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Assessment of Factors Contributing to Medicine Expiry in Rwanda: Case of the Medical Procurement and Production
Theogene Hakuzimana1,2, Pierre Claver Kayumba1, Innocent Hahirwa3
1EAC Regional Centre of Excellence for Vaccines, Immunization, and Health Supply Chain Management, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
Background:
Regardless of the significant efforts used and put in place to enhance supply chain performance in Rwanda, there is still poor inventory management and big loss due to expiry of medicines at Medical Procurement and Production Division (MPPD).
Objective:
To assess the factors that contributes to expiry of medicines at MPPD and formulate recommendations for the improvement of the current situation.
Methods:
This is a descriptive cross-sectional study used for 25 respondents. A questionnaire containing closed-ended questions was used focusing on factors contributing to expiries of medicines for each product category managed by MPPD from 2014-2018. Additionally, the researcher reviewed all inventory reports, including expiries for the same period under study. The study focused on targeting respondents working at MPPD as pharmacists both technical and administrative, also other non-pharmacist working in the warehouse were considered as respondents. The hard copy of questionnaire was handed over to 26 respondents and requested to provide filled questionnaire within seven days. Twenty-five respondents were able to return the filled questionnaire on time, giving 96% response rate.
Results:
The study found that in MPPD, medicines are still expiring. During five years (from 2014 up to 2018) the total expired products were valued at RWF 6,046,778,655 for all program categories: HIV commodities had the largest share 53.3%, Essential Medicines 22.5%, Malaria 13%, Maternal Child Health commodities 5.7%, Products used for Community health workers 4.5%, TB products 1% and 0.1% for Family Planning products. The study found that major contributing factors for expiry of health commodities at MPPD, are ranked as follows: Supply chain management 90%, other factors 73%, Poor storage management 68% and Excessive drug supply 67%.
Conclusion:
Considering the study results, it looks like no significant effect of excessive drug supply and inventory management on the expiration of medicines at MPPD. However, the Supply Chain Management components are the most vulnerable to contribute to the expiration of medicines at MPPD. There are many changes to be done inside the institution to remedy the issue of expiration like working according to the standard operating procedures, improving the Skills of personnel in supply chain management, empowering the procurement unit with skilled personnel and improving the communication with stakeholders to facilitate the smooth and quick replenishment and distribution of the stock.
Insights
Poor supply chain management leads to significant medicine expiry losses at Rwanda's Medical Procurement and Production Division (MPPD). Addressing these issues is crucial to reduce waste and improve healthcare delivery.
Area of Science:
- Public Health
- Supply Chain Management
- Pharmaceutical Management
Background:
- Despite efforts to improve supply chain performance in Rwanda, the Medical Procurement and Production Division (MPPD) faces significant losses due to medicine expiry.
- Poor inventory management practices contribute to substantial wastage of essential medicines.
Purpose of the Study:
- To identify factors contributing to medicine expiry at the MPPD.
- To develop recommendations for enhancing medicine supply chain management and reducing expiry-related losses.
Main Methods:
- A descriptive cross-sectional study was conducted with 25 respondents at the MPPD.
- Data was collected using questionnaires and a review of inventory and expiry reports from 2014-2018.
- The study targeted pharmacists and warehouse personnel involved in medicine management.
Main Results:
- Over a five-year period (2014-2018), expired medicines at MPPD were valued at RWF 6,046,778,655.
- HIV commodities constituted the largest share (53.3%) of expired products.
- Key factors contributing to expiry were supply chain management (90%), other factors (73%), poor storage (68%), and excessive supply (67%).
Conclusions:
- Supply chain management components are highly vulnerable and significantly contribute to medicine expiration at MPPD.
- Improvements needed include adherence to standard operating procedures, enhanced personnel skills in supply chain management, and better stakeholder communication.
- Empowering the procurement unit and ensuring timely stock replenishment and distribution are essential to mitigate medicine expiry.
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