Procurement, Availability, Affordability and Use of Essential Medicines and Health Supplies at Community Level in Uganda
DOI:
https://doi.org/10.14738/assrj.27.1132Abstract
Purpose - The challenges associated with procurement in Uganda lead to non-availability of essential medicines and health supplies. Some citizens do not afford prescribed medicines, leading to irrational use. This paper examines procurement, availability, affordability and use of essential medicines and health supplies at community level.
Design/methodology/approach – The study covered a total of 8 purposively selected districts in Uganda. Both quantitative and qualitative methods were used. The study was guided by 22 medicines and health supplies as indicator items. Using mixed methods, data was collected, analysed and interpreted in relation to the drug supply management practice.
Findings – Procurement regulations were not complied with. Health units did not stock all recommended items. Stock outs were more prevalent at lower than higher health units. Affordability was found to be a problem, leading to patients bribing medical personnel to get some medicines and health supplies at cheaper prices. For all sampled respondents, all dimensions of proper use of medicines and health supplies like advice on utilization and side effects and knowledge on appropriate storage conditions for medicines and health supplies were below acceptable levels.
Originality – Whereas there is extensive work on supply chain of medicines and health supplies, not enough knowledge exists which is specific to supply chain at community level for developing counties. Besides, the tracking study that combines procurement, availability, affordability and use is very insightful and a strong starting point for future theoretical work.References
Agaba, E and Shipman, N. (2007). “Public Procurement Reform in Developing Countries: The Ugandan Experience” Boca Raton, FL: Academics Press. and equity. Penang, Malaysia, Consumers InternationalHRegional Office for Asia and the Balasubramaniam K. Health and pharmaceuticals in developing countries: towards social justice
Kaufmann, J.R., Miller, R. and Cheyne, J. (2011), “Vaccine supply chains need to be better funded and strengthened, or lives will be at risk”, Health Affairs, Vol. 30 No. 6, pp. 1113H21.
Kumar, S., NiedanHOlsen, K. and Peterson, L. (2009), “Educating the supply chain logistics for humanitarian efforts in Africa: a case study”, International Journal of Productivity and Performance Management, Vol. 58 No. 5, pp. 480H 500.
Levesque, J.F., Harris, M.F. and Russell, G. (2013), “Patient centred access to health care: conceptualizing access at the interface of health systems and populations” International Journal for Equity in Health Vol. 12 No. 18
Myhr K. Comparing prices of essential drugs between four countries in East Africa and with international prices. MSF Conference, Nairobi 2000
Okiror, B. (2009), “Drug shortage hits Uganda”, The New Vision, March 21, available at: www.newvision.co.ug/D/8/13/675331
Robertson, J. et al. 2009. What essential medicines for children are on the shelf? Bull World Health Organ, 87, 231 – 237.
Sussanne, G., Ewen, M., Noguchi, M. and Liang, R. (2006), “Price availability and affordability: an international comparison of chronic disease medicines”
Thai, K.V. (2001). “Public Procurement ReHexamined.” Journal of Public Procurement, Vol.1 pp 9H50 World Health Organisation – Health financing and access to effective interventions, 2010. Available at www.who.int/healthsystems/topic/financng
World Health Organisation – Primary Health Care, World Health Statistics, 2008. Available at: www.who.int/whr/2008
World Health Organisation Briefing Note H Access to Controlled Medications Programme. Geneva, World Health Organisation, 2012. Available at: www.who.int/.../medicines/.../ACMP_BrNote_PainGLs_EN_Apr2012..
