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 and Joan N Kalyango1,2*
1Department of Pharmacy, 2Clinical
Epidemiology Unit, College of Health Sciences, Makerere
University, Kampala, Uganda
*For correspondence:
E-mail:
nakayaga2001@yahoo.com Tel:
+256-772-412548
Received: 22
March
2010 Revised
accepted: 25 October 2010
Tropical
Journal of Pharmaceutical Research, December 2010;
9(6):
557-564
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
