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Stock-outs of antiretroviral and tuberculosis medicines in South Africa: A national cross-sectional survey.
- Source :
-
PloS one [PLoS One] 2019 Mar 12; Vol. 14 (3), pp. e0212405. Date of Electronic Publication: 2019 Mar 12 (Print Publication: 2019). - Publication Year :
- 2019
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Abstract
- Background: HIV and TB programs have rapidly scaled-up over the past decade in Sub-Saharan Africa and uninterrupted supplies of those medicines are critical to their success. However, estimates of stock-outs are largely unknown. This survey aimed to estimate the extent of stock-outs of antiretroviral and TB medicines in public health facilities across South Africa, which has the world's largest antiretroviral treatment (ART) program and a rising multidrug-resistant TB epidemic.<br />Methods: We conducted a cross-sectional telephonic survey (October-December 2015) of public health facilities. Facilities were asked about the prevalence of stock-outs on the day of the survey and in the preceding three months, their duration and impact.<br />Results: Nationwide, of 3547 eligible health facilities, 79% (2804) could be reached telephonically. 88% (2463) participated and 4% (93) were excluded as they did not provide ART or TB treatment. Of the 2370 included facilities, 20% (485) reported a stock-out of at least 1 ARV and/or TB-related medicine on the day of contact and 36% (864) during the three months prior to contact, ranging from 74% (163/220) of health facilities in Mpumalanga to 12% (32/261) in the Western Cape province. These 864 facilities reported 1475 individual stock-outs, with one to fourteen different medicines out of stock per facility. Information on impact was provided in 98% (1449/1475) of stock-outs: 25% (366) resulted in a high impact outcome, where patients left the facility without medicine or were provided with an incomplete regimen. Of the 757 stock-outs that were resolved 70% (527) lasted longer than one month.<br />Interpretation: There was a high prevalence of stock-outs nationwide. Large interprovincial differences in stock-out occurrence, duration, and impact suggest differences in provincial ability to prevent, mitigate and cope within the same framework. End-user monitoring of the supply chain by patients and civil society has the potential to increase transparency and complement public sector monitoring systems.<br />Competing Interests: The authors have declared that no competing interests exist.
- Subjects :
- Anti-Retroviral Agents therapeutic use
Antitubercular Agents therapeutic use
Community Health Services methods
Cross-Sectional Studies
Female
HIV Infections drug therapy
Health Facilities
Humans
Male
Public Health
Public Sector
South Africa
Surveys and Questionnaires
Tuberculosis drug therapy
Anti-Retroviral Agents supply & distribution
Antitubercular Agents supply & distribution
Public Health Administration methods
Subjects
Details
- Language :
- English
- ISSN :
- 1932-6203
- Volume :
- 14
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- PloS one
- Publication Type :
- Academic Journal
- Accession number :
- 30861000
- Full Text :
- https://doi.org/10.1371/journal.pone.0212405