Factors influencing availability, of essential drugs in primary health care facilities in Kisarawe district, coast region.

Abstract

This study focused on "Factors influencing availability of essential drugs in primary health care facilities in Kisarawe district, Coast Region". It was conducted in a good spirit of assisting District Health Management Team to improve drug availability in public primary health care facilities. Previous research findings do not provide sufficient information regarding factors which could influence drug availability in public primary health care facilities. A total of seven out of thirteen public primary health care facilities in the district were selected and studied. They included the available two health centres, and among eleven dispensaries, five were selected randomly. For the purpose of this study few factors were studied. Factors which were studied included drugs supply, staffing, prescribing patterns, storage conditions, number of users per month and availability of other partners delivering health care within the catchment area. Availability of reference manuals sucn as the 'standard treatment guidelines' from the Ministry of Health was also determined. Information was collected by interviews, observations and review of records. Study findings showed that drug availability was better in the health centres than in the dispensaries, which possibly related to the large quantity of stock supplied to health centres, less number of users per month, 'presence of better storage conditions . and presence of other alternatives of health care delivery (such as missionary dispensary and medical stores).

Vll Although dispensaries had higher proportion of correct prescriptions (91.2%) compared to the health centres (81.5%), they recorded low drug availability. This could be attributed to the fact that dispensaries received low quantity of stock than health centres, had more users per month compared to health centres, had poor storage conditions as some facilities stored drugs at home, and lacked alternative options for health care delivery within their catchment areas. In both groups of primary health care facilities, drug supply was regular and none of the facilities had the 'standard treatment guideline' from the Ministry of Health. The cold chain was operating in the health centres only. In the dispensaries visited the cold chain was about to. collapse as there was either no kerosene or the refrigerators needed repair. Analysis of prescriptions from Health Management Information System (HMIS) record books for the previous six months showed that the higher the qualification of the prescriber the higher the proportion of correct prescriptions. These findings were in line with the current on-going health sector reforms in Tanzania. Unlike other studies, this study offers more information on factors studied. Information gathered from the study and recommendations given at page 43 of this dissertation can guide the District Health Management Team (DHMT) in improving drug availability, staffing, and the quality of care in primary health care facilities.