https://dr.ur.ac.rw/handle/123456789/1489 This community comprises documents related to RCE-VIHSCM 2026-04-15T19:32:45Z https://dr.ur.ac.rw/handle/123456789/2129 Availability and price variation of essential medicines in public health facilities in Rwanda during the Covid-19 pandemic. Case study of district hospitals in Kigali City and Eastern Province NYAGATUNTU, Valens Background: Since long ago, humanity has been facing natural disasters, calamities, and pandemics whose aftermaths were disastrous and affected the availability of essential medicines. Smallpox and tuberculosis devastated the globe before the advancement of health sciences. The situation worsened in December 2019 with the Breakout of COVID-19. The pandemic has affected over 200 countries and territories, with outbreaks in countries such as Mexico, Brazil, South Africa, Western Europe, India, Peru, and the United States of America are just a few of the countries involved among others. This study was conducted to see how the COVID-19 pandemic impacted the availability and price of essential medicines in public health facilities in Rwanda. Methods: Cross-sectional descriptive study design was used to determine how the COVID-19 pandemic affected the availability and price of essential medicines in Rwandan public health institutions. Participants were selected using the purposive sampling method. To collect data on the availability of vital products, stock cards of essential drugs were carefully selected. Checklists and end-to-end structured questionnaires were used to collect data based on USAID Logistics Indicators Assessment Tool (LIAT). The data were entered into MS Excel, then analyzed with SPSS software version 21.0. Results: The findings of this scientific work revealed that the level of availability was (89%) and the price during COVID-19 was high relative to the selling price before COVID-19 pandemics where the high price change rate was observed at Cimetidine inj. 200mg/2ml (201%), Dexamethasone 4mg/ml 1ml inj (254%), Examination gloves latex, non-sterile (265%) and Adrenaline inj. 1mg/ml (214%). The availability has been mostly affected by factors like limited number of suppliers and heavy workload (89%), absence from work due to COVID-19 illness (84%), and other factors linked to COVID-19 movement restrictive measures. Conclusion: The level of availability was at 89%, the delivery status and the level of sufficiency were appreciated. However, more than 73% concurred on factors such as the limited number of suppliers, heavy workload, absence from work due to illness, long lead time, limited transport affected the availability of EM in the Public Health Facilities in Rwanda. Hence, the price of essential medicines during the COVID19 pandemic was high relative to the price before the COVID-19 pandemic. Master's Dissertation 2022-01-01T00:00:00Z https://dr.ur.ac.rw/handle/123456789/2128 Factors affecting sustainability of new technologies for health supply chain management in the regional referral hospitals of Uganda FRANCIS, OBOI Background: The lack of sustainability of suitable health technologies has been mooted as one of the causes of poor performance of health supply chains in many countries. This together with poor supply chain practices results into weak information systems, poor commodity management and ultimately stock outs and wastages. Addressing challenges related to sustainability of new technologies is therefore critical in realizing the benefits of the technologies in improving Health Supply Chain Management (HSCM). This study assessed factors affecting sustainability of new technologies in HSCM in Regional Referral Hospitals of Uganda (RRHs). Method: This was a mixed methods study employing both qualitative and quantitative methods of data collection. Participants were purposively selected from fourteen RRHs Uganda. The data collected was entered into epidata, cleaned and exported to SPSS version 26 and Microsoft excel for analysis. Results: Most of the RRHs reported having no access to reliable internet connectivity 9 (64.3%), no Information Technology (IT) staff to support use of technologies 10 (71.4%) and no separate budget for new technologies 13(92.8%) and their maintenance 11(78.6%). Most of the funding for introduction of the new technologies was provided by the implementing partners 11 (78.6%). Filling of established supply chain management positions and training of supply chain staff on use of new technology in majority of RRHs 6(42.9%) was to a level of 75%. The majority 11(78.6%) of the respondents revealed that technology had increased their workload and few 6(42.9%) were consulted before a new technology was introduced. Only half 7 (50%) reported having adequate knowledge on use of the new technologies. The proposed interventions to improve sustainability of new technologies included; involvement of various stakeholders, good leadership and governance, capacity building, budgeting and planning for new technologies. Conclusion and recommendations: The main facility factors reported to affect sustainability of