Stock-outs of essential health products in Mozambique - longitudinal analyses from 2011 to 2013
| Autor: | João Luis Manuel, Sarah Gimbel, Fatima Cuembelo, Titos Quembo, Roxanne Hoek, James Pfeiffer, Bradley H. Wagenaar, Kenneth Sherr, Stephen Gloyd, Cathy Michel, Pires Afonso |
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| Rok vydání: | 2014 |
| Předmět: |
Drug supply
Population Developing country World Health Organization Health Services Accessibility Article Negatively associated Environmental health Humans Longitudinal Studies Healthcare Disparities education Generalized estimating equation Mozambique Stock (geology) education.field_of_study Public Health Environmental and Occupational Health Health services research Health Planning Cross-Sectional Studies Infectious Diseases Equipment and Supplies Family planning Pharmaceutical Services Workforce Parasitology Health Facilities Health Services Research Rural Health Services Business Drugs Essential Delivery of Health Care human activities |
| Zdroj: | Tropical Medicine & International Health. 19:791-801 |
| ISSN: | 1360-2276 |
| DOI: | 10.1111/tmi.12314 |
| Popis: | Objectives To assess the relationship between health system factors and facility-level EHP stock outs in Mozambique. Methods Service provisions were assessed in 26 health facilities and 13 district warehouses in Sofala Province Mozambique from July to August in 2011-2013. Generalized estimating equations were used to model factors associated with facility-level availability of essential drugs supplies and equipment. Results Stock-out rates for drugs ranged from 1.3% for oral rehydration solution to 20.5% for Depo-Provera and condoms with a mean stock-out rate of 9.1%; mean stock-out rates were 15.4% for supplies and 4.1% for equipment. Stock-outs at the district level accounted for 27.1% (29/107) of facility-level drug stock-outs and 44.0% (37/84) of supply stock-outs. Each 10-km increase in the distance from district distribution warehouses was associated with a 31% (CI: 22-42%) 28% (CI: 17-40%) or 27% (CI: 7-50%) increase in rates of drug supply or equipment stock-outs respectively. The number of heath facility staff was consistently negatively associated with the occurrence of stock-outs. Conclusions Facility-level stock-outs of EHPs in Mozambique are common and appear to disproportionately affect those living far from district capitals and near facilities with few health staff. The majority of facility-level EHP stock-outs in Mozambique occur when stock exists at the district distribution centre. Innovative methods are urgently needed to improve EHP supply chains requesting and ordering of drugs facility and district communication and forecasting of future EHP needs in Mozambique. Increased investments in public-sector human resources for health could potentially decrease the occurrence of EHP stock-outs. |
| Databáze: | OpenAIRE |
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