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埃塞俄比亚奥罗米亚地区阿姆哈拉地区公共卫生设施中抗疟疾药品库存控制系统的做法及相关挑战。

Practices of anti-malaria pharmaceuticals inventory control system and associated challenges in public health facilities of Oromiya special zone, Amhara region, Ethiopia.

机构信息

Ethiopian Pharmaceuticals Supply Agency, Dessie hub, Dessie, Ethiopia.

Department of Pharmacy, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia.

出版信息

BMC Public Health. 2021 Nov 6;21(1):2026. doi: 10.1186/s12889-021-12033-8.

DOI:10.1186/s12889-021-12033-8
PMID:34742282
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8572494/
Abstract

BACKGROUND

Anti-malaria pharmaceuticals inventory control system helps to maintain an appropriate stock level using logistics management information system records and reports. Antimalaria pharmaceuticals are highly influenced by seasonality and demand variation. Thus, to compensate the seasonality, resupply quantities should be adjusted by multiplying the historical consumption with the Look-ahead seasonality indexes (LSI) to minimize stock-outs during the peak transmission season and overstocks (possible expiries) during off-peak seasons The purpose of this study was to assess anti-malaria pharmaceuticals inventory control practice and associated challenges in public health facilities of the Oromiya special zone, Amhara region, Ethiopia.

METHODOLOGY

Facility-based cross-sectional study design employing both quantitative and qualitative methods, explanatory sequential mixed method, of data collection and analysis was used in all public health facilities in the Oromia special zone from September 1 to September 30, 2019. The study was conducted in 27 health centers and 2 hospitals, the dispensing units managing anti-malaria pharmaceuticals and data was collected using observation checklists The quantitative data were analyzed by Statistical package for social sciences using linear regression. Purposive sampling was used to select key informants and 12 in-depth interviews were conducted by the principal investigator. Thematic analysis was performed using Nvivo 11 plus and interpretation by narrative strategies.

RESULTS

The quantitative finding in this study revealed that none of the health facilities surveyed calculated months of stock and multiplied the historical consumption with look ahead seasonal indices (LSI) to forecast the upcoming year consumptions.. Average months of stock of anti-malaria pharmaceuticals were 5.32 months with the annual wastage rate of 11.32%. The point and periodic availability of anti-malaria pharmaceuticals was 72.38 and 77.03% respectively. The number of stocks out days within the previous 6 months was 41.34 days. The study also reported bin card usage (β = - 3.5, p = 0.04) and availability of daily dispensing register (β = - 2.7, p = 0.005) had statistically significant effect on anti-malaria pharmaceuticals inventory control practice. The perceived challenges attributed to the poor anti-malaria pharmaceuticals inventory control practice were lack of integrated pharmaceutical logistics system training, management support, inadequate and near expiry supply from pharmaceuticals supply agency, job dissatisfaction, and staff turnover.

CONCLUSION

Inventory control practices for anti-malaria pharmaceuticals was poor as indicated by maximum stock level and none of the health facilities calculated months of stock and the previous consumption was not multiplied by look ahead seasonal indices to compensate the seasonal and demand variation. Efforts should be under-taken by concerned bodies to improve inventory control practice; such as training and regular follow up have to be provided to the health professionals managing anti-malaria pharmaceuticals.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/118e/8572494/4c096bbbe728/12889_2021_12033_Fig6_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/118e/8572494/4405bb3dbe94/12889_2021_12033_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/118e/8572494/4c096bbbe728/12889_2021_12033_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/118e/8572494/4abc867da903/12889_2021_12033_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/118e/8572494/81adeec09667/12889_2021_12033_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/118e/8572494/b87fd6f61a27/12889_2021_12033_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/118e/8572494/07a9dd7e6c8a/12889_2021_12033_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/118e/8572494/4405bb3dbe94/12889_2021_12033_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/118e/8572494/4c096bbbe728/12889_2021_12033_Fig6_HTML.jpg
摘要

背景

抗疟药品库存控制系统有助于利用物流管理信息系统记录和报告维持适当的库存水平。抗疟药品受季节性和需求变化的影响很大。因此,为了弥补季节性,应通过将历史消耗量乘以前瞻性季节性指数(LSI)来调整补货数量,以在高峰传播季节最小化缺货量,并在淡季(可能过期)中避免库存过多。本研究旨在评估埃塞俄比亚奥罗米亚特别行政区公共卫生机构的抗疟药品库存控制实践和相关挑战。

方法

2019 年 9 月 1 日至 9 月 30 日,在奥罗米亚特别行政区的所有公共卫生机构中采用定量和定性方法、解释性顺序混合方法进行了基于设施的横断面研究设计。该研究在 27 个卫生中心和 2 家医院进行,管理抗疟药品的配药单位使用观察清单进行数据收集。定量数据采用社会科学统计软件包进行线性回归分析。采用目的性抽样选择关键信息提供者,并由主要调查员进行 12 次深入访谈。使用 Nvivo 11 plus 进行主题分析,并通过叙述策略进行解释。

结果

本研究的定量结果表明,在所调查的卫生设施中,没有一个设施计算了库存月份,并将历史消耗量乘以前瞻性季节性指数(LSI)来预测来年的消耗量。抗疟药品的平均库存月份为 5.32 个月,年损耗率为 11.32%。抗疟药品的即时和定期可得性分别为 72.38%和 77.03%。在过去 6 个月内,缺货天数为 41.34 天。研究还报告说,药柜使用(β=-3.5,p=0.04)和每日配药登记册的可用性(β=-2.7,p=0.005)对抗疟药品库存控制实践有统计学上的显著影响。归因于抗疟药品库存控制实践不佳的感知挑战包括缺乏综合药品物流系统培训、管理支持、药品供应机构供应不足且接近过期、工作不满和员工流失。

结论

抗疟药品的库存控制实践很差,表现为最高库存水平,没有一个卫生设施计算库存月份,并且没有将以前的消耗量乘以前瞻性季节性指数来补偿季节性和需求变化。有关机构应努力改善库存控制实践;例如,必须向管理抗疟药品的卫生专业人员提供培训和定期跟进。

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本文引用的文献

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Factors contributing to medicines wastage in public health facilities of South West Shoa Zone, Oromia Regional State, Ethiopia: a qualitative study.埃塞俄比亚奥罗米亚州西南绍阿地区公共卫生设施中药物浪费的影响因素:一项定性研究
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Logistics management information system performance for program drugs in public health facilities of East Wollega Zone, Oromia regional state, Ethiopia.埃塞俄比亚奥罗米亚州东沃洛格地区公共卫生设施规划药物的物流管理信息系统绩效。
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