Assessment of Supply Chain Management of Anti Retro-viral Drugs in Public Hospitals in Addis Ababa, Ethiopia
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Date
2017-05
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Addis Ababa University
Abstract
Acquired Immune Deficiency Syndrome (AIDS) is a disease caused by a retrovirus known as human immune deficiency virus (HIV). The virus attacks the immune system and weakens the body’s natural defense system to fight against infection. Highly active antiretroviral therapy (HAART) is the cornerstone of management of patients with HIV infection. This study therefore sought to assess supply chain management of ARV drugs in all public hospitals in Addis Ababa, Ethiopia. The study employed a facility based cross-sectional descriptive quantitative study and retrospective document review. The total sample size for the study was all public hospitals (censes). The study included heads of the pharmacy; ART dispenser and ART store manager/general store manager of the public hospitals as a target population of the study. The study specifically gathered data on quantification, ordering and receiving of ARV drugs, inventory management procedures, storage conditions and distribution of ARV drugs within all the public hospitals in Addis Ababa. Both structured questionnaires and observation check lists were used to gather these data and analysis were done using words, graphs, tables and statistics.
Statistical Package for Social Sciences (SPSS) version 20 was used for analysis. Overall, the mean age of public hospitals had an experience on ART service provision 15.6 years. The study revealed that 20(86.95%) of federal hospital and 14(82.5%) regional hospitals pharmacies properly report and have the record of patients by regimen data. And 25 (62.5%) of the hospitals were using a compensation of electronic dispensing tool (EDT) data, ART pharmacy data and ART clinic data for reporting. EDT: enables pharmacy staff at the facility level to manage patients, plan follow- ups and monitor stock levels; however among the respondents 16(69.56%) from federal hospitals and 14(82.35%) from regional hospitals have EDT tool but among this only 13(56.52%) federal hospitals and 11(64.7%) of regional hospitals electronic dispensing tools functional. 24(60%) used EDT for recording daily dispensing drugs, for trucking patients by regimen & following patient treatment. Almost above half 24(60%) of the hospitals used EDT for recording daily dispensing drugs, for trucking patients by regimen & following patient treatment. Of all the participants only 12(52%) of the respondents from federal hospitals and 10(58.82%) of the respondents from regional hospitals had ART training. The majority of the federal hospitals 5 (45.5%) and regional hospitals 6(54.55%) were able to submit the requisition and report of ARV drugs to Pharmaceutical Fund and Supply Agency according to the schedule.
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An emergency order would be needed to avoid reaching a stock out before the end of the review period 20% of the federal hospitals and 15% of the regional hospitals had more than three emergency order of ARV drugs were placed on the past 6 months. 5(50%) of stock out of ARV drugs occurred in the hospitals due to not receiving the exact quantity they have ordered. Stock out was high for Nvp240ml in federal hospitals 3(60.0%). A well-organized storeroom will simplify a facility’s work; time will not be wasted trying to find needed supplies among ten hospitals 5(50%) of the hospitals have separated store for ARV drug and also 3(30%) of them have expiry date trucking chart. Logistics Management Information System (LMIS) is to support the management of essential pharmaceuticals like ARV drugs 5(21.5%) of federal hospitals and 6(35.3%) of regional hospitals have computer based LMIS. The remaining 18(78.3%) of federal hospitals and 11(64.7%) of regional hospitals have paper based LMIS; they used computerized EDT at dispensary and Health Commodities Management Information System (HCMIS) in the store. The study concludes that there were stock outs of ARV drugs which are an indicator of weak supply chain and also inadequate data on patient by regimen and stock status of ARV drugs. It was also noted that in majority of the cases the professionals were unable to handle the computerized LMIS, as desired. It was recommended for the hospitals handling ARV drugs to have adequate and reliable patient information and drug utilization data on hand and improve their storage conditions and prevent expiry and wastage of expensive ARV drugs.
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Keywords
ARV drugs, ART, LMIS