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      Factors affecting the availability of tracer health commodities in public facilities at Tana River County, Kenya

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          Abstract

          Background

          Delivery of quality healthcare is significantly based on the level of commitment among health facilities. This includes building a strong system with the continued availability of tracer commodities. Human resources, financing, health information provision, and technologies integrated into the care environment have been vital in defining improved care.

          Methods

          This was a cross-sectional study conducted in health facilities in Tana River County. A census method was used where all 62 health facilities across different tiers of healthcare delivery were considered. Out of 62 facilities, 60 participated in the study. A structured questionnaire and a checklist were used to collect data. Data were analysed using both descriptive and inferential statistics at 0.05 level of significance. Statistical Package for Social Sciences version 26 was used for data analysis.

          Results

          Majority of the participants were nurses (71.7%), male (68.3%), and diploma holders (78.3%). The mean availability of the tracer commodities was 68.73%. The human resource-related factors influencing availability were personnel training on commodity management (β = 4.56, 95%CI 2.29–11.21, p = 0.012) and presence of pharmaceutical technicians dispensing commodities (β = 2.85, 95%CI 1.29–5.21, p = 0.005) Financial factors investigated revealed that those who were in county hospitals (β = 19.11, 95%CI 7.39–30.83, p = 0.002) and facilities which has disbursement of budgetary allocation on time (β = 12.08, 95%CI 3.11–23.57, p = 0.002) had higher availability of tracer commodities.

          Conclusion

          There was moderate availability of tracer commodities which was influenced by training, personnel, level of the facility, and budget allocation on time.

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          Most cited references13

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          Monitoring service delivery for universal health coverage: the Service Availability and Readiness Assessment

          Objective To describe the Service Availability and Readiness Assessment (SARA) and the results of its implementation in six countries across three continents. Methods The SARA is a comprehensive approach for assessing and monitoring health service availability and the readiness of facilities to deliver health-care interventions, with a standardized set of indicators that cover all main programmes. Standardized data-collection instruments are used to gather information on a defined set of selected tracer items from public and private health facilities through a facility sample survey or census. Results from assessments in six countries are shown. Findings The results highlight important gaps in service delivery that are obstacles to universal access to health services. Considerable variation was found within and across countries in the distribution of health facility infrastructure and workforce and in the types of services offered. Weaknesses in laboratory diagnostic capacities and gaps in essential medicines and commodities were common across all countries. Conclusion The SARA fills an important information gap in monitoring health system performance and universal health coverage by providing objective and regular information on all major health programmes that feeds into country planning cycles.
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            Ongoing Initiatives to Improve the Quality and Efficiency of Medicine Use within the Public Healthcare System in South Africa; A Preliminary Study

            Introduction: South Africa has an appreciable burden of both communicable and non-communicable diseases as well as high maternal, neonatal, and child morbidity. In recent years there have been significant strides with improving the public health system, and addressing current inequalities, with the right to health a constitutional provision in South Africa. Initiatives include the introduction of National Health Insurance, programmes to enhance access to medicines for patients with chronic diseases, as well as activities to improve care in hospitals, including improving pharmacovigilance. Consequently, the objective of this paper is to review ongoing initiatives within the public healthcare sector in South Africa and their influence to provide future direction. Method: Principally a structured review of current and planned activities. Results: There have been a number of major activities and initiatives surrounding the availability and access to medicines in the public system in recent years in South Africa. This includes a National Surveillance Centre and an innovative early warning system for the supply of medicines as well as the development of a National Health Care Pricing Authority and initiatives to improve contracting. There have also been developments to improve the supply chain including instigating Medicine Procurement Units in the provinces and enhancing forecasting capabilities. Access to medicines is improving though the instigation of stable chronic disease management initiatives to increase the number of external pick-up points for medicines. There are also ongoing programmes to enhance adherence to medicines as well as enhance adherence to the Standard Treatment Guidelines and the Essential Medicines List with their increasing availability. In addition, there is a movement to enhance the role of health technology assessment in future decision making. Hospital initiatives include increased focus on reducing antimicrobial resistance through instigating stewardship programmes as well as improving adverse drug reaction reporting and associated activities. Conclusion: Overall, there are an appreciable number of ongoing activities within the public healthcare system in South Africa attempting to ensure and sustain universal healthcare. It is too early to assess their impact, which will be the subject of future research.
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              The effects of medicines availability and stock-outs on household’s utilization of healthcare services in Dodoma region, Tanzania

              Abstract Low- and middle-income countries have been undertaking health finance reforms to address shortages of medicines. However, data are lacking on how medicine availability and stock-outs influence access to health services in Tanzania. The current study assesses the effects of medicine availability and stock-outs on healthcare utilization in Dodoma region, Tanzania. We conducted a cross-sectional study that combined information from households and healthcare facility surveys. A total of 4 hospitals and 89 public primary health facilities were surveyed. The facility surveys included observation, record review over a 3-month period prior to survey date, and interviews with key staff. In addition, 1237 households within the health facility catchment areas were interviewed. Data from the facility survey were linked with data from the household survey. Descriptive analysis and multivariate logistic regressions models were used to assess the effects of medicine availability and stock-outs on utilization patterns and to identify additional household-level factors associated with health service utilization. Eighteen medicines were selected as ‘tracers’ to assess availability more generally, and these were continuously available in ∼70% of the time in facilities across all districts over 3 months of review. The main analysis showed that household’s healthcare utilization was positively and significantly associated with continuous availability of all essential medicines for the surveyed facilities [odds ratio (OR) 3.49, 95% confidence interval (CI) 1.02–12.04; P = 0.047]. Healthcare utilization was positively associated with household membership in the community health insurance funds (OR 1.97, 95% CI 1.23–3.17; P = 0.005) and exposure to healthcare education (OR 2.75, 95% CI 1.84–4.08; P = 0.000). These results highlight the importance of medicine availability in promoting access to health services in low-income settings. Effective planning and medicine supply management from national to health facility level is an important component of quality health services.
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                Author and article information

                Contributors
                erutungwa75@gmail.com
                Journal
                J Pharm Policy Pract
                J Pharm Policy Pract
                Journal of Pharmaceutical Policy and Practice
                BioMed Central (London )
                2052-3211
                15 November 2023
                15 November 2023
                2023
                : 16
                : 145
                Affiliations
                [1 ]EAC Regional Centre of Excellence for Vaccines, Immunization and Health Supply Chain Management, College of Medicine and Health Sciences, University of Rwanda, ( https://ror.org/00286hs46) Kigali, Rwanda
                [2 ]Tana River County Government (004), Mombasa, Kenya
                [3 ]Faculty of Health Sciences, University of Nairobi, ( https://ror.org/02y9nww90) Nairobi, Kenya
                [4 ]School of Business, College of Business and Economics, University of Rwanda, ( https://ror.org/00286hs46) Kigali, Rwanda
                [5 ]School of Public Health, College of Medicine and Health Sciences, University of Rwanda, ( https://ror.org/00286hs46) Kigali, Rwanda
                Article
                658
                10.1186/s40545-023-00658-6
                10648676
                37968772
                1d72fade-d279-4184-a58f-1d3e997b8685
                © The Author(s) 2023

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 3 August 2023
                : 8 November 2023
                Categories
                Research
                Custom metadata
                © Dr. Zaheer-Ud-Din Babar and Auckland UniServices Ltd. 2023

                tracer commodities,stock control cards,availability,public health facilities,tana river county

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