Drug stock-outs: Inept supply-chain management and corruption

Bateman, Chris

doi:10.7196/samj.7332

Cited by 58 publications

(56 citation statements)

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“…Having access to worldclass medication and initiation thresholds is small comfort when reports from across the country of drug stock-outs suggest a major problem in supply systems well beyond HIV care. [19] Some high-risk sexual behaviours seem to be on the rise. [1] Key populations, such as sex workers, men who have sex with men, truckers, adolescents, heterosexual men and others are not accessing services enough.…”

Section: Resultsmentioning

confidence: 99%

A brief history of South Africa's response to AIDS

Simelela

Venter

2014

S Afr Med J

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Section: Resultsmentioning

confidence: 99%

A brief history of South Africa's response to AIDS

Simelela

Venter

2014

S Afr Med J

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“…There has also been a spate of media reports on stock-outs of essential medicines for treatment of HIV and major chronic non-communicable diseases. [3,4] A 2012 publication by the National Department of Health (NDoH) [5] reported a 54% failure in compliance with measures addressing availability of medicines and recommended priority attention to supply chain management. Local research has found that confidence in the public sector has waned as a result of stock-outs.…”

Section: Researchmentioning

confidence: 99%

Inefficient procurement processes undermine access to medicines in the Western Cape Province of South Africa

et al. 2017

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Background. South Africa (SA) has experienced several stock-outs of life-saving medicines for the treatment of major chronic infectious and non-communicable diseases in the public sector. Objective. To identify the causes of stock-outs and to illustrate how they undermine access to medicines (ATM) in the Western Cape Province, SA. Methods. This qualitative study was conducted with a sample of over 70 key informants (frontline health workers, sub-structure and provincial health service managers). We employed the critical incident technique to identify significant occurrences in our context, the consequences of which impacted on access to medicines during a defined period. Stock-outs were identified as one such incident, and we explored when, where and why they occurred, in order to inform policy and practice. Results. Medicines procurement is a centralised function in SA. Health service managers unanimously agreed that stock-outs resulted from the following inefficiencies at the central level: (i) delays in awarding of pharmaceutical tenders; (ii) absence of contracts for certain medicines appearing on provincial code lists; and (iii) suppliers' inability to satisfy contractual agreements. The recurrence of stock-outs had implications at multiple levels: (i) health facility operations; (ii) the Chronic Dispensing Unit (CDU), which prepacks medicines for over 300 000 public sector patients; and (iii) community-based medicines distribution systems, which deliver the CDU's prepacked medicines to non-health facilities nearer to patient homes. For instance, stock-outs resulted in omission of certain medicines from CDU parcels that were delivered to health facilities. This increased workload and caused frustration for frontline health workers who were expected to dispense omitted medicines manually. According to frontline health workers, this translated into longer waiting times for patients and associated dissatisfaction. In some instances, patients were asked to return for undispensed medication at a later date, which could potentially affect adherence to treatment and therapeutic outcomes. Stock-outs therefore undermined the intended benefits of ATM strategies. Conclusion. Addressing the procurement challenges, most notably timeous tender awards and supplier performance management, is critical for successful implementation of ATM strategies.

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“…As mentioned, it is heartening to see that some measures are already in place to address the HIV-poverty nexus in South Africa but many challenges remain, not least the lack of basic income support for vulnerable households and mismanagement in the public health system that undermines the reliable provision of ART (Bateman 2013). In light of these ongoing challenges and the enduring association of HIV/AIDS and poverty, the policy suggestions above are worth considering.…”

Section: Resultsmentioning

confidence: 92%

Rethinking the Poverty-disease Nexus: the Case of HIV/AIDS in South Africa

Pienaar

2015

J Med Humanit

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While it is well-established that poverty and disease are intimately connected, the nature of this connection and the role of poverty in disease causation remains contested in scientific and social studies of disease. Using the case of HIV/AIDS in South Africa and drawing on a theoretically grounded analysis, this paper reconceptualises disease and poverty as ontologically entangled. In the context of the South African HIV epidemic, this rethinking of the poverty-disease dynamic enables an account of how social forces such as poverty become embodied in the very substance of disease to produce ontologies of HIV/AIDS unique to South Africa.

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Drug stock-outs: Inept supply-chain management and corruption

Cited by 58 publications

References 0 publications

A brief history of South Africa's response to AIDS

A brief history of South Africa's response to AIDS

Inefficient procurement processes undermine access to medicines in the Western Cape Province of South Africa

Rethinking the Poverty-disease Nexus: the Case of HIV/AIDS in South Africa

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