An Analysis of Expired Medicines Management System at Health Facilities in Chipinge District Manicaland Province, January- December 2021

Abstract

Expired medicines kept in hospitals for long are a threat to human beings, animals and the environment and this is most commonly the result of inadequate knowledge among Health Care Workers (HCW) manning the medicine stores. An analytic cross sectional study was done in at public health facilities registered with the Ministry of Health and Child Care to compile an inventory of expired medicines from January 2021 to December 2021 and classify them according to class. The study also intended to observe the attitude and levels of knowledge of health care workers towards the disposal of expired medicines through informant interviews from the registered facilities and a health facility checklist. SPSS 22.0 was used for data analysis. These workers 25 males and 24 female consisted mostly of nurses (76%) and few doctors (8%). Only 6% officers from the pharmacy department. Forty (80%) of the sampled respondents had a system for tracking expiry dates of medicines. However only 13 respondents (26%) had a system for tracking expired medicines awaiting disposal whilst 36 participants were not aware of the system. Nurse aides were noted to be responsible for stock management in 51% of the facilities, whilst nurse and pharmacy technicians contributed 38% and 10% respectively. Thirty-two percent of entries of expired medicines into the expired medicines register were antiinfective medicines and the this was followed by anti-retrovial medicines at 27% and resuscitation medicines at 20%. The majority of medicines came from the national pharmacy (80%) and 16% came from private suppliers. On the facility checklist, it was noted 96% of facilities had the updated protocols and policy manuals for disposal of short-dated and expired medicines and 91 % had a register of medicines. Seventeen (35%) of the facilities kept institutional records for an acceptable period of time whilst 23% indiciated that they did surveys for short dated medicines. The district pharmacy was noted no have a shortage of adequate space, resulting in ripple effect on medicine storage in peripheral health facilities. Sex was noted to have a weak connection to having a system for tracking expired medicines (p = 0.242). It was also noted that that there was a weak association between availability of a policy and procedure manual for disposal of expired medicines and availability of a system for tracking expired medicines awaiting disposal (p = 0.559). There was also a significant association between the health worker who does stock management and availability of a system for tracking expired medicines awaiting disposal (p =0.022). The researcher recommended the ministry to train all incoming nurses on medicine stock management and discouraged this task from being seconded to auxiliary officers. There is also a strong need to improve medicine ordering such that shortdated medicines should not be delivered to facilities.