Drugs In Health Facilities Research Articles

Determinants of stock-outs of first line anti-tuberculosis drugs: the case of public health facilities of Addis Ababa city administration health bureau, Addis Ababa, Ethiopia

BackgroundThe health sectors success has been determined by consistent and reasonably priced health commodities supply. Despite possible death from the disease, Tuberculosis (TB) can be prevented with early diagnosis and appropriate treatment for which enough, effective, and qualified medicines need to be available. However, studies revealed stock of anti-TB drugs in health facilities. Here we present the recent finding on determinants of stock out of Anti-TB drug at public health facilities of Addis Ababa.ObjectiveThis study aimed to identify determinants of stock outs of first line anti TB drugs at public health facilities under Addis Ababa City Administration Health Bureau.MethodMixed study design were employed. A total of 106 facilities were included in the sampling frame and data were collected from the study population such as drug store managers of health facilities providing TB treatment using semi structured questionnaire and through in-depth interview with Addis Ababa hubs of the Ethiopian Pharmaceuticals Supply Agency (EPSA), Addis Ababa City Administration Health Bureau and selected heads of pharmacy departments of health facilities from May 1–30, 2020 considering one year back retrospective data from March 20,2019 to March 20,2020. Structured record review of data from Logistics Management Information System (LMIS) tools having TB drugs was done using structured observation checklist. Data were entered, cleaned, and analyzed using SPSS Version 20. Both descriptive and multiple logistic regression analysis were performed.Result52(62.7%) of health facilities encountered stock out for at least one of these drugs during the past 1 year. Rifampicin 75 mg + Isoniazid 50 mg (RH 75/50 mg) were most stocked out first line anti-TB drug from 33(39.8%) of facilities with 17 mean stocks out days while Rifampicin 75 mg + Isoniazid 50 mg + Pyrazinamide 150 mg (RHZ 75/50/150 mg) were the least first line anti-TB drug stocked out from facilities with mean 5 days of stock out. Delayed supply of anti TB drug from EPSA, delivery of reduced quantity of anti TB drugs by EPSA and stocked out of anti TB Drugs at EPSA were significant determinate factors of stock out of first line anti-TB drug from facilities with 95%CI of 10.34(2.167–49.329), 11.452(2.183–60.079) and 5.646(1.240–25.707) respectively.ConclusionAbove median of health facilities encountered stock out of first line anti-TB drug in Addis Ababa. Delayed supply of anti TB drug from EPSA, delivery of reduced quantity of anti TB drugs by EPSA and stocked out of anti TB Drugs at EPSA were significant determinate factor of stocked out of first line anti-TB drug from facilities. EPSA and other responsible bodies shall work collaboratively to improve their service and ensure availability of adequate amount of Anti TB drug in health facilities.

Profil Peresepan Antipsikosis di Unit Rawat Jalan Rumah Sakit Mitra Keluarga Bekasi Timur Periode April – Mei 2021

One of the global burdens currently engulfing the world is the COVID-19 pandemic. But before COVID-19 was declared a pandemic by the WHO, the world was struggling with the global burden of mental disorders. WHO states that depression and anxiety are mental disorders with the highest frequency. Mental disorders are one of the health problems that often go unnoticed. To treat mental disorders, antipsychotic therapy is needed which can be obtained at various health facilities, one of which is the Mitra Keluarga Hospital, East Bekasi, which serves patients with mental disorders. Antipsychotics are useful in the therapy of acute and chronic psychosis, a mental disorder such as dreams and imaginary thoughts (hallucinations) and normalize abnormal behavior. The purpose of this study was to determine the profile of antipsychotic prescribing in the pharmacy outpatient unit at Mitra Keluarga Hospital, East Bekasi for the period April – May 2021. This study was conducted using a quantitative descriptive method by taking primary data from doctor's prescriptions containing antipsychotics. The results obtained can see the profile of the most widely used antipsychotic prescribing based on the active substance, drug class, drugs used concurrently with antipsychotic drugs and the most widely used antipsychotic drugs by gender. The final analysis results obtained can assist in the procurement of antipsychotic drugs in health facilities.

