Berhanemeskel Eyerusalem, Beedemariam Gebremedhin, Fenta Teferi Gedif
Departement of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Ethiopia, P. O. Box: 1176, Addis Ababa, Ethiopia.
J Pharm Policy Pract. 2016 Mar 31;9:11. doi: 10.1186/s40545-016-0060-z. eCollection 2016.
A wide range of pharmaceutical products are needed for diagnosis, treatment, and prevention of HIV/AIDS. However, interrupted supplies and stock-outs are the major challenges in the supply chain of ARV medicines and related commodities. The aim of this study was to assess the supply chain management of HIV/AIDS related commodities in public health facilities of Addis Ababa, Ethiopia.
A descriptive cross-sectional survey complemented by qualitative method was conducted in 24 public health facilities (4 hospitals and 20 health centers). A semi-structured questionnaire and observation check list were used to collect data on HIV/AIDS related service, reporting and ordering; receiving, transportation and storage condition of ARV medicines and test kits; and supportive supervision and logistics management information system. In addition, in-depth interview with flexible probing techniques was used to complement the quantitative data with emphasis to the storage condition of ARV medicines and test kits. Quantitative data was analyzed using SPSS version-20. Analysis of qualitative data involved rigorous reading of transcripts in order to identify key themes and data was analyzed using thematic approach.
The study revealed that 16 health centers and one hospital had recorded and reported patient medication record. Six months prior to the study, 14 health centers and 2 hospitals had stopped VCT services for one time or more. Three hospitals and 18 health centers claimed to have been able to submit the requisition and report concerning ARV medicines to Pharmaceutical Fund and Supply Agency according to the specific reporting period. More than three-fourth of the health centers had one or more emergency order of ARV medicines on the day of visit, 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. Overall, nearly 3/4th of the health facilities faced stock-out of one or more ARV medicines and test kits on the day of visit.
There was no adequate data on patient medication record and stock status of HIV/AIDS related commodities. Moreover there were frequent stock-outs of ARV medicines and HIV test kits, which was an indicator of the weak supply chain management. Hospitals and health centers, therefore, should devise a system to capture and make use of patient medication record and stock status information so as to ensure continuous supply of the commodities.
诊断、治疗和预防艾滋病毒/艾滋病需要各种各样的药品。然而，供应中断和缺货是抗逆转录病毒药物及相关商品供应链中的主要挑战。本研究的目的是评估埃塞俄比亚亚的斯亚贝巴公共卫生机构中艾滋病毒/艾滋病相关商品的供应链管理情况。
在24个公共卫生机构（4家医院和20个健康中心）开展了一项描述性横断面调查，并辅以定性方法。采用半结构化问卷和观察检查表收集有关艾滋病毒/艾滋病相关服务、报告和订购情况；抗逆转录病毒药物和检测试剂盒的接收、运输和储存条件；以及支持性监督和物流管理信息系统的数据。此外，运用灵活的探测技术进行深入访谈，以补充定量数据，重点关注抗逆转录病毒药物和检测试剂盒的储存条件。定量数据使用SPSS 20版进行分析。定性数据分析包括对访谈记录进行仔细研读以确定关键主题，并采用主题分析法进行数据分析。
研究显示，16个健康中心和1家医院记录并报告了患者用药记录。在研究前六个月，14个健康中心和2家医院曾一度或多次停止自愿咨询检测服务。3家医院和18个健康中心称能够按照特定报告期向药品基金和供应机构提交有关抗逆转录病毒药物的请购单和报告。超过四分之三的健康中心在访视当天有一次或多次抗逆转录病毒药物紧急订单，而所有医院在研究前6个月内紧急订单超过3次。在过去6个月中，所有医院和近一半的健康中心检测试剂盒紧急订单超过3次。总体而言，近四分之三的卫生机构在访视当天面临一种或多种抗逆转录病毒药物和检测试剂盒缺货的情况。
关于患者用药记录和艾滋病毒/艾滋病相关商品库存状况的数据不足。此外，抗逆转录病毒药物和艾滋病毒检测试剂盒经常缺货，这表明供应链管理薄弱。因此，医院和健康中心应设计一个系统来获取并利用患者用药记录和库存状况信息，以确保商品的持续供应。
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