Inventory Management Practices and the Effectiveness of the Supply Chain of Essential Medicines in the Public Sector. Evidence from Six Selected Public Hospitals in Uganda

Introduction: Malaria is a killer disease in the tropical environment; artemisinin-based combination therapies (ACTs) play a central role in treating malaria. Thus, the supply and presence of ACT drugs in hospitals are a key feature in the fight against malaria. Supply chain management literature has focused on the private sector, and less attention has been paid to the public sector, especially hospitals. Aim: This study uses an interdisciplinary lens in investigating how to boost the supply and distribution of ACTs to save lives in low-income countries, specifically in Uganda. Methodology: The study adopted a quantitative research design using a questionnaire as the data collection instrument. Of the 440-population size, 304 of the sample population participated in the study. The model was estimated using structural equation modeling (SEM) to establish the causal relationship among the variables. Results: From the SEM analysis, all the hypotheses were significant at p < 0.05. The availability of ACTs is strongly affected by strategic dimensions (0.612), followed by operation dimensions (0.257); strategic determinants significantly affect operational determinants by a magnitude of 0.599. The indirect influence of the strategic determinants via operational determinants on the availability of ACTs is not significant. Overall, the factors explained 63.9% of the observed variance in the availability of ACTs, and the ACT availability can be predicted as follows: ACT availability = 0.612 × strategic determinants + 0.256 × operation determinants. Top management commitment and organizational responsiveness are among the items that positively affect the availability of ACTs. Conclusion: Strategically, hospital management should invest in cheap technology and software to minimize the unavailability of medicines. Our research suggests that strategic and operational determinants should be integrated into the hospitals’ core business and implemented by the top management. The article contributes to theoretical and policy direction in the public sector medicine supply chain, specifically in public hospitals.

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Inventory Management Practices and Supply Chain Performance of Antiretroviral Medicines in Public Hospitals in Nyamira County, Kenya

Rwanda Journal of Medicine and Health Sciences ◽

10.4314/rjmhs.v4i2.5 ◽

2021 ◽

Vol 4 (2) ◽

pp. 257-268

Author(s):

Anyona Johnson ◽

Karimi Peter ◽

Maru Shital

Keyword(s):

Supply Chain ◽

Inventory Management ◽

Lead Time ◽

Management Practices ◽

Performance Metrics ◽

Public Hospitals ◽

Supply Chain Performance ◽

Key Informant ◽

Wastage Rate ◽

Reporting Rates

BackgroundUnreliable supply systems have plagued the provision of an uninterrupted supply of life- saving medicines in many developing countries, with antiretroviral (ARV) medicines having the worst repercussions.ObjectiveTo identify the inventory management practices used, evaluate the supply chain performance, and determine the challenges affecting inventory management of ARV medicines in public hospitals.MethodsThe study used a descriptive cross-sectional design, gathering snapshot data on inventory management practices happening in all the 8 public hospitals across Nyamira County. Data collection was done using structured questionnaires, key informant interviews, checklists and data from the national health information system.ResultsThe response rate was 97.3% for the questionnaires and 100% for the key informant interviews. The prevailing inventory management practices were: use of scheduled inventory control model (80.95%), forecasting demand using previous consumption data (100%), keeping accurate and updated stock records for each commodity (92.31%), having essential logistical data in reports (100%), including safety stock (61.54%) when ordering and keeping ARV medicines in dedicated stores (75%). With the exception of order lead time (17.98 days), the other supply chain performance metrics namely stock out rate (52.12%), stock wastage rate (43.2%), and reporting rates (70.84%) were found to be deficient. The challenges mostly affecting inventory management included inadequate staff and training, lack of proper storage, and unreliable supply of medicines.ConclusionInventory management practices were according to the recommended best approaches despite various challenges. The supply chain performance metrics evaluated, with the exception of order lead time, were all found to be unsatisfactory owing to the high stock out rates, below par reporting rates and high stock wastage rate due to expiries discovered. Adoption of an electronic inventory system, use of data for decision making, dedicated storage of ARV medicines, and inclusion of buffer stock, are some strategies to improve inventory management.Rwanda J Med Health Sci 2021;4(2): 257-268

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Leveraging technology and supply chain to improve family planning logistics in Pakistan

Eastern Mediterranean Health Journal ◽

10.26719/2021.27.7.672 ◽

2021 ◽

Vol 27 (07) ◽

pp. 672-678

Author(s):

