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Availability and Expiry of Essential Medicines and Supplies During the ‘Pull’ and ‘Push’ Drug Acquisition Systems in a Rural Ugandan Hospital
Abstract
Methods: Records of 27 essential medicines and 11 medical supplies were reviewed over two-year periods in the Push (2000 - 2001) and Pull system (2004 - 2005). Key informant interviews were conducted. The data were analyzed using STATA version 8. Comparison of availability was effected using Wilcoxon signed rank tests.
Results: The median number of days out-of-stock for drugs and medical supplies was 94 versus 24 (p < 0.001) and 8 versus 0 (p < 0.39) for the Push and Pull systems, respectively. The mean percentage days out-of-stock in the two periods was 15.3 % versus 3.5 % (p < 0.001) and 1.8 % versus 1.3 % (p = 0.34) for drugs and medical supplies, respectively. Expired drugs were worth USD 1584 (25 items) in 2000/2001 and USD 1307 (13 items) in 2004/2005. Factors contributing to availability of supplies were inadequate training, lack of transport and inadequate funding.
Conclusion: The Pull system improved availability of essential medicines and reduced the volume of expiries. Availability of funds, transport, staff training and supervision should be addressed for maximal benefits.
Keywords: Push system, Pull system, Availability of medicines, Medicines expiry
Tropical Journal of Pharmaceutical Research December 2010; 9 (6): 557-564
