Extent of medicines wastage and its contributing factors in public health facilities of south west Shoa Zone, Oromia Regional State, Ethiopia: a cross-sectional survey

Abstract

Medicine wastage is a longtime problem of public health facilities in Ethiopia. However, evidence on the extent and type of wastage as well as its contributing factors are limited. Therefore, the aim of this study was to determine the extent of medicine wastage and identify its contributing factors in public health facilities of South West Shoa Zone, Oromia Regional State, Ethiopia. A cross-sectional survey was conducted in 10 public health facilities (1 hospital and 9 health centres).  The value (i.e. the buying price), types and sources of wasted medicines were collected from records of medicines wastage, disposal report, commercial invoices and bin cards. And, the results are summarized using descriptive statistics. In terms of monetary value, the three years (2012/13-2014/15) wastage was estimated to be 500,522.10 (7.5%) Ethiopian Birr (ETB). Of the 144 items (by generic name) wasted, oral rehydration salt 245 osml/l powder (6.3%), metronidazole 250 mg capsule (4.1%), and tetracycline 250 mg capsules (3.2%) were the top three items by value. Anti-infectives (39.1%), medicines used for correcting water, electrolyte and acid-base balance (12.9%) and gastro intestinal acting medicines (10.6%) were also the top three therapeutic classes of medicines with high wastage rate. The main contributing factors identified for medicine wastage are: supplier’s delivery of near expiry date medicines, lack of a system to exchange nearly expired medicines from one facility to another, absence of electronic stock management tools and shortage of pharmacy professionals in the health facilities. In conclusion, the extent of medicine wastage in public health facilities decreased over the three consecutive years. However, the extent of the problem was still very high compared to the national target. A platform that facilitates communication among key supply chain actors should be devised to make informed decision including redistribution of overstocked and near expired products to less stocked and high consumption areas.

Keywords: medicines wastage, wastage rate, expired medicines, contributing factors, Ethiopia