Muhammad Tariq ◽

Ambreen Khan ◽

Kayhan Motla

Keyword(s):

Supply Chain ◽

Family Planning ◽

Public Sector ◽

Inventory Management ◽

Grey Literature ◽

Strategic Decisions ◽

Policy Makers ◽

The Public ◽

Supply Planning ◽

Facility Level

Background: Pakistan and USAID have invested in improving the contraceptive supply chain data and commodity security. In 2011, the first digital contraceptive logistics management information system (cLMIS) was launched, enabling supply chain data visibility from the federal level to health facilities. The system has built-in modules on forecasting and supply planning, inventory management, consumption reporting, business intelligence tools, automatic email and SMS alerts. Using these features, policy-makers and health managers annually forecast needs, and procure contraceptives accordingly. Aims: The objective of this research was to understand the existing technological platforms for family planning (FP) supply chain data visibility and the potential impact on contraceptive commodity security. Methods: The authors reviewed available published and grey literature papers on contraceptives and supplies in Pakistan. We extracted data from the cLMIS, evaluated indicators including reporting compliance, reported stock-out rates, and contraceptive performance. The analysis was validated by reviewing supply chain and FP indicators, such as average monthly consumption, months of stock, and couple years of protection. Results: The cLMIS has resulted in improved distribution, early warning and accountability at the lowest tiers in the FP supply chain in the public sector. At the facility level, FP commodity availability increased from 40% in 2009 to 84% in 2018. Conclusion: Contraceptive supply chain has seen significant growth over the past decade to meet expanding reproductive health evidence to inform strategic decisions; cLMIS is a prime contributor to improvements registered in FP stock availability at public sector facilities

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Collaborative management of inventory in Australian hospital supply chains: practices and issues

Supply Chain Management An International Journal ◽

10.1108/13598541211212933 ◽

2012 ◽

Vol 17 (2) ◽

pp. 217-230 ◽

Cited By ~ 50

Author(s):

Vikram Bhakoo ◽

Prakash Singh ◽

Amrik Sohal

Keyword(s):

Supply Chain ◽

Supply Chains ◽

Inventory Management ◽

Management Practices ◽

Public Hospitals ◽

Healthcare Sector ◽

Collaborative Management ◽

Materials Management ◽

Content Type ◽

Australian Hospital

PurposeThe purpose of this paper is to develop an understanding of the nature of collaborative arrangements that partners in Australian hospital supply chains use to manage inventories.Design/methodology/approachA case study involving a supply chain network of ten healthcare organisations (three pharmaceutical manufacturers, two wholesalers/distributors and five public hospitals) was studied. Data included 40 semi‐structured interviews, site visits and examination of documents.FindingsThis study highlights the existence of a variety of collaborative arrangements amongst supply chain partners such as the “Ward Box” system (a variant of the vender managed inventory system) between wholesalers/distributors and hospitals. The materials management departments were more willing than their pharmacy counterparts to participate in a variety of partial and complete outsourcing arrangements with wholesalers/distributors and other hospitals. Several contingent factors were identified that influenced development of collaborative arrangements.Research limitations/implicationsThis study is limited to the Australian healthcare sector. To improve generalisability, this study could be replicated in other industry sectors and countries.Practical implicationsApplication of collaborative arrangements between manufacturers and wholesalers/distributors would improve inventory management practices across the supply chains. Also, learning from materials management departments could be transferable to pharmacy departments.Originality/valueSeveral contingent variables for the implementation of collaborative inventory management arrangements between healthcare supply chain partners have been identified. Methodologically, data across three echelons in the supply chains (manufacturers, wholesalers/distributors and hospitals) were collected and analysed.

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Availability, prices and affordability of essential medicines for children: a cross-sectional survey in Jiangsu Province, China

BMJ Open ◽

10.1136/bmjopen-2018-023646 ◽

2018 ◽

Vol 8 (10) ◽

pp. e023646 ◽

Cited By ~ 3

Author(s):

Xiaoluan Sun ◽

Jing Wei ◽

Yuan Yao ◽

Qiutong Chen ◽

Daiting You ◽

...