new technologies were lack of separate budget for maintenance of new technologies, few supply chain staff, lack of access to reliable internet connectivity and lack of IT support. Increased workload and lack of consultation before introduction of new technologies were reported as individual factors affecting sustainability. The government needs to improve on provision and maintenance of new technologies infrastructure such as reliable internet connectivity, electricity and computers, fill existing staffing positions to 100%, plan and separate budget allocation for new technologies maintenance. The government should consider creating positions of IT in RRHs structure Master's Dissertation 2022-01-01T00:00:00Z https://dr.ur.ac.rw/handle/123456789/2124 Factors contributing to wastage of Measles-Rubella and Bacillus Calmette–Guérin vaccines at health facilities: case study of Rombo DC, Tanzania Remig, John The multi-dose lyophilized vaccines (Measles/Rubella and Bacillus Calmette–Guérin vaccines) have limited time for use after reconstitution and hence have an avoidable wastages which make vaccinators to hesitate to open the vial for few clients. In line with this the study sought to assess the rate of vaccine wastage at the facility and further examine the influence of vaccinators and vaccine handlers’ education, attitude and practices on MR and BCG vaccines wastage. To achieve the intended objectives a structured questionnaire and vaccine stock monitor in tool were used to gather data from the vaccinator and vaccine handlers in 34 vaccination facilities in Rombo district, Kilimanjaro Tanzania. The data collected covered one year, a period before Covid19 pandemic and during Covid –19 pandemic (July 2019 to June 2020). The average vaccine wastage mean was 32.03% and 59.53% for MR and BCG vaccine respectively, likely wise the average wastage for un-open was 0.52% and 2.12% for MR and BCG vaccines respectively. Where for opened vial wastage was 27.28% and 57.09% for MR and BCG vaccines respectively. Before Covid-19 the average wastage was 23.09% and 57.94% for MR and BCG vaccines while during Covid-19 the average wastage was 32.51% and 60.47% respectively. Most of the service providers were knowledgeable and they had positive attitude on MR and BCG vaccine wastage, stock management and usage strategies to reduce wastage. The study also revealed a positive relationship between knowledge and practice where increased knowledge lead to proper practices which in turn reduces vaccine wastage. The vial size was the main contributing factors for MR and BCG vaccine wastages at the health facilities. Rescheduling days for vaccination was a strategies for reducing vaccine wastage fearing open vaccines for few clients. Attitude was observed to negatively relate to vaccine wastage that is a positive attitude to managing vaccine results into decrease in vaccine wastage and vice versa. The study recommends for improved knowledge of the vaccinators and vaccine handlers for them to be able to perfect their practices which include proper scheduling of the vaccination dates and number of the clients. Master's Dissertation 2022-01-01T00:00:00Z https://dr.ur.ac.rw/handle/123456789/2079 Assessment of factors affecting effective vaccine cold chain management in public health facilities in Kisii County, Kenya DAPHINE, KERUBO NYANDONDI Background To maintain a reliable vaccine cold chain, different key procedures need to be observed during storage, transportation, handling, and administration to the end user. Otherwise, there will be loss of vaccine potency leading to death due to vaccine preventable diseases. Objective The objective was to assess the factors affecting effective vaccine cold chain management in public health facilities in Kisii County, Kenya Methods The study was carried out in public health facilities that offer immunization services in Kisii County. A descriptive cross-sectional design was adopted, and ninety-four health facilities selected. The respondents were vaccine handlers in the selected health facilities. Data collection was done using structured questionnaires. Data was analyzed by use of Microsoft Excel and Statistical Package for Social Sciences (SPSS)software(Ver 28,2021) and results presented in tables. Study approval was sought from the ethics committee, KNH/UON-ERC prior to commencing the study. Results The vaccine handlers in Kisii county have adequate knowledge , the right practices, and a positive attitude towards effective vaccine cold chain management. There was availability of functional refrigerators and thermometers, lack of backup generator and fuel and inadequate equipment maintenance .The most common barriers to effective vaccine cold chain management included insufficient funding, inadequate qualified human resource, lack of new technology and lack of equipment maintenance. Conclusion and recommendations The gaps identified include financial, technological, and human resource. There is therefore need for resource mobilization to curb the identified gaps. Master's Dissertation 2019-01-01T00:00:00Z