{"id":68967,"date":"2024-03-16T17:40:21","date_gmt":"2024-03-16T17:40:21","guid":{"rendered":"https:\/\/www.africa-press.net\/uganda\/?p=68967"},"modified":"2024-03-16T16:39:10","modified_gmt":"2024-03-16T16:39:10","slug":"public-hospitals-grapple-with-medicine-stockouts","status":"publish","type":"post","link":"https:\/\/www.africa-press.net\/uganda\/all-news\/public-hospitals-grapple-with-medicine-stockouts","title":{"rendered":"Public hospitals grapple with medicine stockouts"},"content":{"rendered":"

Africa-Press – Uganda. <\/strong><\/span>The late delivery of essential medicines, expiry of drugs, and acute stockouts continue to threaten the operations of key government referral hospitals in north and north-eastern Uganda.<\/b><\/p>\n

The press has established that Gulu, Mbale, Moroto and Mubende regional referral hospitals have been critically affected.<\/p>\n

Ms Chemurian Everlyn, a drug dispenser at Gulu Regional Referral Hospital, last week told the Deputy Inspector General of Government, Ms Patricia Achan, that late deliveries of essential medicines by the National Medical Stores (NMS) had resulted in serious setbacks in their operations.<\/p>\n

\u201cWe have the delivery schedule for receiving drugs from NMS, but we don\u2019t receive the items (drugs) requested as stipulated. When it is overdue, it makes things hard for us here,\u201d Ms Chemurian told Ms Achan during a spot check at the facility, adding, \u201cSometimes we outsource from the lower units to bridge the gaps resulting from stockouts. We have always called as far as Lira and Arua referral hospitals and sometimes Mulago National Referral Hospital where we ask them for stocks of medicines, reagents and other supplies if they have them in excess.\u201d<\/p>\n

The press understands that missing medical supplies that fashioned an acute drug stockout that rocked Gulu Regional Referral Hospital the past eight months has crippled a number of units. The most affected are the children\u2019s ward, as well as the maternity and women\u2019s unit.<\/p>\n

\u201cThere are units at the hospital that do not handle very big numbers of patients, and we run to them and retrieve certain items that are in most need and we take them to casualty, surgical, and maternity wards,\u201d Ms Margaret Bazio, the officer-in-charge of the Nutrition Unit, who doubles as the acting Principal Nursing Officer at the hospital, disclosed, adding, \u201cIf you are in charge of a unit and have something excess, you are asked to donate it to those units that do not have it.\u201d<\/p>\n

Running on empty<\/b><\/p>\n

We also understand that over the last one and half years, the spectre of a drug stockout has continued to hover above the hospital, thanks in no small part to a Shs1.3b annual budget that only covers just 25 percent of the facility\u2019s needs.<\/p>\n

\u201cQuite frequently, we don\u2019t have enough medicines and health supplies. Sometimes people are told to buy [medical supplies for themselves],\u201d Dr Peter Mukobi, the hospital director, conceded, adding, \u201cOur actual needs are about Shs4b if we are to serve the numbers we deal with. On average, we serve about 200,000 patients every year, it is a very big number…\u201d<\/p>\n

NMS reportedly delivered drugs to the hospital in the first week of December. Dr Mukobi noted that while such supplies are done every two months, the stock usually depletes during the first fortnight of the first month.<\/p>\n

\u201cThe items last for a maximum of three weeks and may even take a week or a longer period, but this is the reason why quite often we don\u2019t have everything, even IV fluids, needles, and gloves, they get over in a very short while,\u201d he revealed, adding that the stop-start nature of the supplies does not help matters.<\/p>\n

This can be dangerous in multiple ways. For instance, at Moroto Regional Referral Hospital, the 2022\/2023 end-of-year stock balances for essential medicines showed that expired drugs valued at Shs9.06m were being mixed up together with live medicines in the storage stands.<\/p>\n

Because requested quantities of medical supplies were not being honoured by NMS, stocks of Losartan-H tablets, Amlodipine, gauze, blood transfusion sets, cannulas, examination gloves, jik, plaster, folic acid, etc. had run out from the facility.<\/p>\n

Moroto is not an outlier. Mbale Regional Referral Hospital has also been struggling to dispense services to the population due to a drug stockout that resulted in a lack of several essential, vital and necessary drugs. In 2023, expired drugs weighing 2.32 tonnes were returned from Mbale Regional Referral Hospital\u2019s stores to NMS for destruction, according to its end-of-year stock balances for essential medicines.<\/p>\n

