Associations Between Practices and Behaviors at the Health Facility Level and Supply Chain Management for Antiretrovirals: Evidence from Cameroon, Namibia, and Swaziland
| Autor: | David Kapaon, Angela Y Chang, Diana Bowser, Laura Krech, Thomas J. Bossert, David Mabirizi |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Knowledge management
Anti-HIV Agents Supply chain MEDLINE HIV Infections Materials management 03 medical and health sciences 0302 clinical medicine Health facility Humans 030212 general & internal medicine Cameroon Medical prescription 030219 obstetrics & reproductive medicine Supply chain management business.industry fungi General Medicine Original Articles Focus Groups Materials Management Hospital Focus group Namibia Hospitals Anti-Retroviral Agents Health Facilities International development business Delivery of Health Care Eswatini |
| Zdroj: | Global Health: Science and Practice |
| ISSN: | 2169-575X |
| Popis: | Using antiretrovirals (ARVs) as tracer products, we identified the following key practices that may affect supply chain management at the facility level: order verification, actions taken when stock is received, changes in prescription and dispensing due to ARV stock-out, actions to ensure patient adherence, and communication with other affiliated facilities and higher-level supply chain management. We propose a set of indicators to measure these practices. Background: While measuring, monitoring, and improving supply chain management (SCM) for antiretrovirals (ARVs) is understood at many levels of health systems, a gap remains in the identification and measurement of facility-level practices and behaviors that affect SCM. This study identifies practices and behaviors that are associated with SCM of ARVs at the hospital level and proposes new indicators for measurement. Methods: We performed an in-depth literature review to identify facility-level practices and behaviors and existing indicators that are associated with SCM. We used the United States Agency for International Development's 2013 National Supply Chain Assessment Toolkit to define 7 supply chain function areas to frame the study. Qualitative, semistructured key informant and focus group interviews were conducted in hospitals with health professionals from Cameroon, Namibia, and Swaziland to understand facility-level practices and behaviors. Results: Using the results from 54 key informant and focus group interviews from 12 hospitals, we identified 30 practices and behaviors that may affect ARV SCM at the facility level. The following practice areas were particularly associated with SCM: order verification, actions taken when ARV stock is received, changes in prescription and dispensing due to ARV stock-out, actions to ensure patient adherence, and communication with other affiliated facilities and higher-level SCM. We subsequently developed measurable indicators for future research. Conclusion: This study characterizes facility-level practices and behaviors that can affect ARV SCM. It also identifies gaps in their measurement. While this study uses ARVs as a tracer medicine to understand gaps in practices at the facility level, many of the findings are more broadly applicable to other medicines in an integrated setting. This study provides real-world evidence and the groundwork for further research to characterize the link between 30 facility-level practices and behaviors and ARV SCM at the facility and central levels. |
| Databáze: | OpenAIRE |
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