Performance of Pharmaceutical Logistics Management System for Maternal Health Medicines in Selected Public Health facilities an Hawassa City, Ethiopia

Abstract

Background: An effective implementation of effective pharmaceutical logistic system such as Pharmaceutical Logistics Management System (PLMS) and/or Integrated Pharmaceutical Logistics System (IPLS) is crucial as they enhances/promotes patient care, improves availability/accessibility of drugs, and reduces costs of drugs such as maternal health medicines. The Ministry of Health (MOH) of Federal Republic of Ethiopia is working hard to reduce maternal mortality and morbidity through implementation of various approaches that include PLMS. However, the current status of PLMS particularly IPLS and its associated factors in the study area are not well studied. This study would provide updated information to concerned authorities and stakeholders on the factors affecting effective implementation of PLMS in Ethiopia in general and in the study area in particular.

Objective: This study was conducted to assess the pharmaceutical logistic system focusing on Maternal Health Medicines at public hospitals in Hawassa city, Ethiopia, 2023/24.

Method: A facility based cross-sectional study was conducted in public hospitals in Hawassa city administration in 2023/24, using both qualitative and quantitative methods. Data were collected using the Logistics System Assessment Tool (LSAT), Logistics Indicators Assessment Tool (LIAT), interviews of health professionals working in drug supply chains, and observation of practices in the hospitals selected for the study. Document (bin card) review was also used to collect data. The quantitative data were analyzed using descriptive statistics (Frequency and percentages) and multiple regressions in SPSS, and the results are describes in texts and displayed in Tables and Figures. The qualitative data, on the other hand, were analyzed thematically and integrated with the quantitative findings.

Results: The study found that only 31.1% of respondents rated the overall performance of the maternal health medicine supply chain as adequate, with a grand mean ± standard deviation (x± SD) of 3.32±0.7. The key factors associated with poor performance included quality of service, organizational function, cost/financial gaps, and employee skill gaps (p<0.05). Qualitative findings further revealed that the PFSA's paper-based Logistics Management Information System (LMIS) faces problems on data quality, timeliness, and consistency issues due to lack of staff training, while transitioning to an electronic LMIS is hindered by infrastructure, integration, and capacity challenges, leading to stock outs and missing supply chain data, requiring a comprehensive approach to strengthen the LMIS.

Conclusions: This study found the overall performance of logistic pharmaceutical system was on maternal health medicine to be inadequate. The identified key challenges were poor service quality, organizational dysfunction, access issues, cost/financial barriers, and employee skill gaps. These factors were associated with decreased performance, and addressing them should be a focus for interventions. Moreover, regular supervisory supports and timely feed backs were not common in the health facilities selected for the study. These need due attention to improve supply and managements of pharmaceuticals including maternal health medicines.