Advertisement

Topics

Improving Supply Chain for Essential Drugs in Low-Income Countries: Results from a Large Scale Randomized Experiment in Zambia.

07:00 EST 1st January 2019 | BioPortfolio

Summary of "Improving Supply Chain for Essential Drugs in Low-Income Countries: Results from a Large Scale Randomized Experiment in Zambia."

Despite increased investments in procurement of essential medicines, their availability at health facilities remains extremely low in many low- and middle-income countries. The lack of a well-functioning supply chain for essential medicines is often the cause of this poor availability. Using a randomized trial conducted in 439 health facilities and 24 districts in Zambia, this study helps understand the optimal supply chain structure for essential medicines distribution in the public sector in low-income countries. It shows that a more direct distribution system where clinics order and receive medicines supply directly from the central agency through a cross-docking arrangement significantly reduces the duration and frequency of stockouts compared to a traditional three-level drug distribution system. As an example, the frequency of stockouts for first line pediatric malaria medicines reduced from 47.9% to 13.3% and the number of days of stockout in a quarter reduced from 27 days to 5 days. The direct flow of demand and order information from health facilities to the central supply agency reduces the problem of diffuse accountability that exists in multi-tiered distribution systems. It also shifts the locus of decision making for complex supply chain functions such as scarce stock allocation and adjustment of health facility order quantities to levels in the system where staff competency is aligned with what the function needs. Even when supply chain system redesign such as the one evaluated in this paper are demonstrated to be technically robust using rigorous evidence, they often require navigating a complex political economy within the overall health system and its actors.

Affiliation

Journal Details

This article was published in the following journal.

Name: Health systems and reform
ISSN: 2328-8620
Pages: 158-177

Links

DeepDyve research library

PubMed Articles [25595 Associated PubMed Articles listed on BioPortfolio]

Integrated aquaculture contributes to the transfer of mcr-1 between animals and humans via the aquaculture supply chain.

Since its discovery in 2015, the mobile colistin resistance gene mcr-1 has been reported in bacteria from >50 countries. Although aquaculture-associated bacteria may act as a significant reservoir for...

An empirical study on solving an integrated production and distribution problem with a hybrid strategy.

Coordination is essential for improving supply chain performance, and one of the most critical factors in achieving the coordination of a supply chain is the integrated research of production and dist...

Impacts of external shocks on the decisions of hog supply chains under liquidity constraints from the perspective of commercial credit.

Certain attributes of the hog industry increase the production risk in nodal enterprises of the hog supply chain, leading to high financing costs and eventually resulting in liquidity constraints. Whe...

Phosphate supply security for importing countries: Developments and the current situation.

Phosphorus's essentiality for all life on Earth is beyond doubt. As one of the three major macronutrients, it is a crucial building block of modern-day mineral fertilizers and, thus, an essential prod...

Safety of blood donation by individuals over age 70 and their contribution to the blood supply in five developed countries: a BEST Collaborative group study.

Some countries impose an upper age limit on whole blood and double RBC donation while others do not. We evaluated the safety of blood donation in older individuals (≥71 years), and their contributio...

Clinical Trials [9080 Associated Clinical Trials listed on BioPortfolio]

Differences Between Essential Medicines Lists in 135 Countries and Model List of Essential Medicines

The World Health Organization (WHO) has developed a model list of more than 400 medicines and recommends that each country adapt the list to its own circumstances. More than 100 countries ...

First Breath: Neonatal Resuscitation in Developing Countries

In developing countries, neonatal death from birth asphyxia is a major problem. This study will be conducted in several countries to determine if the combined Neonatal Resuscitation Progra...

The Australian Parental Supply of Alcohol Longitudinal Study (APSALS)

Parents can positively influence their children's alcohol use. One strategy they use is to provide their children with alcohol, believing it is the best way to teach their children how to ...

Influence of of a Lipid Emulsion on Inflammatory Response and Hepatic Function

Lipid emulsions are an essential part of parenteral nutrition, both as a part of energy supply, and as a source of essential fatty acids. It has been shown that the fatty acid composition ...

Branched-chain Amino Acid Supplementation for Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is the fifth most common cause of cancer death among men. While several new treatment options have recently become available, they are costly and have a pote...

Medical and Biotech [MESH] Definitions

Drugs considered essential to meet the health needs of a population as well as to control drug costs. (World Health Organization Action Programme on Essential Drugs, 1994, p3)

Drugs which have received FDA approval for human testing but have yet to be approved for commercial marketing. This includes drugs used for treatment while they still are undergoing clinical trials (Treatment IND). The main heading includes drugs under investigation in foreign countries.

Countries in the process of change directed toward economic growth, that is, an increase in production, per capita consumption, and income. The process of economic growth involves better utilization of natural and human resources, which results in a change in the social, political, and economic structures.

Improving the NUTRITIONAL VALUE of plant foods by augmenting the plant's environment, by using PLANT BREEDING, or by GENETIC ENGINEERING plants to increase their ability to synthesize VITAMINS or uptake essential NUTRIENTS from the soil.

A cabinet department in the Executive Branch of the United States Government concerned with improving and maintaining farm income and developing and expanding markets for agricultural products. Through inspection and grading services it safeguards and insures standards of quality in food supply and production.

Advertisement
Quick Search
Advertisement
Advertisement

 


DeepDyve research library

Relevant Topics

Pharmacy
Pharmacy is the science and technique of preparing as well as dispensing drugs and medicines. It is a health profession that links health sciences with chemical sciences and aims to ensure the safe and effective use of pharmaceutical drugs. The scope of...

Pediatrics
Pediatrics is the general medicine of childhood. Because of the developmental processes (psychological and physical) of childhood, the involvement of parents, and the social management of conditions at home and at school, pediatrics is a specialty. With ...


Searches Linking to this Article