Monitoring of Drug Planning and Procurement in Lubuk linggau City Health Department in 2021

For monitoring the planning and procurement of drugs, complete and accurate data and information are needed from the central, provincial, district and health facilities. Especially with the implementation of the JKN program, which has the potential to increase the need for drugs in health facilities. The purpose of the study is to describe the process of planning and procuring drugs from the health office and formulate solutions to increase the availability of drugs from the Lubuklinggau City Health Office. The methods of The research is qualitative. Then This research was conducted at the Pharmaceutical Technical Service Unit of the Lubuklinggau City Health Office with 10 informants. The research was conducted from October to November 2021 in the working area of the Lubuklinggau City Health Office. The results of the study were that it was found that the Pharmacy Installation and Public health center in the scope of the Lubuklinggau City Health Office in 2021 experienced a drug void. Furthermore, the planning process has been carried out by the Integrated Drug Planning Team but is not optimal. The drug procurement process uses the e-catalog method in accordance with the Decree of the Minister of Health of the Republic of Indonesia No. 1121/MENKES/SK/XII/2008. The conclusion is that drug management at the Lubuklinggau City Health Office has been in accordance with Kepmenkes No. 1121 of 2008 but has not been maximized. It is hoped that the Lubuklinggau City Health Office can accommodate all types of drugs rationally according to the drug needs of the public health center.

Essential Drugs Inadequacy is an Impediment to Utilization of Universal Health Coverage; the Case of Seme Sub-County in Kisumu County, Kenya

Introduction: Many countries have been putting more effort in Universal Health Coverage through strengthening health systems to provide affordable, safe and high quality care. The Kenya government prioritized attainment of Universal Health Coverage which aimed at cushioning citizens against out of pocket expenditure on health services, though faced with challenges of staffing and inadequate medical supplies for proper implementation. Aim: This was a descriptive cross sectional study design which examined the factors influencing utilization of Universal Health Coverage utilization in Seme Sub County. Subject and Methods: The study targeted both community members and health facility managers. The health facilities were stratified according to their levels of care and randomly selected. The catchment population was stratified by administrative locations and a proportionate sampling technique applied giving a computed sample size of 377 participants, determined by Fischer’s formula. The descriptive statistics were organized and summarized using tables and charts, while logistic regression analysis determined relationship between variables. Results: The study revealed that availability of essential drugs in health facilities contributed positively in utilization of UHC as the availability of drugs in health facility is 2.52 times more likely to make people solely use UHC (OR=2.52, 95%CI=1.36- 4.69, p<0.05). Conclusion: Essential drugs have direct significant influence on utilization of UHC services by community members. Considerable progress will only to materialize through improved supply of adequate essential drugs and procurement of essential medical equipment in the government health facilities in Kisumu County.

ANALISIS FAKTOR YANG BERPENGARUH TERHADAP KONVERSI SPUTUM BASIL TAHAN ASAM PADA PENDERITA TUBERKULOSIS

Tuberculosis (TB) is caused by bacteria (Mycobacterium tuberculosis) that most often affect the lungs. The incidence of tuberculosis in Indonesia is high because the success rate of tuberculosis treatment has decreased which causes the chain of transmission continues to occur. The main government programs to decrese the incidence and increasing the success treatment with the Directly Observed Treatment (DOTS) program. One important indicator of the DOTS program to assessing the success of tuberculosis treatment is the conversion of positive AFB sputum to negative at the end of the intensive phase of treatment. AFB sputum conversion to negative at the end of the intensive phase of treatment is influenced by several internal factors such as level of education and income, gender, adherence, patient's nutritional status, and comorbidities. Then external factors can also influence the AFB sputum conversion in anti-tuberculosis treatment such as environmental conditions, smear positivity, drug taking supervisors (PMO), and availability of drugs in health facilities.

Analysis of Cardiovascular Drugs Inventory Control Using ABC-EOQ-ROP-SS Method at Jakarta Islamic Hospital

Cardiovascular disease was still a global threat and give a major role as the number one cause of death in the world. Patients with CVDs should take the medication regularly so that the availability of these drugs in health facilities must be maintained. And then, Cardiovascular drugs were the highest usage costs during 2019, which is around Rp. 6,924,415,718.20 (22.62%) so that it requires special attention to control the inventory. The object of this research was to determine the implementation of cardiovascular drug inventory control using ABC-EOQ-ROP-SS method to minimize the stock inventory, while maintaining the service level. This research used a non-experimental comparative method with retrospective cardiovascular drug data collection in 2019. Data obtained through the documentation of the Pharmacy Installation section and the logistics section. The data were analyzed to determine the cost efficiency of cardiovascular drugs using the ABC-EOQ-ROP-SS method compared to actual data for drug orders in January-December 2019 .The results of ABC-EOQ-ROP-SS methods in controlling cardiovascular drugs can be implemented by the Jakarta Islamic Hospital to minimize stock inventory, while maintaining the service level and can increase the total cost efficiency up to 17,91% of the actual order .

