Hakuzimana Theogene, Kayumba Pierre Claver, Hahirwa Innocent, Kabalisa Max
EAC Regional Centre of Excellence for Vaccines, Immunization, and Health Supply Chain Management, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
Ministry of Health, Kigali, Rwanda.
Rwanda J Med Health Sci. 2021 Sep 10;4(2):281-291. doi: 10.4314/rjmhs.v4i2.7. eCollection 2021 Sep.
Regardless of the significant efforts used and put in place to enhance supply chain performance in Rwanda, there is still poor inventory management and big loss due to expiry of medicines at Medical Procurement and Production Division (MPPD).
To assess the factors that contributes to expiry of medicines at MPPD and formulate recommendations for the improvement of the current situation.
This is a descriptive cross-sectional study used for 25 respondents. A questionnaire containing closed-ended questions was used focusing on factors contributing to expiries of medicines for each product category managed by MPPD from 2014-2018. Additionally, the researcher reviewed all inventory reports, including expiries for the same period under study. The study focused on targeting respondents working at MPPD as pharmacists both technical and administrative, also other non-pharmacist working in the warehouse were considered as respondents. The hard copy of questionnaire was handed over to 26 respondents and requested to provide filled questionnaire within seven days. Twenty-five respondents were able to return the filled questionnaire on time, giving 96% response rate.
The study found that in MPPD, medicines are still expiring. During five years (from 2014 up to 2018) the total expired products were valued at RWF 6,046,778,655 for all program categories: HIV commodities had the largest share 53.3%, Essential Medicines 22.5%, Malaria 13%, Maternal Child Health commodities 5.7%, Products used for Community health workers 4.5%, TB products 1% and 0.1% for Family Planning products. The study found that major contributing factors for expiry of health commodities at MPPD, are ranked as follows: Supply chain management 90%, other factors 73%, Poor storage management 68% and Excessive drug supply 67%.
Considering the study results, it looks like no significant effect of excessive drug supply and inventory management on the expiration of medicines at MPPD. However, the Supply Chain Management components are the most vulnerable to contribute to the expiration of medicines at MPPD. There are many changes to be done inside the institution to remedy the issue of expiration like working according to the standard operating procedures, improving the Skills of personnel in supply chain management, empowering the procurement unit with skilled personnel and improving the communication with stakeholders to facilitate the smooth and quick replenishment and distribution of the stock.
尽管卢旺达为提高供应链绩效付出了巨大努力并采取了相应措施，但医疗采购与生产司（MPPD）仍存在库存管理不善以及药品过期导致的重大损失问题。
评估导致MPPD药品过期的因素，并为改善当前状况制定建议。
这是一项针对25名受访者的描述性横断面研究。使用了一份包含封闭式问题的问卷，重点关注2014 - 2018年MPPD管理的每个产品类别中导致药品过期的因素。此外，研究人员审查了所有库存报告，包括研究期间的过期情况。该研究的目标受访者包括MPPD的药剂师（技术和行政人员）以及仓库中的其他非药剂师工作人员。问卷纸质版已交给26名受访者，并要求他们在七天内提供填写好的问卷。25名受访者按时返回了填写好的问卷，回复率为96%。
研究发现，在MPPD，药品仍在过期。在五年期间（2014年至2018年），所有项目类别的过期产品总价值为6046778655卢旺达法郎：艾滋病毒相关商品占比最大，为53.3%，基本药物占22.5%，疟疾药物占13%，母婴健康商品占5.7%，社区卫生工作者使用的产品占4.5%，结核病产品占1%，计划生育产品占0.1%。研究发现，MPPD卫生商品过期的主要促成因素排名如下：供应链管理占90%，其他因素占73%，储存管理不善占68%，药品供应过多占67%。
考虑到研究结果，药品供应过多和库存管理对MPPD药品过期似乎没有显著影响。然而，供应链管理环节最容易导致MPPD药品过期。该机构内部需要进行许多变革来解决药品过期问题，例如按照标准操作程序工作、提高供应链管理人员的技能、为采购部门配备技术熟练的人员以及改善与利益相关者的沟通，以促进库存的顺利快速补充和分发。