Keyword(s):

Public Sector ◽

Jiangsu Province ◽

Public Hospitals ◽

Essential Medicines ◽

Secondary Outcome ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Public ◽

Medicines For Children ◽

Government Worker

ObjectiveChina has undertaken several initiatives to improve the accessibility of safe and effective medicines for children. The aim was to determine the availability, price and affordability of essential medicines for children.DesignCross-sectional survey.SettingSix cities of Jiangsu Province, China.Participants30 public hospitals and 30 retail pharmacies.Primary and secondary outcome measuresThe WHO/Health Action International standardised methodology was used to collect the availability and price data for 40 essential medicines for children. Availability was measured as the percentage of drug outlets per sector where the individual medicine was found on the day of data collection, and prices were measured as median price ratios (MPRs). Affordability was measured as the number of days’ wages required for the lowest paid unskilled government worker to purchase standard treatments for common conditions.ResultsThe mean availabilities of originator brands (OBs) and lowest priced generics (LPGs) were 7.5% and 34.2% in the public sector and 8.9% and 29.4% in the private sector. The median MPRs of LPGs in both sectors ranged from 1.41 to 2.12 and 1.10 to 2.24, respectively. However, the patient prices of OBs far exceeded the critical level in both sectors, with median MPRs ranging from 2.47 to 8.22. More than half of these LPGs were priced at 1.5 times their international reference prices in the public sector. Most LPGs were affordable for treatment of common conditions in both public and private sectors, as they each cost less than the daily wage for the lowest paid unskilled government worker.ConclusionsAccess to essential medicines for children is hampered by low availability. Further measures to enhance access to paediatric essential medicines should be taken, such as developing a national essential medicine list for children and mobilising the enthusiasm of pharmaceutical firms to develop and manufacture paediatric medicines.

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Detailed cost of robotic-assisted surgery in the Australian public health sector: from implementation to a multi-specialty caseload

BMC Health Services Research ◽

10.1186/s12913-021-06105-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Kate McBride ◽

Daniel Steffens ◽

Christina Stanislaus ◽

Michael Solomon ◽

Teresa Anderson ◽

...

Keyword(s):

Public Sector ◽

Health Sector ◽

Public Hospitals ◽

Fixed Costs ◽

Tertiary Referral Hospital ◽

Robotic Assisted ◽

The Public ◽

Robotic Assisted Surgery ◽

Specific Implementation ◽

Theatre Utilisation

Abstract Background A barrier to the uptake of robotic-assisted surgery (RAS) continues to be the perceived high costs. A lack of detailed costing information has made it difficult for public hospitals in particular to determine whether use of the technology is justified. This study aims to provide a detailed description of the patient episode costs and the contribution of RAS specific costs for multiple specialties in the public sector. Methods A retrospective descriptive costing review of all RAS cases undertaken at a large public tertiary referral hospital in Sydney, Australia from August 2016 to December 2018 was completed. This included RAS cases within benign gynaecology, cardiothoracic, colorectal and urology, with the total costs described utilizing various inpatient costing data, and RAS specific implementation, maintenance and consumable costs. Results Of 211 RAS patients, substantial variation was found between specialties with the overall median cost per patient being $19,269 (Interquartile range (IQR): $15,445 to $32,199). The RAS specific costs were $8828 (46%) made up of fixed costs including $4691 (24%) implementation and $2290 (12%) maintenance, both of which are volume dependent; and $1848 (10%) RAS consumable costs. This was in the context of 37% robotic theatre utilisation. Conclusions There is considerable variation across surgical specialties for the cost of RAS. It is important to highlight the different cost components and drivers associated with a RAS program including its dependence on volume and how it fits within funding systems in the public sector.

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Framework for successful supply chain implementation in healthcare area from provider’s prospective

Asia Pacific Journal of Innovation and Entrepreneurship ◽

10.1108/apjie-04-2018-0024 ◽

2018 ◽

Vol 12 (2) ◽

pp. 135-145 ◽

Cited By ~ 5

Author(s):

Ik-Whan Kwon ◽

Sung-Ho Kim

Keyword(s):

