Anti-Tuberculosis Commodities Management Performance and Factors Affecting It at Public Health Facilities in Dire Dawa City Administration, Ethiopia

Abstract

Background

Health facilities (HFs) need extensive ranges of anti-tuberculosis (TB) drugs and related TB laboratory commodities (LCs) for diagnosis, prevention, and treatment of TB and multi-drug-resistance (MDR)-TB. This study was aimed to assess anti-TB commodities management performance at public HFs of Dire Dawa city administration, Ethiopia.

Methods

A cross-sectional study design in 16 HFs providing TB and MDR-TB related service using quantitative and qualitative method was conducted. Semi-structured questionnaires and observation checklists with logistic indicators assessment tools were used to collect data. We used an in-depth interview and analyzed using a thematic approach. Quantitative data were entered into Epi-Data version 3.1 and transported to SPSS version 20 to analyze the results. Chi-square was used to test the association and a P-value<0.05 was statistically significant.

Results

The majority(13; 81.3%) of HFs used a health commodity management information system. Forty-two (40%) bin cards (BCs) for first line anti-TB drugs were not updated, while 62.5% of BCs were updated for second line drugs. On average, 43% of HFs accurately reported a report and requisition format (RRF) had significant association with the presence of a logistic management information system (LMIS) and standard operating procedure (P=0.019). Of the HFs, 50% had good storage conditions and guidelines (P=0.041). Regimen change (56.3%; P=0.035), receive near expiry (56.3%; P=0.035), and defective practice to first expired-first-out (50%; P=0.007) were reasons for wastages. About 50% and 66.6% of HFs were stocked out for isoniazid 300 mg, rifampicin, isoniazid, pyrazinamide (RHZ fixed dose), and ethambutol 400 mg with a mean stock out duration of 10.8, 18.9, and 70.5 days, respectively. Regimen change (68.8%; P=0.026), low demand (56.3%; P=0.041), and delay to resupply (37.5%; P=0.041) were reasons for stock out of anti-TB commodities.

Conclusion

Anti-TB drugs and LCs management performance of the HFs were found to be defective, which was confirmed by unsatisfactory data records, inconstant reports, deprived stock record accuracy, long lead time, high stock out rate, wastages, defective storage conditions, lack of training, and management support. Hence, respective organizations should improve their responsible activities to secure an uninterrupted supply of anti-TB drugs and LCs.

Keywords:

• anti-TB drugs
• MDR-TB
• laboratory commodities
• health facilities
• Ethiopia

Abbreviations

FDC, fixed dose combination; HCMIS, health commodities management information system; HFs, health facilities; IFFR, internal facility reporting and requisition from; IPLS, integrated pharmaceutical logistic system; LMIS, logistic management information system; MTB/RIF, Mycobacterium Tuberculosis/rifampicin test; PFSA, Pharmaceutical Fund and Supply Agency; RRF, report and requisition format; SOP, standard operating procedures.

Data Sharing Statement

Data can be obtained from the corresponding author upon request.

Supporting Information: Questionnaires and observation checklists to collect data to assess anti-tuberculosis commodities management performance and factors affecting it at public health facilities in Dire Dawa city administration, Ethiopia are available in Supplementary File S1.

Acknowledgments

We are grateful to Jimma University and Dire Daw city administration Health Bureau for their kind support. We would also like to thank all health facilities for their kind and cooperative response to our inquiries information.

Disclosure

The authors report no conflicts of interest in this work.