Factors that affect the availability of medicines in public health facilities in Kenya: A case study of Nairobi city county

Abstract

Background: According to the World Health Organization (WHO), drug shortage is a multifaceted and global problem, affecting both developing and developed countries. Medicines are a crucial part of healthcare, and their availability is important to ensure patients’ access to quality and affordable services. Drug shortages and misuse have a far-reaching effect on patients’ well-being and the hospital’s operations. Objective: To evaluate the factors affecting the availability of medicines in public health facilities within Nairobi City County. Methodology: A descriptive cross-sectional design was used. Purposive sampling was employed to select eight hospitals within Nairobi City County from which twenty-two participants were recruited. Within each facility, key informants were selected from the departments concerned with the management of medicines including pharmacy, procurement and finance departments. Data was collected using questionnaires and key informant interviews. Findings were summarized and presented in tables and graphs. Results: All the facilities had experienced both drug shortages and drug expiries in the previous quarter, with 75% of them having a drug fill rate of between 50% and 70%. The selection and quantification of drugs was carried out by the pharmacy department. Competitive and direct procurement methods were the most common practices. Supplier evaluations were regularly carried out. Inadequate funds, delays in funds disbursement, staffing shortages and bureaucratic bottlenecks were cited as the major challenges. The use of manual data recording systems was common practice. Conclusion: The availability of medicines was dependent on many factors that cut across departments. Lack of medicines was a chronic problem in all the facilities