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

Abstract

One-third of the global population, mostly in sub-Saharan Africa, lacks consistent access to essential medicines. This descriptive study assessed the level of stock-outs and whether distance to district pharmacy, supervision visits or delays in drug delivery from district pharmacy to health centers were associated with stock-outs in 15 rural health centers in northern Rwanda. We extracted data from stock cards, dispensing records and health center registers. One tracer drug, mebendazole, had no stock-outs. Quinine had the most stock-outs, an average of 10.5 months of stock-outs in 10 health centers. No association was found between drug stock-out and distance, supervision visits or delays in drug delivery. We hypothesize that observed stock-outs could be attributed to availability of other dosages of the same medicine, special orders during campaigns, staff turn-over and logistical issues beyond health centers' capacity such as delays in importation. These should be explored more in future studies.

Facility Readiness Assessment for Implementationof Adolescent and Youth Health Care Service in Central Zone, Southern Ethiopia

“…Facility characteristics: this is the third standard as this is a readiness assessment study it focusses on the input aspect of the standard: among the elements of the standard availability of essential medicines were acceptable >= 75% in all surveyed facilities. This finding is in line with study conducted in Sudan [19], and higher than Northern Rwanda in which up to 73% of health facilities faced a challenge of medium to high levels of stock outs and slightly higher than study done in South west Ethiopia, which one third of the health facilities are below the standard [20,21]. This variation may be explained that the drugs were used to assess the readiness in this study may varies in types.…”

Analysis of Pharmaceuticals Inventory Management Using ABC-VEN Matrix Analysis in Selected Health Facilities of West Shewa Zone, Oromia Regional State, Ethiopia

“… 16 Another study conducted on ten tracer drugs in 15 health centers (HC) of Rwanda showed that 73% of the facilities faced a challenge of medium to high levels of stock outs. 17 The study conducted at Adama city (Ethiopia) HCs indicated that the average availability of eleven tracer drugs was 76.3%. 18 Another study conducted at South West Shewa zone (Ethiopia) showed that wastage of medicines in the facilities is increasing from time to time.…”

Adapting operational research training to the Rwandan context: the Intermediate Operational Research Training programme

“…One team assessed clinician adherence to renal function monitoring guidelines for adult HIV patients [30]. Two teams addressed pharmacy issues: one evaluated prescription patterns at a district hospital outpatient clinic [31], and the other described essential medicine stock-outs at health centres [32]. Another assessed dental caries management [33], and the last team assessed using a device to manage respiratory distress in neonatal units [34].…”

“…During the subsequent 1-, 3- and 6-month visits, between 2.3% to 9.3% of patients had their creatinine monitored.In the immediate future, automated testing reminders generated from electronic records can help clinicians adhere to the renal function monitoring guidelines. However, guidelines should be reviewed to assess feasibility in this context and identifying safer ART therapies are recommended.Uwamungu et al 2016 [30]African Journal of AIDS and HIV ResearchAssessing prescribing patterns of essential medicines in three rural district hospitals in RwandaPharmacists; no previous research experiencePercentage of encounters with an antibiotic prescribed (37.2%) was above WHO target, while the percentage of encounters with an injection prescribed (7.2%), percentage of medicines prescribed in generic names (75.0%) or from the National Essential Medicines List (70.5%) were below WHO targets.Monitoring and evaluation of prescribing practices should be incorporated into the national strategy as part of regular clinical audits to address prescribing behaviours.Ntirenganya et al 2015 [31]International Journal of PharmacyAssessment of essential medicine stock-outs in health centres in Burera District in Northern RwandaPharmacist and social support manager; no previous research experience73% of health facilities faced a challenge of medium to high levels of stock-outs.Flexibility in national tender procedures to mitigate the likelihood of essential medicine stock-outs in the event of challenges in the public drug procurement system.Nditunze et al 2015 [32]Rwanda Journal of Medicine and Health SciencesDental caries management at a rural district hospital northern Rwanda: a neglected diseaseM&E and PBF programme managers; no previous research experience97.6% of the patients had their tooth extracted. In addition to dental caries, 74.9% of the patients had chronic pulpitis.Prioritize caries prevention and care using community-based interventions and introduce advanced training, equipment and materials for dental caries management.Mukashyaka et al 2015 [33]Public Health ActionBubble CPAP to support preterm infants in rural Rwanda: a retrospective cohort studyMedical doctors; Previous research experience but never led or published a paperOf bubble CPAP-eligible infants, 59.0% were correctly identified by clinicians and 51.8% were correctly initiated on bubble CPAP.Mentorship and refresher trainings may improve guideline adherence, particularly given high rates of staff turnover.…”