Perceptions of Barriers to Addressing Pharmaceutical Stockout in Timor-Leste

Abstract

Since 2005, stockout of pharmaceuticals has been a constant issue at all health services in Timor-Leste (TL). This study identifies factors that contribute to the ongoing pharmaceutical stockout as perceived by various stakeholders. A mixed-method approach was implemented, including face-to-face interviews with 46 Timorese health professionals involved in the pharmaceutical supply chain, along with documentational review and analysis. The field study was conducted in four locations (Dili, Liquiça, Aileu, and Ermera) from July to October 2018. This paper draws on qualitative accounts of participants' perceptions, which were investigated through an interview schedule in the Tetum language, with transcripts translated into English for analysis. The responses gathered were consistent among various groups of employees. Perceptions of stakeholder views on factors contributing to pharmaceutical stockout were identified. These included issues such as poor coordination, failure to adhere to policy guidelines, significant difficulties, and lack of knowledge with inventory management, quantification, forecasting, and budgetary constraints. A weak logistic management information system and a lack of capacity in inventory management resulted in a lack of reliable data. Other factors, such as political intervention, work ethics and lack of basic infrastructure, such as internet connectivity, were also reported by participants. The findings highlighted that there are multiple factors contributing to the ongoing pharmaceutical stockout. This may be addressed by implementing more culturally appropriate education and training on forecasting methods.