Health Care ◽

Supply Chain ◽

Inventory Management ◽

Health Care Providers ◽

Management Practices ◽

Cost Of Care ◽

Care Providers ◽

Financial Health ◽

Content Type ◽

Supply Chain Finance

Purpose This paper aims to explore avenue where suppliers and manufacturers are aligned with health-care providers to improve supply chain visibility. Supply chain finance is explored to link suppliers/manufacturers with health-care providers. Design/methodology/approach Existing literature on supply chain visibility in health care forms a basis to achieve the study purpose. Alignment calls also for financial health where supply chain partners’ working capital is readily available to execute joint supply chain plan. Findings There is a disjoint in supply chain alliance between suppliers/manufacturers and providers where providers are unable to trace the origin of supplies. Quality care suffers and cost of care rises as providers search for supplies on an emergency basis. This paper provides a framework where solution can be formulated. Research limitations/implications Suppliers/manufactures form a direct strategic alliance with providers where product visibility enables health-care providers with a better patient management with lower cost of supplies. Inventory management and logistics cost will be lowered as better planning/forecasting is in place. This paper does not call for testing any hypothesis. Perhaps, next move along this line will be to investigate financial health of supply chain partners based on supplier relationship management practices. Originality/value This paper proposes health-care supply chain as an alternative solution to achieve the following twin purposes: controlling the cost while improving quality of care through supply chain finance. As far as we know, this study is the first attempt to achieve the goals.

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Supply Chain Management Practices, Competitive Advantage and Organizational Performance

Operations and Service Management ◽

10.4018/978-1-5225-3909-4.ch054 ◽

2018 ◽

pp. 1181-1207 ◽

Cited By ~ 1

Author(s):

Rajwinder Singh ◽

H.S. Sandhu ◽

B.A. Metri ◽

Rajinder Kaur

Keyword(s):

Supply Chain ◽

Supply Chain Management ◽

Customer Satisfaction ◽

Competitive Advantage ◽

Organizational Performance ◽

Inventory Management ◽

Structural Equation Modelling ◽

Structural Equation ◽

Management Practices ◽

Chain Management

Supply chain is the process of continuous flow of products or services from source to the destination. Supply chain management has become an effective tool now a day to survive in this competitive world. Organizations do their best to harvest profits by adopting better supply chain management practices for competitive advantage and organizational performance. In this paper an attempt has been made to understand the relationship among supply chain practices, competitive advantage, and organizational performance using structural equation modelling. This research conceptualizes and develops five secondary dimensions of supply chain practices (Use of technology, SC speed, Customer satisfaction, SC integration, and Inventory management). The research also identifies four primary competitive advantage components (Inventory management, Customer satisfaction, Profitability, and Customer base identification) and six primary organizational performance components (Financial Performance, Market performance, SC competencies, Customer satisfaction, Stakeholder satisfaction, and Innovation and learning). The data for analysis was collected from top 10 non-livestock organized retail players operating in Punjab, Haryana, Chandigarh, New Delhi and, Gurgaon in India. The relationships in the proposed framework were tested using structural equation modelling. The results indicate that Indian retailers know that competitive advantage has high impact on SCP but they have less understanding in matching SCP and competitive advantage with organizational performance.

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Supply Chain Management Practices, Competitive Advantage and Organizational Performance

Global Business Expansion ◽

10.4018/978-1-5225-5481-3.ch039 ◽

2018 ◽

pp. 871-897

Author(s):

Rajwinder Singh ◽

H.S. Sandhu ◽

B.A. Metri ◽

Rajinder Kaur

Keyword(s):

Supply Chain ◽

Supply Chain Management ◽

Customer Satisfaction ◽

Competitive Advantage ◽

Organizational Performance ◽

Inventory Management ◽

Structural Equation Modelling ◽

Structural Equation ◽

Management Practices ◽

Chain Management

Supply chain is the process of continuous flow of products or services from source to the destination. Supply chain management has become an effective tool now a day to survive in this competitive world. Organizations do their best to harvest profits by adopting better supply chain management practices for competitive advantage and organizational performance. In this paper an attempt has been made to understand the relationship among supply chain practices, competitive advantage, and organizational performance using structural equation modelling. This research conceptualizes and develops five secondary dimensions of supply chain practices (Use of technology, SC speed, Customer satisfaction, SC integration, and Inventory management). The research also identifies four primary competitive advantage components (Inventory management, Customer satisfaction, Profitability, and Customer base identification) and six primary organizational performance components (Financial Performance, Market performance, SC competencies, Customer satisfaction, Stakeholder satisfaction, and Innovation and learning). The data for analysis was collected from top 10 non-livestock organized retail players operating in Punjab, Haryana, Chandigarh, New Delhi and, Gurgaon in India. The relationships in the proposed framework were tested using structural equation modelling. The results indicate that Indian retailers know that competitive advantage has high impact on SCP but they have less understanding in matching SCP and competitive advantage with organizational performance.

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