Assessment of supply chain management of laboratory equipment, reagents, supplies and its potential impacts the quality of laboratory diagnostic services of public hospitals in Addis Abeba, Ethiopia.
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Date
2019-10
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Addis Abeba University
Abstract
Background: Supply chain management process allows the right laboratory commodities in the
right quantities in the right condition delivered to the right place at the right time for the right
cost. Poor management of laboratory equipment, reagents and other suppliers with recurrent
stock-outs of reagents, frequent equipment breakdown was a major gap in ensuring quality and
uninterrupted testing leading to patient dissatisfaction, and it needs more attention to strength and
improve supply chain management practices.
Objective: This study aimed to assess supply chain management of laboratory equipment,
reagents, supplies and its impact on the quality of laboratory services of public hospitals in Addis
Ababa, Ethiopia.
Methods: The study employed a quantitative design using a hypothesis testing approach to
identify the effect of supply chain management of laboratory equipment, supplies, reagents,
consumables on quality of laboratory services. 169 questioners were distributed to employees
working in laboratory divided on thirteen (13) public hospitals found in Addis Ababa, from
February 2019 to May 2019 using questioner and observational checklist. After data was entered
to SPSS 23, frequency, percentage was computed, presented using tables and graphs, and Binary
logistic regression was analyzed to see the effect of the independent variables with dependent
variables by using Odds Ratio (OR) with 95% confidence interval with p-value of less than 0.05.
Result: The 61.5% (n=8/13)of public health facilities had policy criteria for selection and
procurement of laboratory commodities, 51.3% (n=7/13) of the laboratory stores met the
standard storage criteria’s which were the good features of supply chain management practices,
while in 77% (n=10/13) of public hospitals laboratory staffs had no access to training particularly
related to supply chain management, during the last six months and visit time 69.2% (n=9/12)
public hospitals encountered stock out reagents and controls of coagulation, hormonal, chemistry
tests, 69.2% (n=9/13) encountered suppliers misbehave during procurement, 61.5% (n=8/12)
public hospital laboratory had no work planned budgetary projections and in the 61.5% (n=8/12)
public hospitals the laboratory professionals were not involved in the procurement process.
73.5% (n=117/159) of participants indicated that the overall extent of supply chain management
of public hospital laboratories were not adequately practiced. 70.4 %( n=112/159), 73.6%
(n=117/159), 69.2% (n=110/159), 74.8% (n=119/159), 79.9% (n=127/159) of participants
indicated there was no adequate practice of logistics management, supplier relation management,
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customer relationship management, information sharing, and order fulfillment respectively. In
case of quality service provision in 84.6% (n=11/13) of public hospitals there was lack of
vaccine against Hepatitis B and 84.6% (n=11/13) of public hospital laboratories did not monitor
quality control for each tests on daily bases. Findings also revealed that 56% (n=89/159) of
laboratory professionals indicated that their laboratory did not provide timely services as per to
preset turnaround times, 57.9 % (n=92/159) of laboratory professionals indicated that their
laboratory did not provide reliable services, 63.3 % (n=101/159) of laboratory professionals
indicated that laboratory service provision was not as per to safety requirements. Logistic
regression showed the difference in supply chain management and quality due to educational
level, degree (AOR=0.25(0.07-0.84)), masters (AOR=0.19(0.04-0.86)). Practicing logistics
management (AOR=3.32, 95% CI= (1.4-8.0) and order fulfillment (AOR=3.56, 95 % CI=(1.329.56)
were
found 3.32 and 3.56 times more likely to provide the quality laboratory service than
those which did not practice it respectively.
Conclusion: Based on the study findings we can conclude that, the supply chain management
practices and provision of quality laboratory at public hospitals needs improvement to meet the
standard. Recruiting employee with higher education, practicing logistics management and order
fulfillment led to success in the provision of quality laboratory services. From observation, our
finding showed lack of training related to supply chain management, non-involvements of
laboratory professionals in purchasing, stock out of reagents and controls, supplier’s
misbehaving and absence of HB vaccine were major gaps in provision of quality of laboratory
services.
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Keywords
Supply chain management, Laboratory, Quality, Service.