Inventory management practices and supply chain performance of antiretroviral medicines in public hospitals in Nyamira county, Kenya

Abstract

Availability of essential medicines at all times in sufficient amounts is crucial to the success of any functioning health system. Unreliable supply systems have however plagued the provision of uninterrupted supply of these life-saving medicines in many developing countries, with antiretroviral medicines used in managing HIV having the worst repercussions. This study sought to: identify the inventory management practices used, evaluate the supply chain performance and determine the challenges affecting inventory management of ARV medicines in public hospitals. The study used a descriptive cross-sectional design and targeted eight public hospitals in Nyamira County, Kenya. Census method was used to sample officers involved in ARV medicines management namely: hospital pharmacists, facility in charges, sub-county pharmacists, antiretroviral therapy nurses, county pharmacist and hospital administrators. Primary data was collected using semi-structured questionnaires, key informant interviews and checklists whereas secondary data was retrieved from the DHIS2. Data collected was analyzed using descriptive statistics. Descriptive statistics was used to provide percentages, frequencies and measures of central tendencies. The study found that the prevailing inventory management practices in Nyamira County public hospitals included: use of scheduled inventory control model (80.95%), forecasting demand using previous consumption data (100%), keeping accurate and updated stock records for each commodity (92.31%), including essential logistical data in reports (100%), including safety stock (61.54%) and keeping ARV medicines in dedicated stores (75%). With the exception of order lead time (17.98 days), the other supply chain performance metrics namely stock out rate (52.12%), stock wastage rate (43.2%) and reporting rates (70.84%) were found to be deficient. The challenges mostly affecting inventory management unearthed were: inadequate staff, inadequate training, lack of proper storage and unreliable supply of medicines. The study recommends regular training, adoption of electronic inventory system, use of data for decision making, dedicated storage of ARV medicines and inclusion of buffer stock as some strategies to improve the inventory management and consequently supply chain performance of ARV medicines