Assessment of Essential Medicines Stock-Outs at Health Centers in Burera District in Northern Rwanda

Nditunze, L; Makuza, S; Amoroso, CL; Odhiambo, J; Ntakirutimana, E; Cedro, L; Mushinzimana, J; Hedt-Gauthier, B

doi:10.4314/rj.v2i1.12f

Cited by 6 publications

(5 citation statements)

References 2 publications

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“…The mean stock-out duration for the review period was 41.4 and 54.3 days for APTS and non APTS sites respectively. The stock-out duration at both sites was lower than the study result shown in Rwanda 10.5 months, 29 the national level 92.2 days, 6 and the study on outcomes of APTS of 43.3 days for APTS and 61.1 days for non-APTS implementing hospitals. 23 In both cases it opposes the HSDP target (0 stock-out days).…”

Section: Stockout Durationcontrasting

confidence: 58%

<p>Effect of Auditable Pharmaceutical Services and Transaction System on Pharmaceutical Service Outcomes in Public Hospitals of SNNPR, Ethiopia</p>

Beyene¹,

Abuye²,

Tilahun

2020

IPRP

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Background: Auditable pharmaceuticals service and transaction system (APTS) is unique in its systems strengthening approach. It is a data-driven package of interventions designed to establish accountable, transparent, and responsible pharmacy practice. The objective of this study was to assess the outcome performance of pharmaceuticals services among selected hospitals with and without the APTS system in SNNPR, Ethiopia. Methods: A cross-sectional comparative facility-based study was conducted at public hospitals by using an intervention and control approach to estimate the significance of the difference between average performances of APTS and non-APTS hospitals. A case-tocontrol ratio was applied to decide the number of sites and a simple random lottery sampling technique was employed to select control sites. The sample size formula was used to determine the proposed population for patient care indicator assessment. Epidata version 3.1 and SPSS version 23 were used for analysis. The study was conducted from March 1 to 30, 2019. Results: APTS implemented hospitals attained 92.3% patient satisfaction on the overall pharmacy services compared to 47.5% for non-APTS hospitals. They have improved essential drugs (EDs) availability, minimum stock-outs, and reduced wastage rates, unlike control groups. They undertook workload analysis to assess human power sufficiency; generate reliable information from accurate recording culture for decision making; practiced transparency and accountability through conducting physical inventory and daily sales tracking/ management system; and made budget utilization rationale applying ABC analysis, VEN analysis, ABC/VEN reconciliation, and stock status analysis (SSA) that non-APTS hospitals did less/not. Conclusion: In general, higher performances were observed in APTS implemented hospitals than non-APTS hospitals regarding patient knowledge, satisfaction, and medicine availability at stores. In all cases, it needs improvement to achieve target values.

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Section: Stockout Durationcontrasting

confidence: 58%

<p>Effect of Auditable Pharmaceutical Services and Transaction System on Pharmaceutical Service Outcomes in Public Hospitals of SNNPR, Ethiopia</p>

Beyene¹,

Abuye²,

Tilahun

2020

IPRP

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“…With all these efforts at international and national levels, so far in Rwanda only a single, small study has been published on medicine availability. It investigated stock-out times of 10 essential medicines in 15 rural health centers in a single district of Rwanda in the year 2013, and reported that on average these medicines were out of stock for 2.7 months; quinine tablets were out of stock even for 10.5 months [8]. Beyond that report, no further results have been published about availability, prices and affordability of medicines in Rwanda.…”

Section: Introductionmentioning

confidence: 99%

Prices, availability and affordability of medicines in Rwanda

2020

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Background Access to affordable and good quality medicines is a key to meeting Sustainable Development Goal No. 3 by the year 2030. Prices, availability and affordability of essential medicines have been studied in many developing countries, but no such information has been published about Rwanda yet. This study aimed at providing data on prices, availability and affordability of medicines in different health facilities of Rwanda. Methods A survey was carried out on availability, prices and affordability of 18 medicines in Kigali City and five districts of Rwanda. 44 health facilities were surveyed, including public and faithbased hospitals, public and faith-based health centers and private pharmacies. The standardized methodology developed by WHO and Health Action International (HAI) was used to collect and analyze the data. Findings Prices for generic medicines in public and faith-based health facilities were remarkably low, with median price ratios (MPRs) of 1.0 in comparison to the international procurement prices published by Management Sciences for Health. In private pharmacies, prices were twice as high (MPR = 1.99 for generics). Availability of medicines fell short of the of 80% target set by WHO, but was better than reported from many other developing countries. Availability of medicines was highest in the private sector (71.3%) and slightly lower in the faith-based (62.8%) and public (59.6%) sectors. The government procurement agency was found to work efficiently, achieving prices 30% below the international procurement price given in the International Medical Product Price Guide. Affordability of medicines was better in the public and faith-based sectors than in the private sector. Conclusion In Rwanda, medicines are affordable but poorly available in both the public and the faithbased sectors. Further improvements of the availability of medicines in the public and the

