Factors affecting the availability of drugs used to manage hypertension and diabetes Mellitus in public health facilities at Nakuru County

Abstract

INTRODUCTION: Patients should always have access to medicines to ensure adherence and prevent the long term complications associated with poor management of hypertension and diabetes mellitus. This is possible through good procurement practices such as proper selection, proper quantification and other logistical aspects such as distribution and storage.

OBJECTIVES: Consequently, this study sought to mainly evaluate the factors that affect the availability of drugs used to manage hypertension and diabetes mellitus in public health facilities at Nakuru County. Specifically it sought to determine the types of anti-hypertensive and anti- diabetic drugs available in public health facilities; assess the procurement practices of anti- hypertensive and anti-diabetic drugs in public health facilities; and describe the storage and inventory management practices of anti-hypertensive and anti-diabetic drugs in public health facilities.

METHODS: A cross-sectional research design was used to assess the factors that affect availability of drugs used to manage hypertension and diabetes mellitus in public health facilities in Nakuru County, Kenya. The study targeted the 198 public health facilities in Nakuru County. Stratified random sampling technique was utilized to select 132 public health facilities. The study utilized survey questionnaires to collect data. To test and ascertain the reliability of the instruments to see if they measure the instruments in a manner that would be repeatable, a pilot study was done on 26 respondents from the sub county (10% of the sample size). To ascertain the extent to which the measuring instruments actually measure the study variables efficiently, the supervisor reviewed the content of the instruments and advised accordingly. Quantitative data from the questionnaires was analyzed using key statistical tools like the mean, counts, standard deviation and percentages. Then, the study employed multivariate regression analysis as an inferential statistical tool to assess the extent to which the factors (procurement practices and inventory practices) had impacted on availability of anti hypertension and anti-diabetes drugs in public health facilities in Nakuru County RESULTS: The adjusted R square of .619 show that type of antihypertensive and diabetes drugs, procurement practices and storage and inventory management practices factors predicted availability of those drugs at 61.9%. This is a significant predictor value that implies that type of antihypertensive and diabetes drugs, procurement practices and storage and inventory management practices factors have a significant influence on availability of drugs used to manage hypertension and diabetes mellitus. Further, the p-value of .001 which is <0.05 shows that type of antihypertensive and diabetes drugs, procurement practices and storage and inventory management practices factors have a significant relationship with availability of drugs used to manage hypertension and diabetes mellitus .

CONCLUSION: The antihypertensive and diabetes drugs were mainly inadequate or totally unavailable. Also, the referral hospital was much endowed with antihypertensive and diabetes drugs followed by the health center then sub county hospital and finally the dispensary. The dispensary suffered most due to unavailability of antihypertensive and diabetes drugs followed by the health center and then the sub-county hospitals. The procurement practices of anti Hypertension and anti-diabetic drugs were not effective and efficient. Further, the dispensaries then the sub county hospitals followed by the health centres were places where procurement practices ineffectiveness and inefficiencies were most seen which affected availability of antihypertensive and diabetes mellitus drugs. The storage and inventory practices of anti Hypertension and anti-diabetic drugs were effective and efficient at the public health facilities in Nakuru County. Further, the county referral hospital was most effective and efficient storage and inventory management which helped advance antihypertensive and diabetes mellitus drugs availability followed by the sub county hospitals, dispensaries and lastly the health centers. Engaging in public private partnerships to inject financial resources and creating a procurement vii committee to oversee all procurement practices and align them to the public procurement Act of 2015 to ensure antihypertensive and diabetes mellitus drugs are available at all times are some of the key strategies that management can use.