Availability and Expiry of Essential Medicines and Supplies During the ‘Pull’ and ‘Push’ Drug Acquisition Systems in a Rural Ugandan Hospital
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Date
2010
Journal Title
Journal ISSN
Volume Title
Publisher
Tropical Journal of Pharmaceutical Research
Abstract
To assess the impact of the ‘Pull’ system on the availability and reduction of expiry of
essential medicines and medical supplies and to determine factors affecting their availability in Kilembe
Hospital, Uganda.
Methods: Records of 27 essential medicines and 11 medical supplies were reviewed over two-year
periods in the Push (2000 - 2001) and Pull system (2004 - 2005). Key informant interviews were
conducted. The data were analyzed using STATA version 8. Comparison of availability was effected
using Wilcoxon signed rank tests.
Results: The median number of days out-of-stock for drugs and medical supplies was 94 versus 24 (p <
0.001) and 8 versus 0 (p < 0.39) for the Push and Pull systems, respectively. The mean percentage
days out-of-stock in the two periods was 15.3 % versus 3.5 % (p < 0.001) and 1.8 % versus 1.3 % (p =
0.34) for drugs and medical supplies, respectively. Expired drugs were worth USD 1584 (25 items) in
2000/2001 and USD 1307 (13 items) in 2004/2005. Factors contributing to availability of supplies were
inadequate training, lack of transport and inadequate funding.
Conclusion: The Pull system improved availability of essential medicines and reduced the volume of
expiries. Availability of funds, transport, staff training and supervision should be addressed for maximal
benefits.
Description
Keywords
Push system, Pull system, Availability of medicines, Medicines expiry
Citation
Tumwine, Y., Kutyabami, P., Odoi, R. A., & Kalyango, J. N. (2010). Availability and expiry of essential medicines and supplies during the ‘pull’and ‘push’drug acquisition systems in a rural Ugandan hospital. Tropical Journal of Pharmaceutical Research, 9(6).