AIDS and Society Research Unit, Centre for Social Science Research, University of Cape Town, South Africa.
S Afr Med J. 2017 Aug 25;107(9):738-740. doi: 10.7196/SAMJ.2017.v107i9.12476.
Shortages of essential medicines are a daily occurrence in many of South Africa (SA)'s public health facilities. This study focuses on the responses of healthcare workers to stock-outs, investigating how actors at the 'front line' of public health delivery understand, experience and respond to shortages of essential medicines and equipment in their facilities. Findings are based on focus groups, observations and interviews with healthcare workers and patients at healthcare facilities in the Eastern Cape Province of SA, conducted as part of the Mzantsi Wakho study. The research revealed a discrepancy between 'informal' definitions of stock-outs and their reporting through formal stock-out management channels. Front-line healthcare workers had designed their own systems for classifying the severity of stock-outs, based on the product in question, and on their potential to access stocks from other facilities. Beyond formal systems of procurement and supply, healthcare workers had established vast networks of alternative communication and action, often using personal resources to procure medical supplies. Stock-outs were only reported when informal methods of stock-sharing did not secure top-up supplies. These findings have implications for understanding the frequency and severity of stock-outs, and for taking action to prevent and manage stock-outs effectively.
在南非（SA）的许多公共卫生机构中，基本药物短缺是每天都在发生的事情。本研究聚焦于医疗保健工作者对缺货的应对措施，调查在公共卫生服务的“前线”的参与者如何理解、经历和应对其设施中基本药物和设备的短缺。研究结果基于在南非东开普省的医疗机构中与医疗保健工作者和患者进行的焦点小组、观察和访谈，这是 Mzantsi Wakho 研究的一部分。研究揭示了“非正式”缺货定义与通过正式缺货管理渠道报告之间的差异。一线医疗保健工作者根据所涉及的产品以及从其他设施获取库存的潜力，自行设计了缺货严重程度的分类系统。除了采购和供应的正式系统外，医疗保健工作者还建立了广泛的替代沟通和行动网络，经常利用个人资源采购医疗用品。只有在非正式的库存共享方法未能确保补充供应时，才会报告缺货情况。这些发现对理解缺货的频率和严重程度以及采取行动有效预防和管理缺货具有重要意义。
