Week 11 - Introduction to Medicines & Technology
Session 3 - Addressing Medicine Stock-outs in SA
- Activity 9.3.1: Addressing Medicine Stock-outs
- Learning Outcome
- Session summary and reflection
Activity 9.3.1: Addressing Medicine Stock Outs
1. Why do you think some areas on the heat map experience stock-outs more than others? Use examples from the heat map to explain your answer.
When comparing data between Gautueng and North West. You can see great discrepancies
Gauteng has zero stock outs whereas North West has a stock out in nearly half of the meds.
This is most likely due to poor infrastructure, education and technology.
2. What do you see as some of the negative implications caused by stock-outs?
- Health Risks: Patients, especially those with chronic conditions like HIV/AIDS, face serious health risks if they miss doses due to stock-outs. This can lead to disease progression, drug resistance, and, in severe cases, death.
- Loss of Trust: Frequent stock-outs erode public confidence in the healthcare system, making people less likely to rely on public health services for their needs.
- Increased Financial Burden: Patients, especially in rural areas, may need to travel multiple times to access medicine, leading to additional expenses for transportation, child care, and potential wage losses.
- Emotional and Psychological Stress: Patients and their families may experience anxiety and stress due to the uncertainty of access to essential medicines, impacting their overall well-being.
- Workload for Healthcare Staff: Healthcare providers, such as nurses and pharmacists, face added stress and workload as they try to manage stock-outs, ration supplies, and borrow from other facilities to meet patient needs.
- Non-Adherence and Resistance: Stock-outs disrupt patients’ medication adherence, particularly for those on long-term treatment like antiretrovirals (ARVs), increasing the risk of drug resistance and poorer health outcomes.
3. Using the Health Systems Building Blocks Framework, how can the different building blocks work together to prevent medicine stock-outs.
You may consider some of the following on the Stop Stock-outs Project:
❏ Who is leading this initiative?
❏ How is it funded?
❏ What services are provided by the project?
❏ Who is involved in running the project?
❏ What technologies are being used to address the main issue?
Leadership and Governance:
- The SSP is led by a consortium of six civil society organizations, including Section 27, Médecins Sans Frontières (MSF), Rural Health Advocacy Project (RHAP), Rural Health Doctors Association of Southern Africa (RuDASA), Southern African HIV Clinician Society, and the Treatment Action Campaign (TAC).
- These organizations provide strategic oversight and advocate for policy changes to ensure consistent medicine supply in public health facilities.
- Leadership within these organizations helps to drive awareness, accountability, and policy reforms at the national level to address systemic issues leading to stock-outs.
Health Financing:
- The SSP’s funding comes from these organizations, and possibly through donor contributions and grants focused on health advocacy and community health support.
- Adequate funding ensures that the project can maintain services like community outreach, hotline management, and surveys, all of which are essential to tracking and addressing stock-outs.
- Financing also supports the logistical needs of moving and redistributing stock to areas experiencing shortages.
Health Workforce:
- The project involves healthcare professionals, community health workers, and advocacy staff who work together to monitor, report, and respond to stock-outs.
- These workers support the community by managing a case database, providing technical advice, and helping patients navigate stock-out-related issues.
- Training healthcare providers to efficiently manage stock levels and report shortages is crucial to minimize the occurrence of stock-outs.
Medical Products and Technologies:
- SSP utilizes a case management database, hotline reporting, and a telephonic survey to collect real-time data on stock availability in health facilities.
- By using technology to identify “hot spots” with severe shortages, SSP can prioritize urgent needs and facilitate timely redistribution of stock across facilities.
- Efficient inventory management technologies and tracking systems are essential to monitor medicine levels and prevent future shortages.
Health Information Systems:
- SSP collects, compiles, and analyzes data from health facilities to track stock-outs and provide real-time updates on medicine availability.
- The data collected helps in advocacy efforts and provides evidence for policymakers on the extent and impact of stock-outs, promoting data-driven solutions.
- Health information systems ensure transparency and allow for effective monitoring, making it easier to forecast needs and prevent future stock-outs.
Service Delivery:
- SSP works directly with health facilities to address medicine shortages, often redistributing medicines from facilities with surplus to those facing shortages.
- The project also provides a hotline for patients and healthcare workers to report stock-outs, helping to improve response times and mitigate patient risk.
- By ensuring continuous availability of essential medicines, SSP enhances the quality of service delivery in public health facilities, directly impacting patient care and health outcomes.
Learning Outcome - Addressing Medicine Stock-outs in SA
- Describe the problem of medicine stock-outs.
- When medical fascilities run out of medicine disrupting treatment due to logistical challenges, supply chain inefficiencies, inadequate forecasting, and budget constraints.
- Describe how technology offers solutions to reducing medicine stock-outs.
- Technology can help prevent stock-outs by providing real-time inventory tracking, using data analytics for better demand forecasting, and automating procurement processes. Digital inventory management systems and mobile apps can alert suppliers about low stock levels, allowing timely replenishment. Additionally, electronic health records (EHRs) help monitor patient medication needs to anticipate future demand accurately.
- Discuss how the Health Systems Building Blocks Framework can work together to prevent medicine stock-outs.
- Service Delivery: Ensures accessible distribution channels and efficient delivery systems for medicines.
- Health Workforce: Trains staff in inventory management and enhances capacity to manage stock efficiently.
- Health Information Systems: Uses data to monitor medicine supplies, forecast needs, and streamline procurement processes.
- Access to Essential Medicines: Establishes policies to prioritize essential medicines and streamline supply chains.
- Financing: Allocates funds specifically for medicine procurement and supply chain maintenance to prevent budget-related stock-outs.
- Leadership and Governance: Enforces policies and regulatory frameworks to support efficient procurement, inventory control, and accountability in supply chain management.
Session summary and reflection
- The shortage of essential medicines in South Africa’s public health system has damaged trust in the sector and endangered lives, especially in rural and underserved areas. These stock-outs disproportionately affect poor and rural patients who rely on public healthcare, forcing them to incur extra costs for travel and child care, leading to financial strain. Healthcare providers, including nurses and pharmacists, also face increased workload as they ration medicines and borrow supplies to manage shortages.
- To address this issue, the Stop Stockouts Project (SSP), a coalition of six civil society organizations, was founded in 2013. SSP advocates for consistent medicine supplies by monitoring stock-outs, offering technical support, and engaging communities. The project uses a case management database, hotline reporting, and telephonic surveys to track and mitigate stock-outs across health facilities in South Africa. Ensuring the availability of medicines is critical for patient adherence, especially for chronic treatments like ARVs, and for tackling the country’s disease burden.