in selected Primary Health Care Units in North Shewa Zone, Amhara Region, Ethiopia: A qualitative Study

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Addis Abeba University


Introduction: Health Extension Workers (HEWs) play key roles in the health care system of Ethiopia. They do health promotion, prevention and curative activities as well as manage a number of items including medicines at the community and health post level in which access to health care is limited. Even though HEWs manage various medicines, they come across challenges when they order, receive, store and distribute medicines to the community. The extent of challenges they face may vary from region to region and from time to time. However, in Ethiopia few studies have conducted on supply chain management of medicines by HEWs and challenges faced. Method: A qualitative study design was used. In depth interview of HEWs, key informant interviews with pharmacy professionals, two focus group discussions among female community members and observation were carried out. The data was coded and analyzed thematically, based on objectives. Result: HEWs receive a list of drugs from the cluster health center by calculating for a month or two months. And they put medicines on the shelf and cartons without being well arranged. Based on Integrated community case management booklet, HEWs treat patients who are under 5 of age and give medicines for the disease that defines. If it is out of their scope they refer them to the HC. HEWs in North Shewa are dissatisfied with their job because of their salary scale, lack of incentives, unable to upgrade their career. They also feel that they are not as beneficiary as other health workers in terms of other job opportunities. They are also overloaded by nonprofessional activities. The overall HEWs training focuses on family planning whereas medicine management practice training is minimal. Conclusion: HEWs are front line health workers in the rural community. From this study they receive, store and distribute or dispense medicines to consumers not in line with the recommended guidelines. This is due to lack of adequate training, transport, overload with other tasks, and resources limitation including medicines. So the woreda or zonal health offices need to intervene by giving regular and detail medicine supply chain training and in turn improving HEWs supply chain of medicine management practices.



Medicine, Medicine supply chain management, Health Extension Workers