The extent of selected essential medicines stockouts in South Africa (2013-2015)

Abstract

Access to essential medicines in South Africa has been compromised by stockouts in health facilities. This study analyses the occurrence of stockouts for a selection of essential medicines for the period 2013-2015. An analytical cross-sectional design was undertaken using secondary data retrieved from the Stop Stock Outs Project (SSP). Specifically, a descriptive analysis was conducted on data from the 2013-2015 SSP’s case management database of routinely reported stockouts. The Chi-square test of independence was conducted on data from the SSP’s 2015 annual telephonic survey to investigate associations between the occurrence of stockouts, level of health facilities and type of health professionals in the facilities. Two hundred and thirty-one health facilities reported 609 stockouts. Antiretroviral medication had the most stockout reports (77.9%; n=475/609), followed by anti-infectives (17.1%; n=104/609) and tuberculosis medication (4.9%; n=30/609). The highest number of stockout reports were received from Gauteng province and the majority (71.1%; n=150/211) of facilities reporting stockouts were in urban areas. There were more stockouts in ambulatory (level 1) rather than inpatient care facilities (level 2); however, this was not statistically significant (p>0.05). There was a significant difference in the type of health professional and occurrence of stockouts with stockouts being more likely to occur with pharmacy personnel than nurses. This study confirms that South Africa experiences medicine stockouts for many of the essential medicines, with antiretroviral medication being the category most affected. The stockouts vary between provinces and urban-rural divide, but threaten both levels 1 and 2 facilities similarly.