NMS response <\/b><\/p>\n

On Monday, Ms Sheila Nduhukire, the NMS spokesperson, contested the narrative of undersupply, saying, in a statement, that \u201cGulu [Referral Hospital] has just received supplies that would last them three months without any stockout at all and so are Mubende, Lira and the rest.\u201d She also further said health supplies the aforesaid facilities received cannot be exhausted in two months since they are combined cycles for four months.<\/p>\n

Ms Nduhukire also noted that\u2014while lower health facilities in Mbale and Moroto districts had not yet been supplied\u2014\u201cthe lower health centres in Mbale and Moroto will receive their supplies in the course of this month.\u201d<\/p>\n

Audit query<\/b><\/p>\n

The Essential Medicines and Health Supplies Manual 2012 requires an effective stock management system that ensures the right medicines of the right quality and quantities are available at the right place, at the right time, and at the right cost. However, Auditor General John Muwanga, in his 2023 audit report on the performance of NMS, observed that the national drug distributor was undersupplying health facilities and the supplies came late.<\/p>\n

\u201cNMS budgeted to procure drugs and medical supplies worth Shs185.91b for 3,254 health facilities across the country. Out of the 3,254 health facilities, a total of 3,183 health facilities had under deliveries of drugs and medicine supplies worth Shs26.4b,\u201d Mr Muwanga disclosed, adding, \u201cIn addition, the deliveries were not following the cycles which meant delayed deliveries that caused disruptions in patient treatment. Under-delivery of expected supplies caused drug stockouts and treatment disruptions in the affected health facilities across the country.\u201d<\/p>\n

The hospital sampled during the audit, according to Mr Muwanga, reported drug stockouts for long periods. This significantly affected service delivery. Some of the significant drugs out of stock include Quetiapine, Fluanxol 20mg, Sevoflurane 100 percent v\/v, Trifluoperazine tablets 5mg, Oral Morphine 250ml, 5mg\/5ml among others.<\/p>\n

\u201cI noted under deliveries of ordered medicines and health supplies in all hospital samples worth Shs1.9b. Drug stockouts are not only detrimental to the lives of patients who need these drugs but also erode patients\u2019 confidence in the public health care system, which may lead them to seek inappropriate and expensive alternative health care services elsewhere,\u201d the Auditor General noted.<\/p>\n

System overhaul<\/b><\/p>\n

On Tuesday, Dr Charles Ayume, the chairperson of Parliament\u2019s Committee on Health, said unless the Health and Finance ministries revise the appropriation amount designated to NMS, the challenge is likely to stay.<\/p>\n

\u201cThe ministries of Finance and Health should find ways of ensuring there are funds for the logistics. We know there are medicines in their (NMS) warehouse. That is where the challenge has been, that the money for the logistics does not come on time, even if a driver volunteered, those who offload the drugs need to be instantly paid,\u201d the lawmaker noted.<\/p>\n

Dr Ayume said NMS needs to have a robust logistical system to enable it deliver its mandate.<\/p>\n

\u201cThey do have the trucks, those refrigerated for cold chain cycle, but to run those trucks, you need fuel, drivers with their allowances and the loaders.\u201d<\/p>\n

Dr Ayume admitted that drug stockouts and late deliveries had become a common phenomenon despite its disastrous impact on the quality of life of the population across the country.<\/p>\n

\u201cThe budget doesn\u2019t fully capture the country\u2019s (medical supply) needs. There are gaps here and there but our emphasis is that the little they can supply must come timely, medicine is a commodity that has a huge bearing on people\u2019s lives unlike roads, etc.,\u201d he said,<\/p>\n

He added: \u201cWe have raised it severally in Parliament, and we have had meetings with NMS and they have made promises to rectify these issues, it makes us look quite shabby that we as a government cannot provide the population the health service yet the health care system is funded by their taxes.\u201d<\/p>\n

What triggers the stockouts<\/b><\/p>\n

A 2022 research on health supply chain systems conducted by Ugandan researchers found that less than half (42 percent) of health facilities had computer hardware. The cross-sectional study was undertaken in 128 public and private-not-for-profit health facilities across 48 districts in the country.<\/p>\n

Titled \u201cHealth supply chain system in Uganda: Assessment of status and of performance of health facilities\u201d, the peer-reviewed study made some handy discoveries.<\/p>\n

For instance, whereas up to 84 percent of the health facilities used a logistics management information System in some shape and form, only six percent of the aforesaid were electronic.<\/p>\n

