2731 International Journal of Medical Science and Clinical Invention, vol. 4, Issue 3, March, 2017
International Journal of Medical Science and Clinical Inventions 4(3): 2731-2739, 2017
DOI:10.18535/ijmsci/ v4i3.2 ICV 2015: 52.82
e-ISSN: 2348-991X , p-ISSN: 2454-9576
© 2017, IJMSCI
Research Article
Predictors of Efficiency in the Supply Chain Management of Essential Medicines
Tshisikhawe Baldwin Phume
1
, Zeleke Worku
2
Tshwane University of Technology (TUT) Business School,159 Nana Sita Street, Pretoria 0001, South Africa, Fax: (+27-12) 382
3052
ABSTRACT:
A study was conducted in Limpopo Province, South Africa to assess and evaluate factors that undermine the quality of service
delivery in the management of essential medicines. The study was based on a stratified random sample of size 135 health facilities
scattered across the Province of Limpopo. Stratification was done by health district. Data was collected by using a structured,
pretested and validated questionnaire of study. Criteria set out by Fauci (2008) and the World Health Organisation (Mendis,
Fukino, Cameron, Laing, Filipe Jr, Khatib, Leowski & Ewen, 2007) were used as benchmark for the assessment of quality of
services. The results showed that standards followed for storing and dispensing essential medicines were inadequate in 100 of the
135 health facilities that took part in the study (74.07%), whereas the standards followed for storing and dispensing essential
medicines were adequate in 35 of the 135 health facilities (25.93%) that were selected for the study. Results obtained from binary
logistic regression analysis showed that adherence to WHO standards on the proper management of essential medicines at health
facilities was influenced by 3 factors. These 3 predictor variables of study were: adherence to recruitment policy, taking inventory
of essential medicines regularly, and the availability of adequate storage facility for essential medicines, in a decreasing order of
strength.
Key words: Limpopo Province, Supply Chain Management, Essential medicines, WHO standards, Efficiency, Odds ratios
INTRODUCTION
The study was conducted in the province of Limpopo in order
to assess the overall efficiency with which essential medicines
were managed in health facilities. The benchmark for adequate
services was defined according to the requirements, guidelines
and regulations issued by the World Health Organisation
(WHO, 2007) to member countries. Essential medicines
include all drugs and medical supplies that are listed on the list
of medical supplies that must be made available at all times at
all private and public health facilities operating in South
Africa. In this regard, it is the duty and obligation of the South
African National Department of Health (2016) to ensure the
availability of essential medicines at all public health care
facilities. The Limpopo Provincial Government of Health
(2016) is equally responsible for ensuring the availability of
essential medicines at all health care facilities operating in the
province of Limpopo. The South African Constitution of 1996
(South African National Government Communications and
Information Systems, 1996) states that all South Africans are
entitled to adequate health care services in which essential
medicines are required by law to be made available at all
public and private health facilities. A complex supply chains
web are used for manufacturing, storing, transporting and
disseminating essential medicines to the patients. The purpose
of this study was to assess and evaluate the degree of
efficiency with which essential medicines were managed in
health care facilities in the province of Limpopo by using
WHO standards as a benchmark.
The study was conducted by gathering empirical data from
employees whose duty is to manage essential medicines in
public and private health facilities operating in Limpopo
Province. According to Quick and Rankin (2005) medicines
save lives and improve health, their non-availability increases
the burden of disease. Many leading causes of discomfort,
disability and premature death can be prevented, treated or at
least alleviated with cost-effective essential medicines
(Embrey, 2012). According to Constitution of South Africa,
access to affordable essential medicines is a basic human right
and a vital component of an efficient health care system. One
of the objectives of the National Drug Policy (NDP) is
therefore to ensure the availability and accessibility of
essential medicines to all citizens of South Africa (NDOH,
2015). In order to address such issues, factors affecting the
performance of essential medicines need to be identified in
order to give guidelines to managers throughout the health
system. In order to achieve this, the South Africa National
Department of Health set of National Core Standards (NCS)
(NDOH, 2015). Currently, Limpopo Department of Health
(LDoH) has outsourced the distribution and warehousing of
pharmaceuticals (Bennett, Quick & Velasquez, 2010;
Summers, Moller, Meyer & Botha, 2011). From this
background this study is to attempts to identity the current
challenges faced by the pharmaceutical supply system in
Limpopo Province and to determine factors affecting the
performance of essential medicines supply chain management.