Assessing factors associated with essential medicine availability at primary health care facilities in KwaZulu Natal, South Africa
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Date
2023
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University of the Western Cape
Abstract
Background: The unavailability of and lack of access to essential medicines are associated with negative health outcomes contributing to morbidity and mortality.
Aim: This study aimed to discuss the availability of essential medicines by assessing how the presence of pharmacist assistants, their knowledge, skills, and the effect of manual vs electronic inventory management systems affect access to essential medicines in Primary Health Care (PHC) facilities in uMgungundlovu district, KwaZulu Natal, South Africa.
Methodology: A prospective descriptive cross-sectional study was conducted using an interviewer-administered structured questionnaire in 44 PHC facilities. Stata (Version 17) and R software environments were used for statistical analyses. Categorical variables were summarized using frequencies, percentages, and frequency tables. Continuous numeric variables were summarized using mean values and standard deviations. Variation among the PHCs was computed and reported using the coefficient of variation. Fisher’s exact test was used to assess the relationship between variables, and the multiple linear regression model was used to assess the influence of independent variables on the dependent variable.
Results: Of the 44 participants, most participants (63.6%, n=28) were aged between 31-40 years, and 52.3% (n=23) were females. Seventy-five percent (n=33) of the participants were Post-Basic Pharmacist Assistants (PBPA). There were no differences in inventory management practices’ performances in facilities with and those without pharmacist assistants. Facilities using electronic inventory management systems had an overall performance of 70.3% (n=28), while those using manual inventory management systems scored 60.2% (n=16). In multiple regression model a change from age category 18-30 years into category 41-50 years increased medicine availability by 0.25 points to a unit (Est B: 0.25; 95%CI: 0.02 - 0.48; p: 0.036). Likewise, moving from a manual inventory management system to an electronic inventory management system increased medicine availability by 0.44 points to a unit (Est B: 0.44; 95%CI: 0.12 - 0.75; p: 0.009). Essential medicines were not adequately available in the uMgungundlovu district.
Conclusion: Factors influencing availability of essential medicines are multidimensional; involving an interplay of behavioral, structural, and institutional factors. Therefore, investments in infrastructure, capacity building, and training are required to improve availability of and access to essential medicines.
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Keywords
Medicine Supply, Stock Management, Stock-Outs, Primary Health Care, Standard Operating Procedures