Management and Accessibility of Essential Medicines to Clients in Machakos County Referral Hospital, Kenya

摘要

Introduction: The World Health Organization estimates that one third of the world population lacks regular access to essential medicines. Inadequate essential medicines relate to the way health systems are organized, financed and managed. A client exit survey conducted in Machakos County Referral Hospital (MCRH) in 2012 indicated that 58% of clients were dissatisfied with availability of EMs in the hospital. Previous studies in MCRH had not established how management influenced accessibility of drugs. Purpose : This study was conducted to determine how management influenced accessibility of essential medicines (EM) to clients. The objective of the study was to establish how EM support systems were organized in the hospital. Methodology: The study included 226 outpatient clients who accessed medicines at the pharmacy, 46 clinicians, the Medical Superintendent, the pharmacist in charge and the in charge of supply chain. Data was collected through structured questionnaires and analyzed through SPSS version 20. Results : The study revealed a significant relationship between organizations of management support systems with accessibility of essential medicines (p=0.037), an average staff shortage of 227 (50%) to mange EMs, out of which 225 (97%) had not been trained on management of EM. The average wait time in pharmacy was less than 10 minutes per client, 93(43%) of all clients were not issued with all the drugs prescribed to them due sock outs, only 7(3%) cited lack of enough money to pay for drugs. There was a financial deficit of (33%) to procure essential medicines quarterly and 130 (60%) of the clients were satisfied with services rendered in the pharmacy. Conclusion : The study revealed both strengths and weaknesses in the management of essential medicines in MCRH, the weaknesses outweighed the strengths and as such influenced negatively accessibility of EMs to clients. Recommendations made to the hospital management included to diversify on resource mobilization, ensure adequate staffing, train all staff on essential medicines management and upgrade the existing health management information system in the hospital.