Factors contributing to persistent stock outs of essential medicines and healh supplies at lower level health facilities in Wakiso District.

Abstract

BACKGROUND: Despite progress in increasing the number of people with access to essential medicines and health supplies (EMHS) over the past decades, vulnerable populations still lack access to them and the situation seems to be deteriorating. EMHS stock-outs at health facilities in Wakiso District and Uganda have continued to undermine the quality of services offered. OBJECTIVE: The main aim of the study was to identify factors contributing to persistent EMHS stock-outs at lower health facilities in Wakiso District. METHODOLOGY: The study was cross sectional employing both qualitative and quantitative data collection methods at thirty (30) lower level public health facilities in Wakiso District. Data for a three year period (April 2004-March 2007) was collected and analysed to provide the trend and factors contributing to persistent EMHS stock outs. RESULTS: Seasonality of EMHS stock outs was evident over the three year period at the three health facility levels in Wakiso District. Stock-outs were generally high in quarter 4 and low in quarter 1. EMHS stock outs were highest at H/C IV but similar at H/C II and III. Healthy facility utilisation (Adjusted Odds ratio (AOR), 95% confidence intervals (CI): 17.2, 2.8-31.6) and poly-pharmacy (AOR, 95%C1: 5.6, 3.4-9.8) were independently associated with EMHS persistent stock out. Availability of essential drug list, training of the EMHS manager, knowledge of HUMC role in EMHS management by the facility in charge and provision of technical supervision by the DHMT were found to modify the effect of use of skills gained after EMHS management training on persistent EMHS stock outs. CONCLUSION: EMHS stock out seasonality exists at lower health facilities in Wakiso District. A number of factors contributed to persistent EMHS stock outs therefore a need to implement an integrated comprehensive strategy to minimise the stock outs.