Assessment of Supply Chain Management of HIV/AIDS Related Commodities in Selected Public Hospitals and Health Centers in Addis Ababa, Ethiopia
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Date
2014-06
Authors
Berhanemeskel, Eyerusalem
Journal Title
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Publisher
Addis Ababa University
Abstract
A wide range of medicines and other pharmaceutical products are needed for diagnosis,
treatment, care, and prevention of HIV/AIDS. However, interrupted supplies and stock outs are
the major challenges in the supply chain of ARV drugs. Therefor the aim of this study was to
assess the supply chain management of HIV/AIDS related commodities at hospital and HCs
level in Addis Ababa, Ethiopia. A descriptive cross sectional survey complemented by
qualitative approach was conducted in 24 government owned health facilities (4 hospitals and 20
health centers) that provide ART, VCT and PMTCT service in Addis Ababa. The sample of
health facilities were calculated by using the Logistic Indicators Assessment Tool (LIAT) for
ARV drugs and Test kits developed by USAID/DELIVER. The data was collected r using semistructured
questionnaires and observation check lists. The study revealed that 16(80%) of Health
Center and 1(25%) of hospital pharmacies properly report and have the record of patients by
regimen data. Almost all facilities had Electronic Dispensing Tool and used it for recording
patient information on daily bases. Only, 14(70%) of the Health Centers used paper based ARV
drugs dispensing register as a backup. Six months prior to the study, 14(70%) of Health Centers
and 2(50%) of the hospitals stopped VCT service due to lack of adequate supply. The majority of
the hospitals 3(75%) and 18(94.7%) of Health Centers were able to submit the requisition and
report of ARV drugs to Pharmaceutical Fund and Supply Agency according to the schedule.
More than three- fourth of the Health Centers had one or more emergency order of ARV drugs,
while all of hospitals had emergency order more than 3 times within 6 months prior to the study.
All of the hospitals and nearly half of the Health Centers had an emergency order of test kits
more than 3 times in the past 6 months. The mean percentage difference between quantity
ordered and received was high for 3TC300/TDF300 (69.6% in hospitals and 51.7% in HCs).
Over all 14(73.7 %) of the Health Centers and 3(75%) of the hospitals faced stock out of one or
more ARV drugs on the day of visit. Stock out was high for nvp200 in hospital 2(50%) and it
was high for tdf300/3tc300 in HCs 7(36.8%). Regarding the stock status of test kits on the day of
visit; only 7(36.8%) of the HCs were fully stocked, while the rest of them were stock out of one
or more selected test kits. Whereas, all of the hospitals were stock out one or more test kits on
the day of visit. Unlike ARV drugs, only 10(52.6%) of HCs and 2(50%) of hospitals had bin card
for the selected test kits on the day of visit. All of the health facilities used both computerized
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and paper based LMIS; they used computerized electronic dispensing tool at dispensary and
Health Commodities Management Information System in the store. The study concludes that
there was not adequate data on patient by regimen and stock status of ARV drugs and Test kits.
There were frequent stock outs of ARV drugs and HIV test kits, which are an indicator of weak
supply chain. The reporting and receiving system of ARV drugs were more organized compared
to HIV test kits. 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 and health
center handling HIV/AIDS related commodities 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 and HIV test kits.
Key words: HIV/AIDS, ARV drugs, HIV test kits, supply chain Management, pharmaceutical
storage
Description
Keywords
HIV/AIDS; ARV drugs; HIV test kits; supply chain Management; pharmaceutical storage