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“…Such endeavours to keep abreast of the health status of HIV-positive patients in the absence of the CD4 + count were triggered by high costs of the CD4 + count diagnostic devices in the past [ 9 , 10 ], making them not easily accessible to resource-limited settings in the developing world [ 11 ] where the health facilities are usually overburdened [ 12 ]. The challenge was exacerbated by operational and logistical issues [ 13 , 14 ] in the supply of essential medicine for the patients [ 15 – 17 ] including frequent instrument breakdown and poor manufacturer maintenance of CD4 + count diagnostics [ 18 ]. Recently, obtaining the CD4 + count has become extraordinarily inexpensive [ 19 – 21 ] and, in the contemporary era of antiretroviral therapy (ART), the monitoring and restoration of patient’s CD4 + count to acceptable levels are now relatively easy [ 22 ] and have led to improved patient survival periods [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

An Evaluation to Determine the Strongest CD4 Count Covariates during HIV Disease Progression in Women in South Africa

et al. 2019

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Introduction Past endeavours to deal with the obstacle of expensive Cluster of Difference 4 (CD4 + ) count diagnostics in resource-limited settings have left a long trail of suggested continuous CD4 + count clinical covariates that turned out to be a potentially important integral part of the human immunodeficiency virus (HIV) treatment process during disease progression. However, an evaluation to determine the strongest candidates among these CD4 + count covariates has not been well documented. Methods The Centre for the AIDS Programme of Research in South Africa (CAPRISA) initially enrolled HIV-negative (phase 1) patients into different study cohorts. The patients who seroconverted (237) during follow-up care were enrolled again into a post-HIV infection cohort where they were further followed up with weekly to fortnightly visits up to 3 months (phase 2: acute infection), monthly visits from 3–12 months (phase 3: early infection) and quarterly visits thereafter (phase 4: established infection) until antiretroviral therapy (ART) initiation (phase 5). The CD4 + count and 46 covariates were repeatedly measured at each phase of the HIV disease progression. A multilevel partial least squares approach was applied as a variable reduction technique to determine the strongest CD4 + count covariates. Results Only 18 of the 46 investigated clinical attributes were the strongest CD4 + count covariates and the top 8 were positively and independently associated with the CD4 + count. Besides the confirmatory lymphocytes , these were basophils , albumin , haematocrit , alkaline phosphatase (ALP) , mean corpuscular volume (MCV) , platelets , potassium and monocytes . Overall, electrolytes, proteins and red blood cells were the dominant categories for the strongest covariates. Conclusion Only a few of the many previously suggested continuous CD4 + count clinical covariates showed the potential to become an important integral part of the treatment process. Prolonging the pre-treatment period of the HIV disease progression by effectively incorporating and managing the covariates for long-term influence on the CD4 + cell response has the potential to delay challenges associated with ART side effects. Electronic supplementary material The online version of this article (10.1007/s40121-019-0235-4) contains supplementary material, which is available to authorized users.

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Assessment of Essential Medicines Stock-Outs at Health Centers in Burera District in Northern Rwanda

Cited by 6 publications

References 2 publications

<p>Effect of Auditable Pharmaceutical Services and Transaction System on Pharmaceutical Service Outcomes in Public Hospitals of SNNPR, Ethiopia</p>

<p>Effect of Auditable Pharmaceutical Services and Transaction System on Pharmaceutical Service Outcomes in Public Hospitals of SNNPR, Ethiopia</p>

Prices, availability and affordability of medicines in Rwanda

An Evaluation to Determine the Strongest CD4 Count Covariates during HIV Disease Progression in Women in South Africa

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