The magnitude and trend of artemether-lumefantrine stock-outs at public health facilities in Kenya

Malaria Journal

Research

Andrew Nyandigisi¹  Sophie Githinji²  Raymond K Sudoi²  Robert W Snow³  Dejan Zurovac⁴  Alex Muturi⁵ 

[1] Division of Malaria Control, Ministry of Public Health and Sanitation, P.O. Box 19982-00202, Nairobi, Kenya;Malaria Public Health and Epidemiology Group, KEMRI/Wellcome Trust Research Programme, PO Box 43640, 00100, Nairobi, GPO, Kenya;Malaria Public Health and Epidemiology Group, KEMRI/Wellcome Trust Research Programme, PO Box 43640, 00100, Nairobi, GPO, Kenya;Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, CCVTM, UK;Malaria Public Health and Epidemiology Group, KEMRI/Wellcome Trust Research Programme, PO Box 43640, 00100, Nairobi, GPO, Kenya;Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, CCVTM, UK;Center for Global Health and Development, Boston University, 02118, Boston, MA, USA;Management for Sciences of Health, P.O. Box 8700-00100, Nairobi, Kenya;

关键词: Supply Chain;    Malaria;    Health Facility;    Public Health Facility;    Monthly Range;   

DOI  :  10.1186/1475-2875-11-37

 received in 2011-11-17, accepted in 2012-02-08,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundHealth facility stock-outs of artemether-lumefantrine (AL), the common first-line therapy for uncomplicated malaria across Africa, adversely affect effective malaria case-management. They have been previously reported on various scales in time and space, however the magnitude of the problem and trends over time are less clear. Here, 2010-2011 data are reported from public facilities in Kenya where alarming stock-outs were revealed in 2008.MethodsData were collected between January 2010 and June 2011 as part of 18 monthly cross-sectional surveys undertaken at nationally representative samples of public health facilities. The primary monitoring indicator was total stock-out of all four weight-specific AL packs. The secondary indicators were stock-outs of at least one AL pack and individual stock-outs for each AL pack. Monthly proportions and summary means of the proportions over the monitoring period were measured for each indicator. Stock-out trends were assessed using linear regression.ResultsThe number of surveyed facilities across 18 time points ranged between 162 and 176 facilities. The stock-out means of the proportion of health facilities were 11.6% for total AL stock-out, 40.6% for stock-out of at least one AL pack, and between 20.5% and 27.4% for stock-outs of individual AL packs. Monthly decrease of the total AL stock-out was 0.005% (95% CI: -0.5 to +0.5; p = 0.983). Monthly decrease in the stock-out of at least one AL pack was 0.7% (95% CI: -1.5 to +0.3; p = 0.058) while stock-outs of individual AL packs decreased monthly between 0.2% for AL 24-pack and 0.7% for AL six-pack without statistical significance for any of the weight-specific packs.ConclusionsDespite lower levels of AL stock-outs compared to the reports in 2008, the stock-outs at Kenyan facilities during 2010-2011 are still substantial and of particular worry for the most detrimental:- simultaneous absence of any AL pack. Only minor decrease was observed in the stock-outs of individual AL packs. Recently launched interventions to eliminate AL stock-outs in Kenya are fully justified.

【 授权许可】

Unknown   
© Sudoi et al; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.