Assessment of Medicines Expiry and its Contributing Factors in Public Health Facilities of South Gondar Zone, Amhara Region,Ethiopia
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Date
2021-03
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Addis Abeba University
Abstract
Introduction: High availability of expired medicine is not only a burden to a health
care system but it also shows existence of a supply chain gap. So, it is imperative to
explore contributing factor for expiry at each stage of the supply chain. In Ethiopia,
although there are reports that reveal the presence of expired medicines in the country,
information on the type and extent of medicines expired as well as its contributing
factor and disposal methods is scanty. The objectives of this study were therefore, to
determine extent (including financial value) and type of expired medicines, to explore
the reasons for expiry and to assess disposal practice of expired medicines in the
health care facilities of South Gondar Zone.
Methods: A sequential explanatory mixed method where a descriptive cross-sectional
study complemented by using qualitative approach was conducted from July 8-2017
to July 7-2018. For the quantitative part, Microsoft excel was applied for the analysis.
For the qualitative part, data was collected through in-depth interview with the key
informants and analyzed thematically. Previous records or reports of expired
medicines in all health facilities were used to determine the type and financial value
of expired medicine that were received by health facilities of South Gondar Zone
during the fiscal year 2017/18.Eighteen key informants were also interviewed to
explore main reasons for medicines expiry within the health facilities and the disposal
practices applied.
Results: Medicines worth of 2,304,830.51 Ethiopian birr were expired in public
health facilities of South Gondar during the study period, giving expiry rate of 6.45
%. Of these, anti-infectives were the most commonly expired group of medicines.
Medicines delivered for various programs particularly for HIV/AIDS had the highest
share in medicines expiry in term of value. Delivery of medicines through push
system, delivery of near to expire medicines by supplier, and lack of communication
and coordination in the health facilities were identified as major reasons for medicines
expiry. Burning of unused medicines in open container and pouring iv fluids into the
hole were commonly used methods to disposed unused medicines.
Conclusion: To reduce expiry: making delivery based on consumption that has longer
shelf life with most effective communication between health care structures should
take to promote regular supply, and rational use of medicines. Disposing expired
medicine by adhering to the national standard on drug management protocols to stop
contamination.
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Keywords
Expired Medicine, Medicine Wastage, Disposal Methods, Public Health Facility, Ethiopia.