Multiple-Strain Malaria Infection and Its Impacts on Plasmodium falciparum Resistance to Antimalarial Therapy: A Mathematical Modelling Perspective.

The emergence of parasite resistance to antimalarial drugs has contributed significantly to global human mortality and morbidity due to malaria infection. The impacts of multiple-strain malarial parasite infection have further generated a lot of scientific interest. In this paper, we demonstrate, using the epidemiological model, the effects of parasite resistance and competition between the strains on the dynamics and control of Plasmodium falciparum malaria. The analysed model has a trivial equilibrium point which is locally asymptotically stable when the parasite's effective reproduction number is less than unity. Using contour plots, we observed that the efficacy of antimalarial drugs used, the rate of development of resistance, and the rate of infection by merozoites are the most important parameters in the multiple-strain P. falciparum infection and control model. Although the drug-resistant strain is shown to be less fit, the presence of both strains in the human host has a huge impact on the cost and success of antimalarial treatment. To reduce the emergence of resistant strains, it is vital that only effective antimalarial drugs are administered to patients in hospitals, especially in malaria-endemic regions. Our results emphasize the call for regular and strict surveillance on the use and distribution of antimalarial drugs in health facilities in malaria-endemic countries.

Situation analysis of healthcare service delivery using geographically weighted regression: (A case study of Sironko District, Eastern Uganda)

Geography plays an important role in planning and allocation of healthcare resources for an effective and efficient health system. Lack of statistical information analyzed using geostatistical tools then becomes a major bottleneck to proper planning and policy formulation in healthcare delivery. This study sought to compare existing health staffing, funding and medical supplies data given minimal national healthcare package, spatially explore the relationship between health service utilization and gaps in resource allocation, and to develop propositions to support the health policy. Facility survey and secondary data collection from the District Health Office and the Ministry of Health were utilized. Geographically Weighted Regression was used to spatially explore the relationships between Out-patient department attendance and gaps in health funding, staffing and stock-out days for essential drugs in health facilities. Global Moran’s I test was performed on the standard residuals to statistically test for their randomness. The analysis yielded local parameter estimates which were mapped to reveal the spatial variation of the relationships. There was strong influence of facility allocation gap in the North West diminishing towards South East, Strong negative influence of the staffing gap in the South West diminishing eastwards, and High influence of Stock-Out days in the South compared to the South West. Basing on the observations, the study proposed increased health vote while revising allocation based more on need other than solely on budgetary allocation of funds, increased staffing and providence of incentives for disadvantaged areas, and monitoring of drug supply and dispensing at health centres.

Factors That Influence Enrolment and Retention in Ghana' National Health Insurance Scheme.

Background: The government of Ghana introduced the National Health Insurance Scheme (NHIS) in 2004 with the goal of achieving universal coverage within 5 years. Evidence, however, shows that expanding NHIS coverage and especially retaining members have remained a challenge. A multilevel perspective was employed as a conceptual framework and methodological tool to examine why enrolment and retention in the NHIS remains low. Methods: A household survey was conducted after 20 months educational and promotional activities aimed at improving enrolment and retention rates in 15 communities in the Central and Eastern Regions (ERs) of Ghana. Observation, indepth interviews and informal conversations were used to collect qualitative data. Forty key informants (community members, health providers and district health insurance schemes’ [DHISs] staff) purposely selected from two casestudy communities in the Central Region (CR) were interviewed. Several community members, health providers and DHISs’ staff were also engaged in informal conversations in the other five communities in the region. Also, four staff of the Ministry of Health (MoH), Ghana Health Service (GHS) and National Health Insurance Authority (NHIA) were engaged in in-depth interviews. Descriptive statistics was used to analyse quantitative data. Qualitative data was analysed using thematic content analysis. Results: The results show that factors that influence enrolment and retention in the NHIS are multi-dimensional and cut across all stakeholders. People enrolled and renewed their membership because of NHIS’ benefits and health providers’ positive behaviour. Barriers to enrolment and retention included: poverty, traditional risk-sharing arrangements influence people to enrol or renew their membership only when they need healthcare, dissatisfaction about health providers’ behaviour and service delivery challenges. Conclusion: Given the multi-dimensional nature of barriers to enrolment and retention, we suggest that the NHIA should engage DHISs, health providers and other stakeholders to develop and implement intervention activities to eliminate corruption, shortage of drugs in health facilities and enforce the compulsory enrolment stated in the NHIS policy to move the scheme towards universal coverage.

