A Study Of Availability Of Essential Medicines And Supplies During Dual Pull-Push System Of Drugs Acquisition In Kaliro District, Uganda

ABSTRACT

The Ugandan government has experimented with various supply chain models for delivery of

essential drugs and supplies. In 20 I 0, the dual pull-push system was adopted; however drug stock

outs are still a common occurrence in health facilities.

This study on availability of essential medicines during the dual Pull-Push system in Kaliro District

was undertaken; this was to be used as an indirect or direct indicator of availability of essential

drugs and medical supplies during the dual pull-push method. The study combined quantitative and

qualitative methods; the study mainly based on; Document review (stock cards, delivery notes, etc)

and Key informant interviews.

Results showed that; average stock-out duration of essential medicines and supplies was 23.89%

(20.47 % and 27.32% for medical supplies). ACT Artemetherllumefantrine 20/120 mg had the

highest percentage out of stock followed by Cotrimoxazole 480mg Tablets 51.6% and 32.4 %,

respectively. Among the shmi falls of the system was; Drug requisitions based on neither morbidity

nor consumption methods of quantification, and among the challenges in the system was; delays

during distribution, Supplying medicines with short shelf life, rare condition drugs or low usage

drugs. In conclusion, the trend of essential medicines and supplies availability of during the dual Pull-push system seemed to be declining since its inception in 2010. It was thus recommended that National

medical stores involve stake holders at all stages of medicines and supplies planning especially the

DHOs, who are the final consumers in the supply chain and Government adopt a revolving drug

fund system, in the form of 'Special Pharmacies and drug stores' to enhance availability of essential drugs in public facilities and improve quality of health care.