Documentation of medicine logistics in primary health care clinics in the Dr Kenneth Kaunda district
Abstract
Health systems throughout the globe face challenges with rising drug costs, decisions regarding the implementation of new drug therapies or using conventional drug therapies, access to drugs across different income groups and geographical barriers (Govindaraj et al., 2000:5; Wiedenmayer et al., 2006:6). South Africa is an upper middle income developing country with an estimated population of 50.59 million, facing major challenges in the health sector (WHO, 2011:170; Engelbrecht & Crisp, 2010:18; Stats SA, 2011:2; Dambisya & Modipa, 2009:4). In South Africa the second largest expenditure item in the health system is medicine (DOH, 2011:68). Managing drug supply is essential and managers should focus on procurement, selection, distribution and use to ensure uninterrupted supply. The general objective of this study was to investigate the current documentation systems in the Dr Kenneth Kaunda district regarding medicine logistics. A mixed method study was done to record information using survey forms and doing observations in primary health care clinics and community health care centres within the DKK district. The research period was from 1 January 2010 until 31 March 2012. The results revealed that the availability of pre–selected essential drugs within PHC clinics were above 80% except for ibuprofen tablets that were only available in 68% of the clinics. Clinic managers indicated that the majority of the required services are rendered within clinics in the DKK district. Twenty seven of the thirty four services mentioned in the research study were provided in 77% of the clinics.
Daily clinic registers are used in 55% of the clinics to capture patient information. According to the results, 53.85% administration clerks, 42.31% professional nurses and 7.7% health councillors are responsible for completing patient registers upon entering the clinic. The results revealed that recorded patient information is used for statistical purposes (67%) and DHIS (25%). The results revealed that professional nurses within the DKK are responsible for dispensing medicines, and SOP?s for dispensing are used in 70% of these clinics. The results also revealed that 80% of registered nurses are responsible for maintaining the
Abstract (continued) ii
medicine room. According to the results, medication is stored in the medicine rooms (30%), consulting rooms (27%) and store rooms (5%). Results revealed that 75% of clinics used standard operating procedures to order their medicine stock and are managed by 23% of sub–district pharmacists, 35% of professional nurses and 40% of clinic managers. The results revealed that minimum and maximum drug estimations, stock cards, frequent stock checking and limiting access to medicine/store rooms to ensure optimum stock levels. The results also revealed that 88% of the clinics in the DKK district had no computer systems. Sub–district pharmacists play an essential role in monitoring budgets, supplying essential medicine, improving quality of care, managing expired stock and visiting clinics on a routine basis.
The limitations for this study were stipulated and recommendations for further research regarding medicine logistics were also made.
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