Evaluation of the Implementation Status, Outcomes and Challenges of “Auditable Pharmaceuticals Transactions and Services” in Selected Hospitals of Ethiopia. October 2015
(2015; 114 pages)

The findings of APTS evaluation by A. Adinew, S. Ololo, F. Tessema. Oct 2015


Background: Availability of essential medicines is necessary to maintain health of the community. In Ethiopia, availability of medicines was low (65%), with high expiry rate (8.24%), low patient knowledge on correct dosage (50.5%) and satisfaction on pharmacy services (74.5%). To avert these problems, the government had enacted legislation on a system called “Auditable Pharmaceutical Transactions and Services (APTS)”. The system is being implemented in more than 45 hospitals. However, the outcomes and challenges in implementation of this system were not evaluated.

Objective: To measure the status, outcomes, and challenges of APTS implementation in selected hospitals in Ethiopia.

Methods: Cross sectional descriptive study and multiple case study designs were used employing both quantitative and qualitative methods. This research was conducted in 10 APTS implementing hospitals. In-depth interviews were made with 10 CEOs and pharmacy heads. Self-administered questionnaire was distributed to 348 pharmacy staffs. APTS reports of 153 months (with different characteristics) were also reviewed. Using W.H.O questionnaire, 1000 patients were interviewed for their knowledge on correct dosage and satisfaction. Quantitative data was entered and analyzed using SPSS version 20. Multivariate logistic regression was used to determine crude and adjusted OR.

Result: The implementation statuses of APTS ranged from 68% to 95%. Slopes for trends of cumulative rate of medicines expiry (-0.089) and gross profit from medicines sales ranged from 77 to 4079 respectively. Patients’, who were served in hospitals which had APTS standards, knew correct dosage 4.6 times more than otherwise (AOR=4.6, C.I.95%). Patients’ satisfaction on pharmacy services were associated with availability of medicines and seated service for special counseling (AOR=2.3, AOR=4, C.I.95%) respectively. Patients served in a hospital which identified medicines for top ten diseases and follow regularly, have got their prescribed medicines 7.5 times more than otherwise (AOR=7.5. C.I. 3.887-14.473)

Conclusion and recommendation: APTS evaluation showed that it reduces rate of medicines expiry and improve patient knowledge on correct dosage and satisfaction. Therefore, I recommended that; APTS should be scaled up to all health facilities in Ethiopia by FMOH and beyond to all African countries by FMOH of Ethiopia and Africa Union.

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