Stock management of emergency obstetric care products in public health facilities in Dar es salaam region, Tanzania

Abstract

Background: In developing countries most women die from pregnancy related complications. In Tanzania maternal deaths is caused by hemorrhage, obstructed labour, unsafe abortion, infection (sepsis), and eclampsia (pregnancy induced hypertension). Indirect causes like malaria, HIV and anemia also contribute to maternal death. All these lives could be saved if affordable, good quality obstetric care were available 24 hours a day, in the presence of skilled birth attendant and available and accessible medicines and medical supplies for emergency obstetric care. Aim of the study: To assess the availability and stock management of emergency obstetric care products in public health facilities. Methods and materials: A Descriptive cross-sectional study was conducted in the public health facilities selected in a stratified random sampling technique to represent the public health facilities found in three municipalities of Dar es Salaam region. The study population included drug store managers, nurses in charge of the labour ward and pregnant women admitted and waiting to give birth (in hospitals), and those present at the facility on the day of visit. The Inventory Management Assessment Tool, a well validated tool of MSH was used to assess the availability of tracer products for the past three months at surveyed health facilities; Questionnaires were used to interview health workers and pregnant women. Data was collected between April 10thand May 29th 2013, after obtaining consent from the study participants. Results: The availability of EmOC products was found to be low at the health facilities; i.e. parental uterotonics by 19%, parenteral antibiotics 23.8%, parenteral anticonvulsants 33.3%. Most anti anemic drugs were seen to be present by 66.7% at the health facilities. Medical supplies showed a significant low availability as well. Most pregnant women were asked to bring in their items for delivery and majorities were able to bring the items that they were asked to bring before they gave birth. The knowledge of the drug store managers on stock management was found to be low. Oxytocin was found to be stored either directly on the floor, in metallic trays or in cool boxes which uses gas as a source of power. The results revealed that the storage condition at the labour ward in hospitals was dissatisfactory as compared to the health centre and dispensary levels where it was very dissatisfactory. Conclusion: The availability of EmOC products was found to be low at the surveyed health facilities. The consumption of EmOC products in the labour wards was found to be lower than the real actual consumption. The storage conditions in the labour wards were very dissatisfactory. Pregnant women were asked to bring in their own products for delivery. The present result shows the stock management of emergency obstetric care products was poor and the products were kept in an inadequate storage area.