Mohammad Khalid, Tajammal Mustafa.
Evaluation of Procurement & Storage of Medicine at Rural Health Centers in District Chiniot.
Esculapio J Services Inst Med Sci Jan ;8(2):60-6.

Objective: To assess the process of procurement and storage of medicines at rural health centres (RHCs) in District Chiniot. Material & Methods: A cross-sectional study was conducted. All 5 RHCs in the District were included in the study and in charge of the RHCs were interviewed on a prescribed questionnaire to assess the procurement of medicines. The condition of stores was assessed by a separate structured check list. Results: Eighty percent of the officers in charge were Senior Medical Officers, 40% had post graduation qualification and majority had 15-20 years experience. 20% had less experience in purchase. Forty percent had Pull and Push both drug procurement systems and 100% calculated their demand on the basis of average monthly consumption, buffer stock and review period basis.All procured major chunk of medicine through District Medical Store but purchase from local market and petty purchases were also made to meet the demand of the patients. Tender was called, and the rate contract was done by District Health Authority and all in charges submitted their demands and supply orders. Majority (80%) of them accepted the drug having more than 75% shelf life. Eighty percent had more than 1 drug store at their health facility and only 40% had got the store white washed annually. 100% maintained their stock by following FIFO and FEFO methods. Despite only 40% received budget in time, 80% utilized the budget 100% and only 60% faced some sort of audit paras. Custodian of RHCs were dispensers at 100% RHCs. 60% in charges had got logistics management training for less than 2 weeks whereas non of the store keeper had got any such training. None of the store had adequate space i.e. 250 sq. ft. 20% stores had leaking roofs. 60% stores had pellets, shelves and racks. Space between stacks and wall was not present in any of these stores. In majority 80% stores the cartons were placed on the floor instead of on the racks. To maintain the cold chain and storage temperature of controlled items, functional refrigerator was present in 80% stores, whereas deep freezer was present in only 20% stores. Tripping and power supply failure is very important issue especially in rural areas. Generators were present in 40% RHCs out of which 20% were not functional.Cleanliness was satisfactory in 100% stores. None of the store was white washed. Exhaust fans were not present in any of these stores. Direct sunlight was not coming into 80% stores. Cross ventilation was ensured in only 60% stores and 80% stores had separate cool place for temperature controlled items. At 100% RHCs stock registers were maintained but stock was physically present as per record at only 20% RHCs.Physical verification of stock by in charge, DOH or EDOH was conducted at 80% RHCs during the year. Major issues / constraints at RHCs were: delay in budget provision and rate contract, insufficient store space and difficulty in unloading the stock. Conclusion: These results indicate that although the in charges had successfully completed the process of procurement, yet there is need for logistics management training. As the store space is insufficient at all RHCs, there is need to build new medicine stores according to the international standards at all RHCs. Timely provision of efficient drugs at RHCs will decrease the morbidity and mortality in the rural community and will help reduce the poverty.

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