Yusuff K B, Tayo F
Department of Clinical Pharmacy & Pharmacy Administration, Faculty of Pharmacy, University of Ibadan, Nigeria.
Afr J Med Med Sci. 2004 Dec;33(4):389-94.
The study set out to identify the strategies for public drug supply in Nigeria, assess its functionality, and recommend appropriate means to ensure regular availability of safe, efficacious, good quality and affordable essential drugs at public health facilities. The investigation was carried out at the Directorate of Pharmaceutical services, Federal Ministry of Health (F.M.O.H) Abuja and Federal Medical Stores, Oshodi, Lagos. Semi-structured interview was conducted with key informants at the Department of Food & Drugs, Drug procurement unit and Central Medical store using structured questionnaires and direct informants answers. Our study shows that public drug supply in Nigeria is governed by a National Drug Policy (NDP) which was introduced in 1990 and it is yet to be reviewed after ten years. We also identified the Central Medical Store (CMS) system as the current public drug supply strategy in Nigeria. Public drug supply is mainly financed by governments and this is inadequate to ensure sustained availability of essential drugs. The major procurement methods in use are open tender and direct procurement. These methods as presently operated suffer from late order placement, delay in payment and poor supplier lead-time mainly attributable to lateness in payment for previous drug supplies. These have contributed to stock out of essential drugs at public health facilities. Major losses due to expiration and spoilage are recorded at both central and peripheral storage points despite adequacy of storage facilities and personnel. Road transportation was the major mode of drug distribution from central to peripheral storage points and shortage of vehicle was a key factor affecting drug distribution. There was an apparent lack of a functioning drug management information system to effectively coordinate public drug supply and there are no definite systems that monitor and evaluate staff performance. The CMS strategy currently used for public drug supply in Nigeria has not ensured regular availability of essential drugs at public health facilities. Our study suggests that this is more of an administrative failure. Public drug supply in Nigeria is therefore in need of urgent reforms and this could be achieved through the use of an autonomous drug supply agency to assure efficiency and sustainability.
该研究旨在确定尼日利亚公共药品供应的策略，评估其功能，并推荐适当的方法，以确保公共卫生机构定期提供安全、有效、质量优良且价格合理的基本药物。调查在阿布贾联邦卫生部药品服务局以及拉各斯奥肖迪的联邦医疗用品商店进行。通过结构化问卷和直接询问受访者答案，对食品药品部、药品采购单位和中央医疗用品商店的关键信息提供者进行了半结构化访谈。我们的研究表明，尼日利亚的公共药品供应受1990年出台的《国家药品政策》（NDP）管辖，且十年后仍未进行审查。我们还确定中央医疗用品商店（CMS）系统是尼日利亚当前的公共药品供应策略。公共药品供应主要由政府资助，但这不足以确保基本药物的持续供应。目前使用的主要采购方法是公开招标和直接采购。目前这些方法存在订单下达延迟、付款延迟以及供应商交货时间不佳等问题，主要归因于之前药品供应付款延迟。这些因素导致公共卫生机构基本药物缺货。尽管储存设施和人员充足，但中央和周边储存点都记录了因过期和变质造成的重大损失。公路运输是药品从中央储存点到周边储存点的主要配送方式，车辆短缺是影响药品配送的关键因素。明显缺乏一个有效的药品管理信息系统来有效协调公共药品供应，也没有明确的系统来监督和评估员工绩效。目前尼日利亚用于公共药品供应的CMS策略未能确保公共卫生机构基本药物的定期供应。我们的研究表明，这更多是行政上的失败。因此，尼日利亚的公共药品供应急需改革，这可以通过设立一个自主的药品供应机构来确保效率和可持续性来实现。
