An investigation into the supply chain and procurement processes of a provincial department of health

Abstract

The supply chain of certain critical medicines is under pressure due to stock shortages. Consumers feel the effect of these stock shortages, specifically those with life-threatening diseases such as TB and HIV. A pharmaceutical supply chain is very complicated and is responsible for ensuring that the appropriate drug reaches the right people at the right time. It is a highly sensitive supply chain and a 100 % customer satisfaction level is not negotiable as services directly influence health and safety. In the South African healthcare environment, the medicine selection and procurement processes vary considerably between the South Africa private and public healthcare sectors. The medicine supply chain plays an important role throughout the entire healthcare value chain. If the supply chain is ineffective, the end-user or patients suffer. Drug shortages are a reality in today's healthcare environment and it is therefore of utmost importance that the drug supply chain is as effective as possible and possible areas of waste are eliminated. The reality is that little is known about the medicine supply chain. The goal of this study is to analyse some of the social commentary that is available regarding the medical supply chain and to convert it to empirical evidence. Fixed-dose ARVs play a very important role in the quality of life of an HIVinfected patient. The usage of Fixed-dose ARVs in South Africa is very high due to the high HIV-infection rate in the country. Internationally and nationally, literature indicates the ineffectiveness of the drug supply chain and comments on how it influences the supply of for example Fixed-dose ARVs to patients who are in dire need of it. The data gathered during the interviews indicate that there has been a massive improvement in the supply of the Fixed-dose ARV to primary healthcare centres in the entire North West province. The provincial department of health implemented measures to ensure that the stock outs that occurred in previous years were eliminated. It was furthermore evident from the research that with the new courier type services that had been implemented, the element of patient adherence was not thought through. Although the medication is available for the patient for use, there is no measure for patient adherence. Limitations to the study were identified and discussed. The study also provides recommendations to the provincial department of health and for future research