Masembe Ishak Kamaradi
Nkumba University, School of Post Graduate Studies and Research , Uganda.
J Public Health Afr. 2016 Dec 31;7(2):558. doi: 10.4081/jphia.2016.558.
This study was an analysis of the effect of strategic planning on procurement of medicals in Uganda's regional referral hospitals (RRH's). Medicals were defined as essential medicines, medical devices and medical equipment. The Ministry of Health (MOH) has been carrying out strategic planning for the last 15 years via the Health Sector Strategic Plans. Their assumption was that strategic planning would translate to strategic procurement and consequently, availability of medicals in the RRH's. However, despite the existence of these plans, there have been many complaints about expired drugs and shortages in RRH's. For this purpose, a third variable was important because it served the role of mediation. A questionnaire was used to obtain information on perceptions of 206 respondents who were selected using simple random sampling. 8 key informant interviews were held, 2 in each RRH. 4 Focus Group Discussions were held, 1 for each RRH, and between 5 and 8 staff took part as discussants for approximately three hours. The findings suggested that strategic planning was affected by funding to approximately 34% while the relationship between funding and procurement was 35%. The direct relationship between strategic planning and procurement was 18%. However when the total causal effect was computed it turned out that strategic planning and the related variable of funding contributed 77% to procurement of medicals under the current hierarchical model where MOH is charged with development of strategic plans for the entire health sector. Since even with this contribution there were complaints, the study proposed a new model called CALF which according to a simulation, if adopted by MOH, strategic planning would contribute 87% to effectiveness in procurement of medicals.
本研究分析了战略规划对乌干达地区转诊医院(RRH)医疗用品采购的影响。医疗用品定义为基本药物、医疗设备和医疗器械。在过去15年里,卫生部(MOH)一直通过卫生部门战略计划开展战略规划。他们的假设是,战略规划将转化为战略采购,从而使RRH能够获得医疗用品。然而,尽管有这些计划,但关于RRH存在过期药品和药品短缺的投诉却很多。为此,第三个变量很重要,因为它起到了调解作用。通过问卷调查收集了206名采用简单随机抽样法选取的受访者的看法信息。进行了8次关键 informant访谈,每个RRH进行2次。举行了4次焦点小组讨论,每个RRH进行1次,5至8名工作人员作为讨论者参与,讨论持续约三个小时。研究结果表明,战略规划受资金影响的比例约为34%,而资金与采购之间的关系为35%。战略规划与采购之间的直接关系为18%。然而,当计算总因果效应时发现,在卫生部负责制定整个卫生部门战略计划的当前层级模式下,战略规划和相关的资金变量对医疗用品采购的贡献率为77%。由于即便有这样的贡献率仍存在投诉,该研究提出了一种名为CALF的新模型,根据模拟结果,如果卫生部采用该模型,战略规划对医疗用品采购有效性的贡献率将达到87%。