Devolution and its effects on health workforce and commodities management \u2013 early implementation experiences in Kilifi County, Kenya

BackgroundDecentralisation is argued to promote community participation, accountability, technical efficiency, and equity in the management of resources, and has been a recurring theme in health system reforms for several decades. In 2010, Kenya passed a new constitution that introduced 47 semi-autonomous county governments, with substantial transfer of responsibility for health service delivery from the central government to these counties. Focusing on two key elements of the health system, Human Resources for Health (HRH) and Essential Medicines and Medical Supplies (EMMS) management, we analysed the early implementation experiences of this major governance reform at county level.MethodsWe employed a qualitative case study design, focusing on Kilifi County, and adapted the decision space framework developed by Bossert et al., to guide our inquiry and analysis. Data were collected through document reviews, key informant interviews, and participant and non-participant observations between December 2012 and December 2014.ResultsAs with other county level functions, HRH and EMMS management functions were rapidly transferred to counties before appropriate county-level structures and adequate capacity to undertake these functions were in place. For HRH, this led to major disruptions in staff salary payments, political interference with HRH management functions and confusion over HRH management roles. There was also lack of clarity over specific roles and responsibilities at county and national government, and of key players at each level. Subsequently health worker strikes and mass resignations were witnessed. With EMMS, significant delays in procurement led to long stock-outs of essential drugs in health facilities. However, when the county finally managed to procure drugs, health facilities reported a better order fill-rate compared to the period prior to devolution.ConclusionThe devolved government system in Kenya has significantly increased county level decision-space for HRH and EMMS management functions. However, harnessing the full potential benefits of this increased autonomy requires targeted interventions to clarify the roles and responsibilities of different actors at all levels of the new system, and to build capacity of the counties to undertake certain specific HRH and EMMS management tasks. Capacity considerations should always be central when designing health sector decentralisation policies.

Preventive Chemotherapy Versus Innovative and Intensified Disease Management in Neglected Tropical Diseases: A Distinction Whose Shelf Life Has Expired.

Preventive Chemotherapy Versus Innovative and Intensified Disease Management in Neglected Tropical Diseases: A Distinction Whose Shelf Life Has Expired.

Is insufficient knowledge of epilepsy the reason for low levels of healthcare in the Lao PDR?

BackgroundThe treatment gap for epilepsy is considerable in low and middle-income countries. In the Lao PDR it is estimated at over 90%. Health workers play a significant role in bridging the gap between people with epilepsy (PWE) and access to epilepsy care. In a national survey we assessed: 1) the knowledge and practices of health workers in the Lao PDR towards the disease, and, 2) patient attendance at health facilities.MethodsWe conducted a random three-stage sampling of health workers at the provincial, district and health center levels in 2009.ResultsOverall, 284 health workers were enrolled in 50 health facilities of 11 provinces: health centers 24.7%; district hospitals 23.2%; and province hospitals 52.1%. Only a minority of these (2.5%) recalled ever having received training or seeking information on epilepsy. Our survey showed a lack of knowledge in diagnosing and prescribing drugs for epilepsy, including phenobarbital, the first-line of treatment. The majority of respondents (59.9%) was unaware of the availability of antiepileptic drugs in health facilities. Only 10 (20%) health facilities, and no health centres, received people with epilepsy. It was estimated that one PWE per month receives medical attention. Traditional beliefs about PWE were common; such as the idea that epilepsy could be transmitted through saliva (63.2%). A higher attendance of PWE was observed in province hospitals where the knowledge of epilepsy care was higher. Global acceptance of people with epilepsy was low.ConclusionsThe low level of knowledge of epilepsy on the part of health workers may be contributing to the wide treatment gap in the Lao PDR. Improving knowledge of this disease and increasing the availability of antiepileptic drugs will reduce misconceptions about epilepsy, thus encouraging more PWE to seek treatment. Community-based educational programs and extensive advocacy for people with epilepsy only began in 2009.