Nagitta Oluka Pross, Mkansi Marcia, Nyesiga Sylvia Desire, Kajjumba George William
Department of Economics and Managerial Sciences, Uganda Management Institute, Kampala, Uganda.
Department of Operations Management, University of South Africa, Pretoria, South Africa.
Med Access Point Care. 2021 Dec 19;5:23992026211064711. doi: 10.1177/23992026211064711. eCollection 2021 Jan-Dec.
Malaria is a killer disease in the tropical environment; artemisinin-based combination therapies (ACTs) play a central role in treating malaria. Thus, the supply and presence of ACT drugs in hospitals are a key feature in the fight against malaria. Supply chain management literature has focused on the private sector, and less attention has been paid to the public sector, especially hospitals.
This study uses an interdisciplinary lens in investigating how to boost the supply and distribution of ACTs to save lives in low-income countries, specifically in Uganda.
The study adopted a quantitative research design using a questionnaire as the data collection instrument. Of the 440-population size, 304 of the sample population participated in the study. The model was estimated using structural equation modeling (SEM) to establish the causal relationship among the variables.
From the SEM analysis, all the hypotheses were significant at < 0.05. The availability of ACTs is strongly affected by strategic dimensions (0.612), followed by operation dimensions (0.257); strategic determinants significantly affect operational determinants by a magnitude of 0.599. The indirect influence of the strategic determinants via operational determinants on the availability of ACTs is not significant. Overall, the factors explained 63.9% of the observed variance in the availability of ACTs, and the ACT availability can be predicted as follows: ACT availability = 0.612 × strategic determinants + 0.256 × operation determinants. Top management commitment and organizational responsiveness are among the items that positively affect the availability of ACTs.
Strategically, hospital management should invest in cheap technology and software to minimize the unavailability of medicines. Our research suggests that strategic and operational determinants should be integrated into the hospitals' core business and implemented by the top management. The article contributes to theoretical and policy direction in the public sector medicine supply chain, specifically in public hospitals.
疟疾是热带环境中的一种致命疾病；以青蒿素为基础的联合疗法（ACTs）在治疗疟疾方面发挥着核心作用。因此，医院中ACT药物的供应和存在情况是抗击疟疾的关键特征。供应链管理文献主要关注私营部门，而对公共部门，尤其是医院的关注较少。
本研究采用跨学科视角，调查如何在低收入国家，特别是乌干达，促进ACTs的供应和分发以挽救生命。
本研究采用定量研究设计，以问卷作为数据收集工具。在440人的总体规模中，有304名样本参与了研究。使用结构方程模型（SEM）对模型进行估计，以确定变量之间的因果关系。
通过SEM分析，所有假设在<0.05时均具有显著性。ACTs的可获得性受到战略维度（0.612）的强烈影响，其次是运营维度（0.257）；战略决定因素对运营决定因素的显著影响程度为0.599。战略决定因素通过运营决定因素对ACTs可获得性的间接影响不显著。总体而言，这些因素解释了ACTs可获得性中63.9%的观察方差，ACTs的可获得性可预测如下：ACT可获得性 = 0.612×战略决定因素 + 0.256×运营决定因素。高层管理承诺和组织响应能力是对ACTs可获得性产生积极影响的因素。
从战略上讲，医院管理层应投资于廉价技术和软件，以尽量减少药品短缺情况。我们的研究表明，应将战略和运营决定因素纳入医院的核心业务，并由高层管理实施。本文为公共部门药品供应链，特别是公立医院的理论和政策方向做出了贡献。
