Drug shortages still a problem for rural areas

A fine-looking structure stands in Mahempe village, Bukhalu Sub-county in Sironko District. It is the Sironko Health Centre III facility.

Inside, children seated on the laps of their mothers scream in pain. Beatrice Kakai is also seated with her one -and-a half–year-old baby. The child is recovering from a bout of malaria suffered several days earlier, for which she was admitted to the facility for three days.

As she waits for the final treatment and a discharge note from the doctor, Kakai says her child’s condition is steadily improving.

While health workers managed to save the baby’s life, Kakai says their effort was almost undermined by a lack of drugs at the centre. “The nurses carried out tests and found that my child’s condition was severe. She was admitted immediately but there were no drugs. I was asked to buy the required medication from a private clinic, which was expensive,” says Kakai.

Like her, many people in rural areas still lack access to essential medicines, used to treat common ailments such as malaria, pneumonia and infections. In eastern Uganda, for example, hard-to-reach areas such as those along Mt Elgon are most affected when it comes to access to essential medicines.

Expensive options
Dr Peter Nabende, the health officer for Sironko District, says the inadequate supply of drugs at various health centres leaves patients to either opt for drugs at the private facilities or flock other facilities that may have the drugs.
“Because of the rampant drug shortages at the lower health centres, many patients now prefer to go to the big hospitals such as Mbale Regional Referral Hospital, which is being overwhelmed by big numbers,” says Dr Nabende.

“The population is growing, so we also need to double the supply of medicine at the health facilities to meet the demand,” says Joseph Kaumba, the in-charge, Sironko Health Centre III.

The Minister for Energy and Mineral Development, Irene Muloni, who has donated anti-malarial drugs to the district, says government needs to invest more resources in addressing the challenges of drug shortages in rural areas. “There have been knowledge gaps between the health staff and health unit management committees about how often requisition for drugs should be made and how to manage stock outs,” she says.

She adds: “Government has two ways of delivering drugs. The push system where drugs are sent as required to the health facilities and the pull system where drugs are directly requested by the facilities.”

National Medical Stores (NMS) spokesperson, Dan Kimosho, says drug shortages in rural areas are caused by several factors. These include inefficiencies by drug managers in making orders for the drugs that specific facilities require, depending on the disease pattern and burden.

“At NMS, we supply drugs to all health facilities every month, I guess the shortage can sometimes result from the big numbers of people accessing the facilities at specific times or an increase in the disease burden,” explains Kimosho.

Policy change
Until 2008, all funds for drugs were sent directly to the districts, which meant they could buy drugs depending on the need at a particular time.

Kimosho, however, says the policy was frustrated by district leaders who instead diverted the money to other things other than purchasing the required drugs.
In some cases, Kimosho says doctors opt to prescribe drugs that are out of supply, yet there the available one could also treat the same condition.

Manafwa District Health Officer, Gideon Wamasebu says to address the problem, health workers in rural, hard-to-reach areas need to follow the Ministry of Health guidelines and prescribe drugs that are available on the government checklist of essential medicines.


SOURCE: Daily Monitor

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