ABSTRACT
Introduction: An organized and systematic drug procurement process based on well-established scientific principles effectively ensures the availability of right medicines in the right quantities, at reasonable prices, and at recognized standards of quality. It ensures ‘value for money’ and ‘economies of scale’ to the best possible extent. Methods: This study was carried out to evaluate various drug procurement and tendering practices prevalent at three tertiary care public health facilities of District Srinagar, the summer capital of J&K state. One children’s tertiary care hospital (CH), one Govt. Medical College Hospital (MCH), one district hospital (DH) was selected for the study. Two different pharmaceutical supply chains were involved in procurement of medicines for the study hospitals. A set of 149 qualitative and 15 quantitative indicators were developed to evaluate drug procurement practices in these healthcare settings. Results: Qualitative indicator based assessment revealed that a centralised procurement and decentralised distribution practice was being followed by both the supply chains studied. Procurement funds were found to be grossly inadequate whereas pre-qualification of suppliers was undertaken. Competitive e-tendering method was followed using double envelope system. However, rate contracts were not regularly updated and there were no means available to check and determine the quality of drugs effectively. Available pool of human resource was found to be inadequate and there were no standard procedures in place to monitor the performance of procurement and supply system on regular basis. Conclusion: Appropriate measures need to be taken for proper selection, quantification, forecasting and procurement of medicines in accordance with well established guidelines to make the supply chain more efficient. Allocation and disbursement of funds for procurement should also be sufficient and timely to cater to the needs of individual hospitals across all levels of care.
ABSTRACT
Introduction: The role and relevance of medicines, vaccines and other health supplies are critical, as they are considered important building blocks of the health care system. Well-located, well-built and secured storage facilities are an essential component of a pharmaceutical supply system. Methodology: This study was carried out at various public sector hospitals of District Srinagar using a set of 138 assessment indicators to study the drug storage and inventory management practices in terms of storage facilities and procedures, inventory and stock management practices and daily, monthly, yearly storage and inventory related activities. Results: Indicator based assessment for drug storage and inventory management practices revealed highest percentage adherence of 80% in managing expired drugs followed by 55.4% in daily, monthly, yearly storage and inventory control activities, 48% adherence in storage procedures, 46.1% in receiving supplies, 42.5% in stock positioning, 40.9% in storage space, 38% in stock management, 26% in stock-outs and the lowest percentage adherence of 22.9% was observed in inventory management. Facility-wise assessment revealed highest overall percentage adherence of 64.1% at Children’s Hospital (CH) followed by 54.3% at District Hospital (DH), 49.3% at Medical College (MC), 29.6 % at Sub-District Hospital (SDH) and 24.4% at Primary Health Centre (PHC). Overall percentage availability of indicator medicines was found to be 32.5% (CH=56.2% & DH=18.6%). Stock cards were not found in any of the health care facility and no expired products were found stocked in CH, MC and DH. Average indenting frequency was found to be 31 days (PHC=60; MC=10) whereas average numbers of medicines indented in one go were found to be 24. Average lead time was found to be 15 days (CH=15; MC=60) whereas average no of stock out days was found to be 66.6 days (CH=10 & PHC=115). Conclusion: Overall adherence towards various storage conditions was found to be less than 50% and lack of adherence to the basic inventory management principles was found to be common