The quality of physical distribution service at the Ethiopian pharmaceutical supply service using a mixed method approach: a case of Dire Dawa Branch
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Date
2024-05
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Addis Ababa University
Abstract
Background - Customer satisfaction is one of an agile supply chain's most commonly utilized
key performance metrics. In low- and middle-income nations, inefficient distribution practices
directly drive-up costs, resulting in medicine stock-outs. Studying distribution service quality in
Ethiopia’s health sector is vital for improving health-care services and implementing national
health-care quality strategies.
Method - The study was conducted at Ethiopian pharmaceutical supply service (EPSS) Dire
Dawa Branch and 56 health facilities in East Harerghe, West Hararghe, Harari region, Somali,
and Dire Dawa from Dec 1, 2023 - Jan 30, 2024. An institution-based cross-sectional study with
a concurrent mixed method approach was conducted to assess health facilities' satisfaction with
the physical distribution service of EPSS using the physical distribution service quality model
(PDSQ), which compares customers' expectations with the perception to generate a gap score
and measure service quality. The study also identified service challenges in the EPSS Dire Dawa
branch using key informant interviews. A stratified random sampling proportionate to size
technique was applied to select hospitals and health centers from the four regions under the
catchment of EPSS Dire Dawa Branch, and purposive sampling was used to select key
informants.
Result- The study revealed that expectation measurement ranges from 4.34 - 4.79 for program
commodities and 4.38 - 4.82 for RDF commodities, indicating high expectations in both cases.
The mean perception value for all four dimensions (Availability, Timeliness, product quality and
responsiveness) ranges from 2.49 - 3.85. The gap score for all four dimensions is negative in
both health commodity types, ranging from -0.69 to -2.34, which indicates the physical
distribution service quality is perceived as low. The mean Gap score for availability was -2.03
and -2.11 in both program and RDF commodities respectively. Regarding the indirect measure
of customer satisfaction, the gap score for all four dimensions is negative. It should be noted that
the physical distribution service public health facilities receive from EPSS is less satisfactory.
The direct measurement of customer satisfaction shows that health facilities have a good level of
satisfaction with the condition of health commodities delivered, average satisfaction with
timeliness of delivery, and responsiveness. The lowest satisfaction level was attained with the
availability of products. The study also indicated that there was a significant difference in
v
customer satisfaction between RDF and the program distribution system regarding the
availability of health commodities (X2 =13.08, df=4) and (P value = 0.004). Regarding
challenges of the physical distribution service transportation challenges with the RDF
distribution system, poor availability of pharmaceuticals, prolonged order cycle time, lack of
supervision, and budget shortage are the main challenges faced by health facilities. Key
informants from EPSS Dire Dawa branch indicated poor data quality, delay in replenishment
from central EPSS, and lack of vehicle as challenges of the distribution service it provides.
Conclusion- Logistics customer service quality measurement is essential to meet customer
requirements.The study found that the physical distribution service of EPSS, Dire Dawa branch,
sub-optimal regarding all the physical distribution quality model dimensions, availability of
health commodities, timeliness, product quality, and responsiveness.
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Keywords
Pharmaceutical Supply Service, Ethiopian, Physical distribution