Medicine shortages and challenges with the procurement process among public sector hospitals in South Africa; findings and implications

Abstract

Background: Medicine shortages are a complex global challenge affecting all countries. This includes South Africa where ongoing medicine shortages are a concern among public sector hospitals as South Africa strives for universal access to healthcare. The objectives of this research were to highlight challenges in the current pharmaceutical procurement process for public sector hospitals. Subsequently, suggest potential ways forward based on the findings as the authorities in South Africa seek to improve the procurement process. Method: Qualitative in-depth interviews were conducted with 10 pharmacy managers in public sector hospitals in the Gauteng Province, South Africa. A thematic content analysis was performed, with transcripts coded by two of the authors. Coding was discussed until consensus was reached. Categories were developed and grouped into themes. Results:The 'Procurement process' emerged from the data as the overarching theme, rooted in three main themes: (i) The buy-out process that was used to procure medicines from suppliers other than the contracted ones; (ii) Suppliers not performing thereby contributing to medicine shortages in the hospitals; and (iii) Challenges such as the inaccuracy of the electronic inventory management system used in the hospitals. Conclusions: Effective management of contracts of suppliers by the Provincial Department of Health is crucial to ensure accessibility and availability of essential medicines to all citizens of South Africa. Ongoing monitoring and support for the future use of computerised inventory management systems is important to reduce medicine shortages, and this is being followed up.

Rapid Assessment of the Potential Paucity and Price Increases for Suggested Medicines and Protection Equipment for COVID-19 Across Developing Countries With a Particular Focus on Africa and the Implications

“…Alongside this, introduce programmes if needed to reduce possible shortages of priority medicines and equipment building on experiences in other countries including recommending substitute medicines where suitable acknowledging the risks ( Acosta et al (2019) , Chigome et al (2019) , Miljković et al (2020a) , Miljković et al (2020) , Modisakeng et al (2020) )…”

Transformation of the Tanzania medical store department through global fund support: an impact assessment study

“…There are many studies pointing to the importance of such interventions as envisaged in the strategic reforms in boosting availability of health commodities. 21 27 30 31 For instance, Modisakeng et al 32 concluded that in order to tackle medicines shortages, there was need for ongoing support to provincial pharmacies in South Africa for better contract management and improved data systems to aid inventory management. Similarly, Meyer et al 33 observed that there were a number of initiatives surrounding the availability and access to medicines in the public system in South Africa; many of which focused on early warning systems for the supply of medicines, improvements in data for quantification and forecasting as well as effective contract management.…”

Response to the Novel Corona Virus (COVID-19) Pandemic Across Africa: Successes, Challenges, and Implications for the Future

“…Medicine shortages are an increasing concern across countries ( Acosta et al, 2019 ) and are a particular issue in Africa where typically up to 94% of its medicines are imported ( N Gage Consulting, 2017 ; Bavier, 2020 ; Dugmore, 2020 ), and supply issues can be exacerbated in countries with ongoing conflicts ( ALCED, 2020 ). However, African countries are already taking steps to address concerns with shortages before and during the pandemic including suggesting potential alternatives ( Chigome et al., 2019 ; Medical Brief, 2020b ; Modisakeng et al., 2020 ; Review Online, 2020 ; Tomlinson, 2020 ). There are also ongoing programmes to address the quality of medicines across Africa.…”