Monday, October 31, 2011


By Bernard Lugongo,The Citizen Reporter

Dar es Salaam. Ninety-two per cent of public health centres in the country face shortage of absorbent surgical gauzes used for preventing severe bleeding during surgery, a new report by a non-governmental organization called Sikika has found.

The report, released yesterday in Dar es Salaam, indicates that out of 71 districts in 18 regions where health officials were interviewed during the survey, only 8 per cent of them were sufficiently supplied with the gauzes.

The shortage is one of the major factors sabotaging efforts to reduce maternal deaths in the country, according to Patrick Kinemo, the Sikika head of Medicines and Supplies Department.

“Unnecessary maternal deaths occur due to a shortage of such items because there is excessive bleeding during delivery,” said Mr Kinemo.

“Some of health officials we interviewed said they face difficulty when doing surgery on expectant women due lack of gauzes.”

He said Sikika conducted the survey as a response to complaints by health services users and providers over the shortage of absorbent gauze, an essential medical supply used in surgeries and cleaning wounds in public health facilities.

The findings show that the shortages were attributed to, among others, the relatively long order cycle because most requisitions were sent to the Medical Stores Department (MSD) on a quarterly basis.

About 70 per cent of the health facilities surveyed waited for about two or more months before receiving their supplies, while only 10 per cent had their orders delivered in less than a month.

The report says the limited funds allocated and disbursed from the central government was also another cause. It adds that the medicine and supply funds allocated by the government were not enough to satisfy the needs.

It noted that this affected forecasting and ordering as the health facilities had to balance the limited funds available in their accounts against the needs, it adds.

The report says difficulties in accessing alternative funds such as Community Health Funds (CHF) and the National Health Insurance Fund (NHIF) by the facilities was also blamed for the shortage of medicines.

It was observed that there was a long process followed by the health facilities when they needed to use funds held in their accounts.

The research also revealed that only 30 per cent of the health facilities were able to buy supplies directly from private suppliers using alternative sources of funds.

The findings establish that most of the orders by district medical officers from the MSD were generally lower than their quarterly demand.

On average, a district needs 148 rolls of surgical gauze per quarter but the average district order was 108 rolls.

The same applied to facilities where their average quarterly demand was 12 rolls but they received 8 rolls.

The main cause of this disparity seemed to be limited funds in MSD accounts.

Apart from poor projection, over 90 per cent of DMOs and health centres received less gauze than they ordered for that perpetuated the shortages and stock-outs.

Though the survey was centered on absorbent gauze, it also assessed the availability of other essential medicines and components such as ALU, surgical gloves, syringes, amoxillin and quinine injections.

However, the report argues that the availability of essential medicines and medical supplies continues to be a challenge in most public health facilities in developing countries.

To solve the shortage problem, Sikika recommended that the MSD and the ministry of Health reviews the three-month order cycle and instead institute one that took only thirty days to reduce the time a facility stayed out of stock.

Also, the government should use the allocation formula it announced when disbursing funds for essential medicines in health facilities and ensure timely and regular disbursement of funds, the report say.


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