In Practice

How front-line healthcare workers respond to stock-outs of essential medicines in the Eastern Cape Province of South Africa

R Hodes, I Price, N Bungane, E Toska, L Cluver

Abstract


Shortages of essential medicines are a daily occurrence in many of South Africa (SA)’s public health facilities. This study focuses on the responses of healthcare workers to stock-outs, investigating how actors at the ‘front line’ of public health delivery understand, experience and respond to shortages of essential medicines and equipment in their facilities. Findings are based on focus groups, observations and interviews with healthcare workers and patients at healthcare facilities in the Eastern Cape Province of SA, conducted as part of the Mzantsi Wakho study. The research revealed a discrepancy between ‘informal’ definitions of stock-outs and their reporting through formal stock-out management channels. Front-line healthcare workers had designed their own systems for classifying the severity of stock-outs, based on the product in question, and on their potential to access stocks from other facilities. Beyond formal systems of procurement and supply, healthcare workers had established vast networks of alternative communication and action, often using personal resources to procure medical supplies. Stock-outs were only reported when informal methods of stock-sharing did not secure top-up supplies. These findings have implications for understanding the frequency and severity of stock-outs, and for taking action to prevent and manage stock-outs effectively.


Authors' affiliations

R Hodes, AIDS and Society Research Unit, Centre for Social Science Research, University of Cape Town, South Africa

I Price, Mathematical Institute, Oxford University, UK

N Bungane, AIDS and Society Research Unit, Centre for Social Science Research, University of Cape Town, South Africa

E Toska, AIDS and Society Research Unit, Centre for Social Science Research, University of Cape Town, South Africa

L Cluver, Child and Family Social Work, Department of Social Policy and Intervention, Oxford University, UK; Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, South Africa

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Keywords

Stock-outs; Essential medicines; Frontline healthcare providers; Procurement and supply; Informal networks; Supply-sharing

Cite this article

South African Medical Journal 2017;107(9):738-740. DOI:10.7196/SAMJ.2017.v107i9.12476

Article History

Date submitted: 2017-08-25
Date published: 2017-08-25

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