Medicine stock Management at primary health care facilities in one South African province

As nations are encouraged to move towards achieving Universal Health coverage (UHC), access to essential medicines needs to be prioritized. In ensuring access to medicines, an important factor to be considered is the uninterrupted availability of essential medicines at the primary health care (PHC) level which is usually the first point of entry into the health system for patients. If South Africa is to move towards achieving UHC, the government must address the issue of unavailability of medicines due to frequent stock outs at the public health facilities. The increase in prevalence of HIV/AIDS and TB has resulted in an increase in the demand for medicines used in the management and treatment of these diseases. Surveys have revealed the extent of stock outs and shortages of medicines used in the management of HIV and TB in South Africa. It has also been predicted that the burden of disease in relation to these diseases is likely to increase in the coming years therefore, it is important for the South African government to address the issues of stock outs. Using a qualitative multiple case study approach, we explored the factors which may influence the management of medicine stock thus causing medicine stock outs at four PHC facilities in two of the districts in the study province. A conceptual framework on the factors influencing medicine stock outs at health facilities was developed from reviewing literature on the subject and this was used to guide data collection and analysis. Our findings revealed that the factors influencing the management of medicine stock leading to medicine stock outs include the lack of capacity in terms of human resources and physical resources at the PHC facilities. Insufficient supervision and support from the district level also had an influence as health workers at the facilities did not always follow the recommended procedures for medicine stock management. We also found that there were gaps in communication between the health workers at the facilities and stakeholders at other levels, particularly the pharmaceutical depot from which the facilities obtained their medicines. The inadequate information systems contributed to this gap in communication. Whilst many studies have focused on the factors that may influence the availability of medicine at higher levels, this study focused on what may influence it at the ground level, the PHC facility level. We anticipate that our findings will inform policy makers on how the availability of medicines at PHC facilities may be improved by focusing on improving the processes in medicine stock management at this level

A Review of ICT Systems for HIV/AIDS and Anti-Retroviral Treatment Management in South Africa

HIV/AIDS is a major global health problem. In South Africa, it is estimated that 5.4 million people are infected by HIV, out of a population of nearly 48 million, giving a prevalence rate of about 11%. About 600,000 individuals are infected with AIDS. Furthermore, the estimates show that, by mid-2006, some 711,000 people were in need of anti-retroviral treatment (ART), while 225,000 were actually receiving it

Comprehensive and integrated district health systems strengthening: the Rwanda Population Health Implementation and Training (PHIT) Partnership

Background: Nationally, health in Rwanda has been improving since 2000, with considerable improvement since 2005. Despite improvements, rural areas continue to lag behind urban sectors with regard to key health outcomes. Partners In Health (PIH) has been supporting the Rwanda Ministry of Health (MOH) in two rural districts in Rwanda since 2005. Since 2009, the MOH and PIH have spearheaded a health systems strengthening (HSS) intervention in these districts as part of the Rwanda Population Health Implementation and Training (PHIT) Partnership. The partnership is guided by the belief that HSS interventions should be comprehensive, integrated, responsive to local conditions, and address health care access, cost, and quality. The PHIT Partnership represents a collaboration between the MOH and PIH, with support from the National University of Rwanda School of Public Health, the National Institute of Statistics, Harvard Medical School, and Brigham and Women’s Hospital. Description of intervention The PHIT Partnership’s health systems support aligns with the World Health Organization’s six health systems building blocks. HSS activities focus across all levels of the health system — community, health center, hospital, and district leadership — to improve health care access, quality, delivery, and health outcomes. Interventions are concentrated on three main areas: targeted support for health facilities, quality improvement initiatives, and a strengthened network of community health workers. Evaluation design The impact of activities will be assessed using population-level outcomes data collected through oversampling of the demographic and health survey (DHS) in the intervention districts. The overall impact evaluation is complemented by an analysis of trends in facility health care utilization. A comprehensive costing project captures the total expenditures and financial inputs of the health care system to determine the cost of systems improvement. Targeted evaluations and operational research pieces focus on specific programmatic components, supported by partnership-supported work to build in-country research capacity. Discussion Building on early successes, the work of the Rwanda PHIT Partnership approach to HSS has already seen noticeable increases in facility capacity and quality of care. The rigorous planned evaluation of the Partnership’s HSS activities will contribute to global knowledge about intervention methodology, cost, and population health impact

Healthcare Issues in the United States and Beyond with Existentialist Philosophy

Healthcare Issues in the United States and Beyond with Existentialist Philosophy Kristen D’EntremontFaculty Sponsor: Gail Faris, Women’s Center The importance of quality healthcare is a personal matter for each and every individual across the globe. We cannot go a day without considering the impact that proper health through good nutrition, disease prevention, and access to care has on our bodies. The topic of medical care has interested me for many years and has lead me to the major and position that I am in today. As a senior, majoring in Biology with a pre-medical focus, I will begin the application process to medical school come June, 2011. By applying in June I will have a gap year between undergrad and medical school. In this year I would like to spend considerable time in a foreign developing country, volunteering in underserved communities. For this reason, I designed a project that would help broaden my view of healthcare systems around the world. The five countries that I chose to research are: Ghana, Haiti, Ecuador, Nicaragua, and the United States. Each of these countries has a great need for further development in their delivery of healthcare. In researching these countries I have discovered the significance that quality nutrition plays on a population and how inadequately equipped many countries are to provide this for their residents. Along with malnutrition, disease prevention and immunization availability play a dramatic role in the overall health of a nation. Above all else I have learned that without proper access, both physically and financially, the qualities of the health resources do not even matter. This project will reveal the shocking realities of the access and importance of healthcare as it is and how it ought to be

Procedures of Nongovernmental Organizations and Social Entrepreneurship in International Development: Two Case Studies

In a world where nongovernmental organizations (NGOs) and social entrepreneurs are becoming increasingly significant in the development of disadvantaged communities around the globe, specific methodological research in the field is more important than ever before. With heightened demand, however, also comes greater responsibility for such organizations to successfully and efficiently ignite positive change in the communities they serve. This paper broadly explores the structures and intentions of NGOs and social enterprises in international community development, particularly discussing steps taken by two comparable case study organizations attempting to establish trusting relationships with community members and respond appropriately to their needs. This paper examines in detail one nongovernmental organization and one social enterprise working to improve public health conditions in rural Guatemala. Curamericas Global, Inc. is an NGO dedicated to improving overall health standards of families through creating self-sustaining, community-run maternal and neonatal health clinics in remote, impoverished communities; Tiendas de Salud is a social enterprise which builds micro-pharmacies in isolated communities, engaging in microlending to employ locals in order to bolster household economic autonomy and improve the access and affordability of medicines for these populations. In this most-similar focused comparison analysis, evaluations of each organization’s projects are closely studied to understand their procedures when intervening in communities