PDF(Pubmed)
Abstract：
BACKGROUND: Stock-outs of some life-saving drugs, such as emergency obstetric drugs, are evident in many health facilities and have been reported to be the leading cause of maternal mortality and morbidity for women from low and middle income countries (LMICs). For many cases, this situation is associated with poor inventory management practices. The aim of this study was to investigate the influence of inventory management practices on the availability of emergency obstetric drugs in Rwandan public hospitals: case of the Rwanda Southern Province. Moreover, to gain a better grasp of the problem and to suggest possible areas for improvement.
METHODS: An institutional-based cross-sectional study was carried out in all ten district hospitals (DHs) providing maternal health care and dispensing emergency obstetric drugs namely; Kigeme DH, Munini DH, Kabutare DH, Kibilizi DH, Gakoma DH, Nyanza DH, Ruhango DH, Gitwe DH, Kabgayi DH and Remera Rukoma DH. Both quantitative and qualitative data were collected and analyzed. Oxytocin injection, Misoprostol tablet and Magnesium sulphate injection as recommended emergency obstetric drugs by WHO, UNFPA and Rwanda Essential Medicines list were included in the study.
RESULTS: The study revealed that keeping logistics management tools up to date is the backbone of inventory management practices in the availability of medicines and medical supplies. The results showed that hospitals with up-to-date logistics tools for their pharmaceutical management were 33.25 times more likely to have their emergency obstetric drugs in stock at all times compared to those that do not regularly update their logistics tools. The proper use of bin cards and electronic software (e-LMIS) contributed greatly to reducing the stock-out rate of emergency obstetric drugs by 89.9% and reduction of unusable to usable stock ratio by appropriate use of simple techniques such as the Min-Max inventory control model by 79%. Over an 18-month period, misoprostol tablet had the highest average days (32) of stock-outs (5.9%), followed by magnesium sulphate injection with an average of 31 days (5.7%), and oxytocin injection with an average of 13 days (2.4%).
CONCLUSIONS: Proper use of pharmaceutical management tools within hospitals premises positively influence the availability of life-saving drugs, such as emergency obstetric drugs. Adequate supply chain staffing in health facilities is the most important key to improving inventory management practices and medicine availability.
METHODS: An institutional-based cross-sectional study was carried out in all ten district hospitals (DHs) providing maternal health care and dispensing emergency obstetric drugs namely; Kigeme DH, Munini DH, Kabutare DH, Kibilizi DH, Gakoma DH, Nyanza DH, Ruhango DH, Gitwe DH, Kabgayi DH and Remera Rukoma DH. Both quantitative and qualitative data were collected and analyzed. Oxytocin injection, Misoprostol tablet and Magnesium sulphate injection as recommended emergency obstetric drugs by WHO, UNFPA and Rwanda Essential Medicines list were included in the study.
RESULTS: The study revealed that keeping logistics management tools up to date is the backbone of inventory management practices in the availability of medicines and medical supplies. The results showed that hospitals with up-to-date logistics tools for their pharmaceutical management were 33.25 times more likely to have their emergency obstetric drugs in stock at all times compared to those that do not regularly update their logistics tools. The proper use of bin cards and electronic software (e-LMIS) contributed greatly to reducing the stock-out rate of emergency obstetric drugs by 89.9% and reduction of unusable to usable stock ratio by appropriate use of simple techniques such as the Min-Max inventory control model by 79%. Over an 18-month period, misoprostol tablet had the highest average days (32) of stock-outs (5.9%), followed by magnesium sulphate injection with an average of 31 days (5.7%), and oxytocin injection with an average of 13 days (2.4%).
CONCLUSIONS: Proper use of pharmaceutical management tools within hospitals premises positively influence the availability of life-saving drugs, such as emergency obstetric drugs. Adequate supply chain staffing in health facilities is the most important key to improving inventory management practices and medicine availability.
摘要：
背景：一些救生药物的缺货，如紧急产科药物，在许多保健设施中都很明显，据报告是低收入和中等收入国家（LMICs）妇女孕产妇死亡率和发病率的主要原因。在许多情况下,这种情况与不良的库存管理做法有关。这项研究的目的是调查库存管理做法对卢旺达公立医院紧急产科药物供应的影响：卢旺达南部省为例。此外，更好地把握问题，并提出可能的改进领域。
方法：在所有十家提供孕产妇保健和分配紧急产科药物的地区医院（DHs）中进行了基于机构的横断面研究；KigemeDH，MuniniDH,KabutareDH,KibiliziDH,加科马DH,NyanzaDH,RuhangoDH,GitweDH,KabgayiDH和RemeraRukomaDH.收集和分析了定量和定性数据。催产素注射液,米索前列醇片和硫酸镁注射液作为WHO推荐的紧急产科药物，人口基金和卢旺达基本药物清单被纳入研究。
结果：研究表明，保持最新的物流管理工具是药品和医疗用品供应库存管理实践的支柱。结果表明，与那些不定期更新其物流工具的医院相比，拥有最新物流工具的医院在任何时候都有紧急产科药物库存的可能性都是33.25倍。适当使用箱卡和电子软件（e-LMIS）极大地有助于将急诊产科药物的缺货率降低89.9％，并通过适当使用Min-Max等简单技术将不可用与可用库存比率降低79％库存控制模型。在18个月的时间里，米索前列醇片的平均缺货天数最高(32)(5.9%)，其次是硫酸镁注射，平均31天(5.7%)，和催产素注射平均13天（2.4％）。
结论：在医院内正确使用药品管理工具会积极影响救生药物的可用性，如紧急产科药物。卫生设施中充足的供应链人员配置是改善库存管理实践和药品供应的最重要关键。
方法：在所有十家提供孕产妇保健和分配紧急产科药物的地区医院（DHs）中进行了基于机构的横断面研究；KigemeDH，MuniniDH,KabutareDH,KibiliziDH,加科马DH,NyanzaDH,RuhangoDH,GitweDH,KabgayiDH和RemeraRukomaDH.收集和分析了定量和定性数据。催产素注射液,米索前列醇片和硫酸镁注射液作为WHO推荐的紧急产科药物，人口基金和卢旺达基本药物清单被纳入研究。
结果：研究表明，保持最新的物流管理工具是药品和医疗用品供应库存管理实践的支柱。结果表明，与那些不定期更新其物流工具的医院相比，拥有最新物流工具的医院在任何时候都有紧急产科药物库存的可能性都是33.25倍。适当使用箱卡和电子软件（e-LMIS）极大地有助于将急诊产科药物的缺货率降低89.9％，并通过适当使用Min-Max等简单技术将不可用与可用库存比率降低79％库存控制模型。在18个月的时间里，米索前列醇片的平均缺货天数最高(32)(5.9%)，其次是硫酸镁注射，平均31天(5.7%)，和催产素注射平均13天（2.4％）。
结论：在医院内正确使用药品管理工具会积极影响救生药物的可用性，如紧急产科药物。卫生设施中充足的供应链人员配置是改善库存管理实践和药品供应的最重要关键。
