Assessment of medicines wastage and its contributing factors in selected public health facilities in South West Shoa Zone, Oromia Regional State, Ethiopia
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Date
2017-06
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Addis Ababa University
Abstract
Medicines wastage occurs when medicines are damaged, obsoleted or expired and become
unsafe for use. It is a burden to many health facilities and increases cost to the health care
system. In Ethiopia, although there are reports that reveal the presence of wasted medicines in
the country, there is limited objective evidence on the type and extent of medicines wastage as
well as its contributing factors. Therefore, the objective of this study was to determine medicines
wastage rate and to identify its contributing factors in the sampled public health facilities of
South West Shoa Zone, Oromia Regional State, Ethiopia. The study employed a facility based
cross-sectional survey and qualitative study in one hospital and nine health centers from May 2-
27, 2016. Both quantitative and qualitative data collection methods were used in the study. The
quantitative data was collected by data abstraction formats and self-administered questionnaires
and analyzed using SPSS version 21.0. The analysis was performed in aggregate and included
descriptive statistics. And the qualitative data was collected through in-depth interview with the
heads of the health facility and pharmacy case team leaders and analyzed using thematic
analysis. The total monetary value of wasted medicines in the surveyed health facilities in EFY
2005-2007 was 500,522.09 Ethiopian Birr, while in the same period all surveyed health facilities
received medicines worth of 6,635,910.97 Ethiopian Birr, resulting wastage rate of 7.5%. Of the
total value of wasted medicines, anti-infectives (39.1%), medicines used for correcting water,
electrolyte and acid-base balance (12.9%) and GIT medicines (10.6%) were the top three
therapeutic classes. Oral rehydration salt 245osml/l powder (6.3%), metronidazole 250mg
capsule (4.1%), and tetracycline 250mg capsules (3.2%) were also the most commonly wasted
medicines. More than half of the wasted medicines were in solid dosage forms (54.3%), followed
by liquid dosage forms (40.8%) and nearly 96% of the source for wastage was expiry of
medicines.
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In both quantitative and qualitative study, delivery of near expiry date medicines by suppliers,
lack of system to move nearly expired medicines from one facility to another, presence of over
stocked medicines due to improper forecasting of need in the facilities, lack of electronic stock
management tools and shortage of pharmacy professionals in the health facilities were identified
as contributing factors for medicines wastage. In conclusion, the extent of medicines wastage in
public health facilities of South West Shoa Zone was estimated to be 7.5%. It is recommended
that the health facilities should document and maintain a written record of all medicines wastage.
A mechanism of exchanging medicines from overstock to under stock areas should be created, and a
strong partnership or a common plat forum should be established among key stake holders to
have regular discussion on preventive strategies.
Key words: Medicines wastage, wastage rate, expired medicines, public health facility,
Ethiopia
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Keywords
Medicines wastage;wastage rate; expired medicines