study area and study period
A cross sectional study was conducted from May 11, 2020 to May 18 2020, in Bahir Dar city. Bahirdar was the capital city of Amhara regional state, situated 578Km from Addis Ababa (capital city of Ethiopia). The town was administratively structured by 06 sub cities and 17 KEBELES and has a total population of 356,757 of whom 168,839 are males and 187,918 females. The town has three government hospitals, 06 health centers, and six private Hospitals.
Study design
A descriptive cross-sectional study complemented with a quantitative method was conducted.
Source of data
Helath centers found in Bahiradr city were the source population.
Data collection instrument and procedure
According to unpublished data of Amhara regional health bureau 25 drugs were identified as Essential medicines. Checklists were used according to Ems lists from the region to assess the availability of essential medicine. Inventory Management Assessment Tool (IMAT) was used to review the essential drugs inventory records of tracer drugs and examine stock records and historical stock outs. An observational method was applied on physical stock of the inventory and the inventory record at the day of visit to check for stock availability, inventory accuracy, stock out durations and stock record variation. For data collection procedure the following issues were addressed: Accuracy of stock record was collected by reviewing of store bin card and comparing it with the physical counts on the day of vwasit. Ratio of inventory variation to total stock was collected by reviewing the available stock level of products in the store and comparing it with difference on the recorded stock level of the product. Data on product availability was collected based on quantity of items on the store at the day of vwasit Data on days out of stock was collected by quantifying number of days of each items was out of stock within the assessment period (the last 100 days).
Data analysis
A data collected by using forms and checklists were entered in to excel for further analysis of Essential medicine availability and to determine inventory management practice of health centers found in Bahirdar city. Stock out of tracer drugs was assessed based on average percentage of time that products were out of stock for the past 100 days and percentage of availability of products in stock was based on the stock available on the day of the assessment.
The following measurements that used for analysis of inventory management were adopted from (13).
Percentage of products in stock: It Measures the system's effectiveness in maintaining a range of products in stock (at the time of the assessment) calculated by.
The total products in stock x100
Total number of products in the study
Then, the average percentage of products available on the day of visit for the facility sample was obtained as follows:
Sum of % of products in stock on the day of assessment for each facility x100
Total number of facilities in the sample
Average percentage of time that products are out of stock: It Indicates the system's capacity to maintain a constant supply of products over time by minimizing the duration of stock outs. It was assessed based on average percentage of time that products were out of stock for the past 100 days.
Total number of days out of stock within the last 100 days x100
Total number of products in the study x 100days
then after, the average percent of time out of stock of the tracer products for the facility sample was obtained using the following formula:
Sum of average % of time that products were out of stock for each facility x100
Total number of facilities in the sample
Percentage of stock records that was accurate: It Indicates the quality of the record-keeping system by identifying the proportion of records that was accurate. The first step was to obtain facility specific percentage of stock records of tracer drugs that was accurate corresponding with physical counts was obtained, using the following formulas:
Count of records that are accurate x100
Total number of products in the study
Thereafter, the average percent of stock records that was accurate for the tracer products for the facility sample was obtained using the following formula:
Sum of average % for each facility x100
Total number of facilities in the sample
Ratio of inventory variation to total stock: It indicates the severity of record-keeping errors. First, facility specific ratio of inventory variation to total stock was obtained as follows:
Total sum of Absolute value of the difference between recorded and physical values x100
The total sum of Physical quantity (based on actual count)
Then, the average ratio of inventory variation to total stock for the facility sample was obtained as follows;
Sum of average ratio of inventory variation for each facility x100
Total number of facilities in the sample
Data quality assurance
In order to check for data collection tool completeness, accuracy, Clarity and consistency pre-test was done in Zenzelma health center. Trainings for two days were obtained for data collectors which were 3rd year pharmacy students.
Ethical consideration
Ethical approval was obtained from the Ethics & research Committee of GAMBY medical and business College. The aim of the study and the way it was going to be conducted was explained to the head of pharmacy unit and pharmacists of each health centers.
Dissemination of the result
At the end of the study, Findings of the study was communicated to stack holders, and will be presented on scientific meetings and conferences as well it will submit for publication on scientific journals.