Back then, as many as 84 percent \u201cof health facilities reported stockouts of essential medicines and health supplies in the past six months,\u201d the study revealed. It added that 59 percent of the stockouts were caused by \u201ca sudden increase in demand; 40 percent [by] delivery gaps\/delayed deliveries; and 35 percent [by] \u201cdiscrepancies in orders and deliveries.\u201d<\/p>\n

The researchers further noted thus: \u201cHealth facilities responded to stockouts through various means, including (75 percent) redistribution (43 percent) purchased from a distributor, and (30 percent) placing emergency orders.\u201d<\/p>\n

They proceeded to conclude thus: \u201cThe findings from this study show that the performance of health facilities in different supply chain processes and functions was defective. To improve the supply chain performance of health facilities, it is important to invest in infrastructure development, provide computer hardware and Internet connection and strengthen the capacity [of] key personnel.\u201d<\/p>\n

It added: \u201cThis is key for ensuring full functionality of the supply chain and availability of quality medicines and health supplies to the end-user.\u201d<\/p>\n

The research was carried in the Journal of Pharmaceutical Policy and Practice.<\/p>\n

For More News And Analysis About Uganda<\/a> Follow Africa-Press<\/a><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

Africa-Press – Uganda. The late delivery of essential medicines, expiry of drugs, and acute stockouts continue to threaten the operations of key government referral hospitals in north and north-eastern Uganda. The press has established that Gulu, Mbale, Moroto and Mubende regional referral hospitals have been critically affected. Ms Chemurian Everlyn, a drug dispenser at Gulu […]<\/p>\n","protected":false},"author":84,"featured_media":68966,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2,3],"tags":[233,240,234],"class_list":["post-68967","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-all-news","category-community","tag-africa-press","tag-africa-press-uganda","tag-uganda"],"yoast_head":"\nPublic hospitals grapple with medicine stockouts - Uganda<\/title>\n<meta name=\"description\" content=\"The late delivery of essential medicines, expiry of drugs, and acute stockouts continue to threaten the operations of ...\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.africa-press.net\/uganda\/all-news\/public-hospitals-grapple-with-medicine-stockouts\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Public hospitals grapple with medicine stockouts\" \/>\n<meta property=\"og:description\" content=\"The late delivery of essential medicines, expiry of drugs, and acute stockouts continue to threaten the operations of ...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.africa-press.net\/uganda\/all-news\/public-hospitals-grapple-with-medicine-stockouts\" \/>\n<meta property=\"og:site_name\" content=\"Uganda\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/AfricaPressTunisiaa\" \/>\n<meta property=\"article:published_time\" content=\"2024-03-16T17:40:21+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/static.africa-press.net\/uganda\/sites\/34\/2024\/03\/sm_1710594277.631824.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"800\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"cfeditoren\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"cfeditoren\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"8 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/www.africa-press.net\/uganda\/all-news\/public-hospitals-grapple-with-medicine-stockouts#article\",\"isPartOf\":{\"@id\":\"https:\/\/www.africa-press.net\/uganda\/all-news\/public-hospitals-grapple-with-medicine-stockouts\"},\"author\":{\"name\":\"cfeditoren\",\"@id\":\"https:\/\/www.africa-press.net\/uganda\/#\/schema\/person\/068c7ab4e9634ae78ec5d54ec46598bb\"},\"headline\":\"Public hospitals grapple with medicine stockouts\",\"datePublished\":\"2024-03-16T17:40:21+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/www.africa-press.net\/uganda\/all-news\/public-hospitals-grapple-with-medicine-stockouts\"},\"wordCount\":1579,\"commentCount\":0,\"image\":{\"@id\":\"https:\/\/www.africa-press.net\/uganda\/all-news\/public-hospitals-grapple-with-medicine-stockouts#primaryimage\"},\"thumbnailUrl\":\"https:\/\/static.africa-press.net\/uganda\/sites\/34\/2024\/03\/sm_1710594277.631824.jpg\",\"keywords\":[\"Africa Press\",\"Africa Press-Uganda\",\"uganda\"],\"articleSection\":[\"all news\",\"community\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\/\/www.africa-press.net\/uganda\/all-news\/public-hospitals-grapple-with-medicine-stockouts#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.africa-press.net\/uganda\/all-news\/public-hospitals-grapple-with-medicine-stockouts\",\"url\":\"https:\/\/www.africa-press.net\/uganda\/all-news\/public-hospitals-grapple-with-medicine-stockouts\",\"name\":\"Public hospitals grapple with medicine stockouts - 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