Hospitals become death trap as drug stock-outs persist

By Deogratias Mmana:

Malawi risks registering rising deaths resulting from Non Communicable Diseases due to limited accessibility to relevant screening services for diabetes and non-availability of medical commodities for diabetes and hypertension.

The country further risks registering high neo-natal and maternal mortality due to non-availability of essential health commodities in the antenatal care and delivery packages.

These are some of the implications cited in a study survey by the Universal Health Coverage Coalition which was conducted in the country’s 10 districts to determine the availability and access to medicines in Malawi.

The study was done in the following districts: Lilongwe, Dowa, Mzimba North, Mchinji, Karonga, Dedza, Nsanje, Salima, Balaka, Phalombe and the findings were released on October 1, 2021.

The study has found that there are prolonged stockouts of essential government-funded health commodities in most health facilities.

For example, the study found that Phimbi health facility in Balaka ran for five months with stockouts for NCD package which include medicines for hypertension treatment.

Nkhwayi health facility in Chiradzulu also had no antenatal care package for five months.

According to the report, Central Medical Stories Trust has had no deworming tablets called Albendazole which is essential for antenatal care package. This has been out of stock for over a year in public health facilities.

CMST also has had no Oxytocin which is essential drug in the delivery package.

The report says the implications of the prolonged stockouts include limited access to essential health services by the citizens.

“Malawi risks registering high neo-natal and maternal mortality due to non-availability of essential health commodities in the antenatal care and delivery packages,” reads the report.

Alongside persistent drug stock-outs, the study also found inadequate specialised human resource as another death trap.

“The implications of inadequate specialised human resource is the non-adherence to guidelines for oversight on health commodities as stipulated in the Malawi Health Commodities ad logistics manual 2003,” reads the report.

Worse still, drug stock-outs should be expected in the current fiscal year because the coalition found that the 2021/2022 budget provision for drugs has been slashed down by 25 percent, falling short of the required budget by K6 billion.

“This may affect availability of drugs,” the report says.

The report has recommended that the Ministry of Health should resume NCD services and ensure availability of drugs for NCDs at primary level.

It has also asked the ministry to increase drug budget allocations and to enhance drug budget transparency. It has also asked for recapitalisation of the CMST.

UNHCC programmes manager Thandie Mchiswe said the findings indicate that there is lack of accountability on essential health commodities at facility level.

Mchiswe also called for strengthening of drug security through drug audits to curb drug pilferage.

“There should also be sanctions and prosecution for perpetrators of drug pilferage,” said Mchiswe who added that DHOs should be provided with copies of delivery notes for health commodities delivered in primary health facilities.

Ministry of Health spokesperson Adrian Chikumbe said the ministry is aware of drug stock-outs especially where government buys from its own drug budget.

He said the ministry has now allowed the district health offices to procure drugs from private pharmacies where CMST has failed to provide.

“That was there before but was abused. But in the short term, we have reverted to it to ensure that health facilities have medicines,” said Chikumbe.

CMSCT spokesperson Herbert Chandilanga said the study specified shortages of nifedipine, propanol and hydrochlorothiazide and several other drugs. Now these therapies are available.

“Stock outs to CMST were due to failure to deliver by some suppliers, largely because of slowed global logistical operations resulting from emergence of Covid-19 transportation restrictions,” he said.

Chairperson of Parliamentary Committee on Heath Matthews Ngwale said recapitalisation of CMST could help the institution to serve better.

Ngwale also said his committee would lobby for increased budget allocations towards drugs.