Procurement and Management of Pharmaceutical Supplies at the Siaya County Referral Hospital

Abstract

Introduction: Pharmaceuticals are integral in-patient care and consume significant institutional and national health expenditure. Pharmaceutical management practices worldwide adopt a centralized, decentralized or mixed approach, to varied outcomes. In Kenya, the Ministry of Health (MOH) alludes to frequent stock-outs, poor procurement and storage practices, inconsistent treatment guidelines, and the use of counterfeit drugs as shortcomings in streamlining patient care and improving health outcomes. The aim of this study was to evaluate the logistical management of pharmaceutical supplies in Siaya County Referral Hospital (SCRH).
Materials and Methods: This was a cross-sectional study. Purposive sampling was done for key-informant interviews (KII). Chart review utilized hospital inventory data for the preceding quarter. Ms Excel was used to analyse the inventory data and the qualitative data was reported and manually analysed thematically.
Results: SCRH has three pharmacies, a drug and therapeutic commission (DTC), an essential drug list (EDL) but is without a formulary or quality assurance department, even though procurement, flow and storage of medicines adheres to set national guidelines. Kenya Medical Supplies Agency (KEMSA) supplies 73.9% of the drugs while direct hospital purchases account for 17.4%. Most drug consumption occurs in the outpatient department (73.5%) and tablets constitute the largest portion of formulations consumed (64.3%). Finally, consumption is less than supply for all the individual drug types.
Conclusion: The facility adheres to national guidelines of procuring and handling pharmaceuticals. Notable shortcomings include the inadequate staffing, lack of a hospital formulary, quality assurance department and an inactive drugs and therapeutic commission (DTC). Also, significant shortfalls in tracer medication exist due to inconsistent delivery timelines by KEMSA.