FACTORS INFLUENCING AVAILABILITY OF ESSENTIAL MEDICINES IN PUBLIC HEALTH FACILITIES IN KENYA: A CASE OF EMBU COUNTY
Caroline Wambui Muiruri - Master of Arts in Project Planning and Management, University of Nairobi, Kenya
Dr. Mercy M. Mugambi - University of Nairobi, Kenya
ABSTRACT
Healthcare provision involves curative, promotive, rehabilitative and preventative care. Both curative and preventative care involves the use of medicines and medical supplies. In order to provide effective treatment essential medicines and medical supplies must be available at the health facilities. About one third of the world’s population lacks access to essential medicines. The situation is worse for the developing continents especially Africa and Asia. Half of the population in Africa lacks essential medicines. This study sought to establish influence of health workers training on availability of essential medicines in public health facilities, to determine influence of health budgetary allocations on availability of essential medicines in public health facilities ,to examine influence of supplier stock levels on the availability of essential medicines in public health facilities and to assess influence of disease prevalence patterns on availability of essential medicines in public health facilities. Descriptive Survey design was used to conduct the research. The target population for the study was health workers dealing with essential medicines in the 94 health facilities in Embu County. Of the target population a sample of 49 health workers was used as derived using Yamane’s formula. Stratified random sampling and simple random sampling procedures were used to determine how the data collection instrument would be distributed. A Questionnaire was administered to the sampled population to obtain data. Data was first coded then analyzed using the statistical Package for Social Sciences (SPSS) and it was further subjected to Chi Square test analysis. Chi Square test is a test used in research to assist in the assessment of relationship between two or more mutually exclusive variables. This technique helps in comparing proportions observed to what would be expected under an assumption of independence between two variables. The study found that majority of the health workers were females and they were generally young. Most had a diploma level of academic qualification and they were nurses who had worked for less than five years. Majority of the health workers had knowledge on essential medicines with a significant number having attended commodity management trainings. The findings also indicated that a significant number of the respondents had attended short commodity management trainings as they felt that they were very relevant in their practice as health workers and there was need to attend such trainings once annually. Most of the sampled facilities were dispensaries which received a significant budget allocation for the procurement of essential medicines. The budget allocations were done quarterly though disbursement was mainly done half yearly. The study showed that Kemsa was the main supplier for essential medicines for the health facilities. However the suppliers did not stock all the essential medicines and their order fulfillment was averagely good. The study also indicated that there were no new diseases reported in a period of one year although if present a substantial amount of the essential medicines would have been consumed. The common diseases treated in the county were both communicable and non communicable diseases. The study revealed that all the factors investigated had an influence on the availability of essential medicines in public health facilities due to untrained staff, inadequate and untimely disbursements of budgets allocated to the health facilities, no of suppliers and supplier stock factors which were seen to inhibit the stocking abilities for the suppliers and the disease prevalence patterns. The study recommended that the stakeholders in health include commodity management trainings as a core discipline in all major health professions. Other recommendations included timely and sufficient budgetary allocation and disbursements to health facilities, increase the no of suppliers, hold regular meetings to provide feedback to the already existing suppliers and conduct surveillance on current disease patterns and also establish response budgets.
