Hlaing Thein, Lat Tun Win
Township Public Health Department, Zigon Township, Bago Region, Myanmar.
Township Public Health Department, Paungde Township, Bago Region, Myanmar.
PLOS Glob Public Health. 2024 Sep 10;4(9):e0003692. doi: 10.1371/journal.pgph.0003692. eCollection 2024.
First-level public health facilities (PHFs) serve as primary providers of essential medicines, necessitating critical attention to drug availability and quality assurance. This study aimed to examine the status of functional areas within the drug supply chain management framework and assess the overall capability maturity at first-level PHFs. The cross-sectional study was conducted among 183 drug store sites from six townships of Pyay District. Only situational analysis was exercised to determine the existing situations. The overall capability maturity was determined according to the definitions of levels of the Capability Maturity Module Tool. 58.47% lacked formal drug supply management training, with 23.5% not undergoing performance reviews. Drug forecasting predominantly relied on a pen-paper system (91.6%) and factors like patient load (87.39%), drug consumption (85.71%), and disease prevalence (64.71%). Store site analysis revealed that 65.03% exhibited marginal capability, lacking standardized drugstores and employing unstandardized procedures. Storage practices varied, with 48.69% storing drugs conveniently and others categorizing them by drug type (32.79%) or using the first-expired-first-out system (40.98%). Approximately 42.69% reported having expired drugs. Concerning transportation costs, 37.16% incurred expenses exceeding 20,000 Kyats per time, with management staff often covering the costs. Waste management methods included burial pits (49.18%), incineration (62.84%), and sharp pits (55.19%). A majority (78.14%) used safety boxes, and 57.38% implemented a color-coded system for waste bins. The logistics management information system was entirely paper-based (100%). On average, assessments of drug quality conditions and physical damages scored 46.51% and 48.20%, respectively. The overall supply chain maturity at first-level public health facilities is at a marginal capability level (36.35%). While some basic drug supply chain management procedures were in place, they were not consistently followed, and many systems remain manual. The findings underscored significant inconsistencies in the management functions of supplied drugs, with poor adherence to Standard Operating Procedure guidelines.
一级公共卫生设施作为基本药物的主要供应者，必须高度关注药品供应和质量保证。本研究旨在考察药品供应链管理框架内各功能领域的状况，并评估一级公共卫生设施的整体能力成熟度。该横断面研究在勃生地区六个乡镇的183个药店网点开展。仅进行了现状分析以确定现有情况。根据能力成熟度模块工具的级别定义来确定整体能力成熟度。58.47%的网点缺乏正规的药品供应管理培训，23.5%未接受绩效评估。药品预测主要依赖纸笔系统（91.6%）以及诸如患者数量（87.39%）、药品消耗（85.71%）和疾病流行率（64.71%）等因素。药店网点分析显示，65.03%的网点能力处于边缘水平，缺乏标准化药店且采用非标准化程序。储存做法各不相同，48.69%的网点方便地储存药品，其他网点按药品类型分类储存（32.79%）或采用先进先出系统（40.98%）。约42.69%的网点报告有过期药品。关于运输成本，37.16%每次产生的费用超过20000缅元，费用通常由管理人员承担。废物管理方法包括掩埋坑（49.18%）、焚烧（62.84%）和利器坑（55.19%）。大多数（78.14%）使用安全箱，57.38%对垃圾桶实施了颜色编码系统。物流管理信息系统完全基于纸质（100%）。药品质量状况和物理损坏的评估平均得分分别为46.51%和48.20%。一级公共卫生设施的整体供应链成熟度处于边缘能力水平（36.35%）。虽然一些基本的药品供应链管理程序已经到位，但并未得到一致遵循，而且许多系统仍然是手工操作。研究结果凸显了所供应药品管理功能方面的重大不一致，对标准操作规程指南的遵守情况很差。
