More money alone will not solve medical stock outs

Despite a lack of funds in the health sector, stock outs at public health facilities will not be improved by more resources alone. A new study by Twaweza and the UK-based Overseas Development Institute (ODI) analyzed the reasons behind stock outs and recommended four new ideas to resolve the problem.

The report, titled Stock-outs of essential medicines in Tanzania, was released by Twaweza and ODI alongside a short policy brief titled What role can citizens play in addressing stock outs?

Tanzania faces severe constraints in health budgets. For example the budget for medicines and medical supplies in 2012-13 was TZS 80 billion against estimated need of TZS 198 billion. However stock outs occur frequently for a range of reasons, not just a lack of resources. The following factors also play a role in continuing stock outs:

  • Politicians prefer visible reforms, such as building dispensaries, over systematic and complex improvements to the delivery of healthcare. Citizens also seem to prefer infrastructure.
  • There are no reliable data on medicine orders, deliveries or use. When data are available, they are used to report to supervisors rather than as tools to help staff manage health facilities.
  • When things go wrong, for example when medicines go missing, there is little or no action to investigate or address the issues. Roles are also unclear so it is difficult to know who is responsible. However some District and Regional Medical Officers do follow up on these issues with some success.
  • Although citizens are aware that stock outs are a problem, they do not know what they can do to solve the problem.

Moving forward
The study also recommended ways of addressing the lack of medicines in public health facilities.

  • Citizens can provide independent verification of what is or is not available at their local health facility – both raising awareness and helping officials to track stocks. Studies such as Uwezo, which covers education, may be of value in health.
  • Data from health facilities should be released so that academia, media and civil society can analyze, interpret and communicate this data to the public.
  • Health officials, facilities and civil society organisations who are solving problems and reducing stock outs should be identified and recognised. The ‘secret’ to their success should be documented and promoted  – rewarding their work, creating an expectation that stock outs can be solved and spurring others to emulate their methods.
  • Government should collaborate with other actors so that they can come up with innovative solutions together.

Read ODI's post about the publication.

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Authors: Emmanuel Malangalila



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