Procurement process and shortages of essential medicines in public health facilities: A qualitative study from Nepal

Adhikari, Basant, Ranabhat, Kamal, Khanal, Pratik, Poudel, Manju, Marahatta, Sujan Babu, Khanal, Saval ORCID:, Paudyal, Vibhu and Shrestha, Sunil (2024) Procurement process and shortages of essential medicines in public health facilities: A qualitative study from Nepal. PLOS Global Public Health, 4 (5). ISSN 2767-3375

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Ensuring access to essential medicines remains a formidable challenge in Nepal. The specific reasons for the shortage of essential medicines within Nepal have not been extensively investigated. This study addresses challenges associated with access to essential medicines, procurement process difficulties, and functionality of inventory management systems at different levels of public health facilities. Fifty-nine semi-structured in-depth interviews were conducted with health managers and service providers at provincial and local levels in six randomly selected districts of Bagmati province, Nepal. Interviews were audiotaped and transcribed verbatim, and the results were analyzed using the inductive approach and were later mapped within the four domains of “Procurement of essential medicines”. The major barriers for the effective management of essential medicines included delays in the procurement process, primarily locally, leading to frequent stock-out of essential drugs, particularly at the health post level. Additionally, challenges arise from storage problems, mainly due to insufficient storage space and the need to manage additional comorbidities related to COVID-19. Other identified challenges encompass the absence of training on logistics management information systems, a lack of information technology resources in primary health facilities, inadequate qualified human resources to operate the IT system, and insufficient power backup. Moreover, unrealistic demand estimation from the service points, inadequate transportation costs, and manual inventory management systems further contributed to the complex landscape of challenges. This study identified procurement delays as the primary cause of essential medicine shortages in Bagmati Province, Nepal. We recommend implementing comprehensive procurement guidelines, collaborative training, and dedicated budgets to address this issue. Improving the procurement and inventory management process in low-resource settings requires a well-trained workforce, suitable storage spaces, and enhanced coordinated administrative tiers within health facilities at different levels to ensure the year-round availability of essential medicines in these settings.

Item Type: Article
Additional Information: Data Availability: All the data underlying the findings are available within the manuscript itself. Funding: The Health Logistics Management Center, Ministry of Social Development, Bagmati Province funded the study. The funding body did not play any role in the study design, collection, analysis, and interpretation of data, nor in writing this menu script. However, no specific funding was received for the publication of this work.
Uncontrolled Keywords: sdg 3 - good health and well-being ,/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Centres > Population Health
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Depositing User: LivePure Connector
Date Deposited: 07 May 2024 09:32
Last Modified: 06 Jun 2024 15:27
DOI: 10.1371/journal.pgph.0003128


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