| dc.description.abstract | Introduction: Medicine stock outs are a common problem in health facilities countries public health facilities. Stock out of medicines in developing patients and health workers outcomes.
Objectives:To establish how health care workers and patients cope with the burden of medicine and how both parties cope with the associated stress impacts stock outs; establish the association between the coping patterns of health care workers
consumers to the same issue in Kabarole District, Western.
Methods: A cross-sectional, mixed methods study of public health facilities in Kabarole district was done using structured questionnaires and key informant interviews of facility in charges. A sample of 141 health care workers was targeted and out of these, 130 respondents participated in the study, indicating a response rate of 92.1%. In addition, a sample of 199 patients was targeted for the study and out of these, 161 participated, indicating a response rate of 81.0%. Data collected data was coded and entered into EPI Data; then transcribed into the Statistical Package for Social Sciences (SPSS) version 10.0 for analysis. To determine the association between the coping patterns of patients and health workers, bivariate analysis of statistical association was done using chi square(x2) test and the unadjusted odds ratio and p value were determined to further analyse this association.
Results: All the 130 health care workers that participated in the study affirmed that they had instances where the medicine choice for a given medication was out of stock. Moreover, 72% of the patients who participated in the study reported that once the medicine prescribed was out of stock, the dispensers would estimate the cost and send them to a private health facility. A fair number of the health consumers (621161) revealed that they bought the medicine in small bits. It was found that 42.0% of the prescribers and 30.0% of dispensers/pharmacy staff advised the patients to buy from the private facilities. More so, 28.5% of the dispensers reported that they sent the patients back to the prescriber to substitute the medicine with an available substitute and 15.7% would simply inform the patient that the medicine was out of stock. Eleven percent (11.5%) of the healthcare workers sent the patients to the nearby public health facility, in the event of medicine stock out. Of the patients sent to neighboring facilities only 6.2. % reported to have gone there. Buying from the private facilities was the major coping pattern to medicine stock (38.4%). A moderate number of patients (40.0%) reported that they would not buy the out of stock of medicine when the health worker did not advise them to. Furthermore, a notable portion attested that they bought the medicine in bits (38.5%). A significant portion (7.5%) would postpone the treatment.
Conclusion: The coping patterns of health care workers and patients included resorting to the private sector, prescription substitution and trying out the neighboring public health facilities. Patients’ coping patterns included buying in small bits, selling farm produce to buy drugs, using savings, going to the nearest public facilities and waiting for the next supply of medicines at the facility. Buying from private facilities was associated with positive coping while going to the nearby public facility was associated with negative coping. It is thus recommended that written protocols on how to handle medicine stock outs should be developed for public health facilities and follow-up of such cases by health care workers to ascertain improvement of the patient should be introduced. Introduction of subscribed medicines for patients in the form of "Special Pharmacies" to enable them buy in private facilities would be beneficial. | en_US |
