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Rational use of Medicines in Relation to Pharmaceutical Supply System in Municipal Hospitals of Dar-es-salaam Region

Protas, B. P. (2011) Rational use of Medicines in Relation to Pharmaceutical Supply System in Municipal Hospitals of Dar-es-salaam Region. Masters thesis, Muhimbili University of Health and Allied Science .

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Pharmaceutical management involves set of practices aiming at ensuring timely availability and appropriate use of safe, effective and quality pharmaceuticals and services in any health care setting. Rational use of medicines is often associated efficiency of pharmaceutical supply system that operates in the health care system. Pharmaceutical supply system involves planning and programming for pharmaceutical requirements, procurement, storage and distribution which are the necessary steps towards rational use of medicines. A cross-sectional study to determine rational use of medicines in relation to pharmaceutical supply system in three conveniently selected municipal hospital of Dar es Salaam region was conducted between January and May 2011. To determine impact of pharmaceutical supply system on rational use of medicines in municipal hospitals of Dar es Salaam region. Retrospective data was collected from July 2009 to June 2010 for the pharmaceutical supply system performance, availability of Tracer medicines and mechanisms to improve rational use of medicines. A total of three hundred (300) outpatients were prospectively interviewed for collection and verification of data on hospitals’ fulfillment on patients’ prescribed medicines requirements using World Health Organization Medicine use indicators and checklists. The supply system had the order delivery time of 1 day and services level i.e. order fulfillment performance of 54.9%, hospitals made on average 76 procurement order in year 2009/2010 with an average of more than twelve procured on emergency basis. 8.9% of the tracer medicines were found to have expired on the day of visit and only 40% of the stock records were found to have no discrepancies. Mean average number of medicines per prescription was 2.8=1.2, with only 60.4% of the prescribed medicine dispensed 55.7% prescribed in generics and 89.4% prescribed from the NEMLIT. 49.7% was the average percentage of reference materials available in the hospitals. Other mechanisms of improving rational use of medicines included establishment of HTC, inservice training and prescribing reviews. The average percentage time out of stock was 29.9% i.e. on average one of the tracer medicines was out of stock for atleast 29 days. There is a need for more emphasis on the improvement of pharmaceutical supply system performance as it has influence on rational use of medicines by influencing availability of medicines.

Item Type: Thesis (Masters)
Keywords: Medicines;Pharmaceutical Supply System;Pharmaceutical Management;Dar-es-salaam
Subjects: Health Systems > Drugs, Medical Supplies & Logistics
Divisions: Muhimbili University of Health and Allied Sciences (MUHAS)
Depositing User: Mr Joseph Madata
Date Deposited: 20 May 2013 07:39
Last Modified: 20 May 2013 07:39

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