Factors Affecting Quality in Public Sector Health Supply Chains in Uganda: A Case of National Medical Stores

Abstract

This study sought to analyze the factors affecting the quality of medicines in Public Sector Health Supply Chains in Uganda taking the case of National Medical Stores (NMS). In particular, the focus was the effect of procurement management, storage of medicines, and pharmaceutical quality assurance on the quality of medicines. The study used perception data collected from a sample of 85 respondents from NMS and Key Informant Interviews with NMS key heads of department. Results were summarized at three levels of analysis, namely; univariate using frequencies and percentages, bivariate analysis using Pearson’s correlation coefficient, and multivariate analysis using multiple linear regression. The objectives of this study were answered with results from the multiple linear regression model. Perception data was used because NMS does not have a quality control laboratory for testing the quality of medicines Findings from the descriptive analysis indicated that respondents agree that procurement management (mean score=4.08), storage of medicines (mean score=4.2), and pharmaceutical quality assurance (mean score=4.0), have a relationship on the quality of medicines distributed to health facilities at NMS. The study revealed that there is a statistically significant positive relationship between procurement management (p-value=0.049) and quality of medicines at NMS with attributes such as medicine specifications, procurement system on evaluating procurement samples, tender evaluation process, and sourcing based on the capability to supply good quality medicines as being key in driving this positive effect. Also, the study further revealed a positive statistically significant effect of pharmaceutical quality assurance (p-value=0.037) on the quality of medicines with attributes such as quality assurance manual, an inspection of all incoming shipments, and expiry of medicines being key in driving this positive effect. However, findings revealed that storage of medicines (p-value>0.05) was not significant at influencing the quality of medicines. The study recommends that: NMS should establish a quality control laboratory for testing the quality of medicines before distributing them to health facilities as this will help in avoiding recall and rejection of medicines in health facilities due to quality standards, NMS should maintain robust procurement systems such that areas such as evaluation of procurement samples, tender evaluation process, and sourcing based on the capability to supply good quality medicines are well managed to reduce on the risk of xii compromising quality during procurement of medicines. Finally, NMS should maintain good storage practices especially temperature monitoring, humidity, and dust in the warehouse as there were revealed as key areas under storage that do affect the quality of medicines.