Assessment of factors contributing to medicines expiry in Rwanda. Case of central medical store; MPPD

Abstract

Since many years, medicines’ supply chain in Rwanda knew much inefficiency from poor quantification, fragmented distribution, and inexistence of a harmonized logistics information system in health. This has led to a disruption in the health commodity supply chain and the government’s ability to achieve its health goals has been compromised. The remediation of these problems has been the establishment of new strategies by the Government of Rwanda (GOR) and the partnership with stakeholders to make more strong and sustainable its supply chain management. Regardless of the significant efforts that used and put in place to enhance supply chain performance in Rwanda, reports done by the Auditor General, have revealed consistent problems related to poor inventory management and big loss due to expiry of medicines at MPPD. From there, it’s important that in-depth exploration be done to understand the status of expiry in detail at Central medical store and identify the factors that contribute to expiry of medicines at that level. The aim of this research was to assess the factors that contribute to or cause expiry of medicines at MPPD and from there formulates some recommendations for the improvement of the current situation. The questionnaire containing closed-ended items has been used during this study. Multiple choices have been given and the respondents were asked to tick appropriate choices. The study found that the total expired products were RWF 6,046,777,655 for all program categories: HIV commodities had the largest share 53.3%, Essential Medicines 22.5%, Malaria 13%, Maternal Child Health commodities 5.7%, Products used for Community health workers 4.5%, TB products 1% and 0.1% for Family Planning products. The study indicated that 60% of the respondents agree that excess drug supply affects the expiry of medicines at MPPD,20% agreed that poor storage conditions affect the expiry of medicines at MPPD against 56% who disagreed that poor conditions affect the expiry of medicines at MPPD, 32% of respondents agreed that supply chain management affects the expiry of medicines at MPPD and for other factors all the statements were agreeable with a percentage above 60 (Rare diseases affect the expiry of medicines at MPPD 88%, Abrupt cessation of use/treatment policy change affects the expiry of medicines at MPPD 80%, Short shelf life affect the expiry of medicines at MPPD 72%, Expensive medicine affects the expiry of medicines at MPPD 72% and donation of management affects the expiry of medicines at MPPD 68% and). The study recommended that further research should be done on the factors that contribute to or cause expiry of medicines at MPPD concerning especially how the institution is accountable on the iii management of products subsidized where Government is funded by donors because they are many that expire at MPPD. Further research should also be conducted on the contribution of customer relationship management on the expiry of medicines at MPPD. There is a need for other researchers to undertake similar studies to ascertain how different institutions (public or private) deal with the issues of medicine expiry