Walker Josephine, Chaar Betty B, Vera Numa, Pillai Alvish S, Lim Jessy S, Bero Lisa, Moles Rebekah J
Faculty of Pharmacy, University of Sydney, Sydney, Australia.
College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji.
PLoS One. 2017 Jun 5;12(6):e0178429. doi: 10.1371/journal.pone.0178429. eCollection 2017.
Medicine access is a human right; yet, concerningly, there are international instances of shortages. Quantitative data has allowed WHO to propose global solutions; however, individualised understanding of specific regions is still required to work towards national solutions. Fiji has an established issue with medication supply and the aim of this study was to use qualitative methods to gain a fuller understanding of this context.
Semi-structured interviews were used to gain the perspective of key stakeholders involved in the Fijian medicine supply chain in regards to causes, impacts and possible solutions of medicine shortages. Thematic analysis was used to analyse the interview data.
In total, 48 stakeholders participated and the information was synthesised into three main themes, causes, impacts and solutions and the sub-themes including; political, system and patient causes, adverse health effects on patients, professional dissatisfaction, monetary loss and loss of faith in the health system, workarounds, operation improvements, government intervention and education and training.
The situation in Fiji is not dissimilar to other instances of shortages around the world and hence international solutions like that proposed by WHO are feasible; however, they must be modified to be uniquely Fijian to work in this context.
获取药品是一项人权;然而,令人担忧的是,国际上存在药品短缺的情况。定量数据使世界卫生组织能够提出全球解决方案;然而,为了制定国家层面的解决方案,仍需要对特定地区进行个性化的了解。斐济存在药品供应方面的既定问题,本研究的目的是运用定性方法更全面地了解这一情况。
采用半结构化访谈,以了解斐济药品供应链中关键利益相关者对药品短缺的原因、影响及可能解决方案的看法。采用主题分析法对访谈数据进行分析。
共有48名利益相关者参与,信息综合为三个主要主题,即原因、影响和解决方案,以及子主题,包括政治、系统和患者原因,对患者的不良健康影响,职业不满,金钱损失以及对卫生系统的信心丧失,变通方法,运营改进,政府干预以及教育培训。
斐济的情况与世界其他药品短缺情况并无不同,因此世界卫生组织提出的国际解决方案是可行的;然而,必须进行调整以使其具有斐济特色,才能在此背景下发挥作用。