Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Availability and Expiry of Essential Medicines and Supplies During the Pull and Push Drug Acquisition Systems in a Rural Ugandan Hospital

Yona Tumwine¹, Paul Kutyabami¹, Richard A Odoi¹, Joan N Kalyango^1,2

¹Department of Pharmacy; ²Clinical Epidemiology Unit, College of Health Sciences, Makerere University, Kampala, Uganda.

For correspondence:- Joan Kalyango Email: nakayaga2001@yahoo.com Tel:+256772412548

Received: 22 March 2010 Accepted: 25 October 2010 Published: 23 December 2010

Citation: Tumwine Y, Kutyabami P, Odoi RA, Kalyango JN. Availability and Expiry of Essential Medicines and Supplies During the Pull and Push Drug Acquisition Systems in a Rural Ugandan Hospital. Trop J Pharm Res 2010; 9(6):557-564 doi: 10.4314/tjpr.v9i6.6

© 2010 The authors.
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Abstract

Purpose: 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.

Keywords: Push system, Pull system, Availability of medicines, Medicines expiry