埃塞俄比亚南方各族州人民区域州医疗机构艾滋病毒/艾滋病商品的供应链管理绩效及其影响因素；从实现90-90-90策略的角度来看

Supply Chain Management Performance of HIV/AIDS Commodities and Factors Affecting It at Health Facilities of SNNPRS of Ethiopia; from the Perspective of Achieving 90-90-90 Strategies.

作者信息

Damtie Teklewold Abiye, Ibrahim Awol Jemal, Yikna Berhan Begashaw

机构信息

Department of Pharmacy, Arba Minch College of Health Science, Arba Minch, Ethiopia.

School of Pharmacy, Faculty of Health Science, Jimma University, Jimma, Ethiopia.

出版信息

Integr Pharm Res Pract. 2020 Jan 10;9:11-21. doi: 10.2147/IPRP.S228162. eCollection 2020.

DOI:10.2147/IPRP.S228162

PMID:32021834

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6966955/

Abstract

BACKGROUND

Health facilities (HFs) need an extensive range of antiretroviral (ARV) drugs and related HIV/AIDS commodities for diagnosis, prevention, and treatment of HIV/AIDS. This study was aimed to assess supply chain management performance from the perspective of achieving 90-90-90 treatment strategy at HFs of Southern Nations, Nationalities and People's Regional State (SNNPRS), Ethiopia.

METHODS

Facilities based cross sectional study design in 30 HFs (9 hospitals and 21 health centers) and five pharmaceuticals fund and supply agencies (PFSAs) was conducted. The HFs were selected randomly. Semi-structured questionnaires and observation checklists with logistic indicators assessment tools (LIATs) were used to collect data for HIV/AIDS related services from November 2016 to May 2017. In addition, we used in-depth face to face interview and thematic approach. Quantitative data were entered into Epi-Data version 3.1 and transported to SPSS version 20 to analyze the result. Qualitative data were analyzed using thematic approach.

RESULTS

Only 9 (30%) HFs had received their orders from PFSA on time from date of report. Average lead time for ARV drugs was 46.4 days in hospitals and 59.2 days in health centers (HCs). Sixteen (60.7%) HFs reported their completed report and requisition format (RRF). From this, 53.3% HFs order was refilled correctly in quantity from that they need. Inventory accuracy rate was 77%. Major HFs, 20 (66.7%) faced at least one-time emergency order for ARV drugs, HIV test kits and viral load (VL) supplies. Whereas, 9 (30%) hospitals and 5 (16.67%) HCs were out of stock two and three times respectively. Sixteen (53.3%) commodities stocked out at least once in six months. Nevirapine (NVP) 10 mg/5 mL in 240 mL was the most stocked out (13 times) for an average 22 days. Uni gold was stocked out (16 times) with average of 34.5 days. Wastage rate was 2.5%. Twenty-five (83.3%) facilities had good storage conditions (>80% to the standard).

CONCLUSION

Unsatisfactory data records, stock-outs, interrupted reports, inaccurate inventory and wastage rates were indicators for defective supply chain management of HIV/AIDS commodities. Respective organizations should improve their responsible activities to secure commodities availability.

摘要

背景

卫生设施需要种类繁多的抗逆转录病毒药物及相关艾滋病毒/艾滋病用品来诊断、预防和治疗艾滋病毒/艾滋病。本研究旨在从实现埃塞俄比亚南方各族州卫生设施90-90-90治疗策略的角度评估供应链管理绩效。

方法

在30个卫生设施（9家医院和21个卫生中心）和5家药品基金与供应机构开展基于机构的横断面研究设计。卫生设施通过随机抽样选取。采用半结构化问卷以及带有后勤指标评估工具的观察清单，收集2016年11月至2017年5月期间与艾滋病毒/艾滋病相关服务的数据。此外，还采用了深入的面对面访谈和主题分析法。定量数据录入Epi-Data 3.1版本，并传输至SPSS 20版本进行结果分析。定性数据采用主题分析法进行分析。

结果

自报告日期起，只有9家（30%）卫生设施按时收到了药品基金与供应机构的订单。医院抗逆转录病毒药物的平均交付周期为46.4天，卫生中心为59.2天。16家（60.7%）卫生设施提交了完整的报告和请购单格式。其中，53.3%的卫生设施的订单按所需数量正确补货。库存准确率为77%。20家（66.7%）主要卫生设施至少有一次抗逆转录病毒药物、艾滋病毒检测试剂盒和病毒载量用品的紧急订单。而9家（30%）医院和5家（16.67%）卫生中心分别出现过两次和三次缺货情况。16种（53.3%）商品在六个月内至少缺货一次。240毫升装10毫克/5毫升的奈韦拉平缺货最为频繁（13次），平均缺货22天。优尼康缺货16次，平均缺货34.5天。损耗率为2.5%。25家（83.3%）机构具备良好的储存条件（>标准的80%）。