Catarina Neves Santos, Bruno Ferreira Pedrosa, Marília Martins, Fábio Gouveia, Fátima Franco, Margarida João Vardasca, Bernardo Pedro, Jorge Domingues Nogueira
Interruptions during general practice consultations: negative impact on physicians, and patients' indifference
Family practice
medical consumable stockouts negatively affect health outcomes impeding delaying effective delivery services also discouraging patients seeking care consequently supply chain strengthening adopted key component national health strategies however evidence factors associated increased consumable availability limited study used 201819 harmonised health facility assessment data malawi identify factors associated availability consumables level 1 facilities ie rural hospitals health centres small number beds sparsely equipped operating room minor procedures estimate multilevel logistic regression model binary outcome variable representing consumable availability 130 consumables across 940 facilities explanatory variables chosen based current evidence subgroup analyses carried assess presence effect modification level care facility ownership categorisation consumables public health disease programme malawis essential medicine list classification whether consumable drug level average national availability results suggest following characteristics positive association consumable availabilitylevel 1b facilities community hospitals 64 odds ratio 164 95 ci 137197 higher odds consumable availability level 1a facilities health centres christian health association malawi privateforprofit ownership 63 163 140189 49 149 124180 higher odds respectively governmentowned facilities availability computer 46 146 132162 higher odds absence pharmacists managing drug orders 85 185 140244 higher odds drug store clerk proximity corresponding regional administrative office facilities greater 75 km away 21 lower odds 079 063098 facilities within 10 km district health office three drug order fulfilments 3 months survey 14 114 102127 higher odds one fulfilment 3 months consumables categorised vital malawis essential medicine list performed considerably better 235 335 95 ci 160705 higher odds essential nonessential consumables drugs performed worse 79 021 008051 lower odds medical consumables terms availability across facilities results provide evidence areas intervention potential improve consumable availability exploration health resource consequences strategies discussed useful guiding investments supply chain strengthening uk research innovation part global challenges research fund thanzi la onse reference mrp0280041 wellcome trust thanzi la mawa reference 223120z21z uk medical research council uk department international development eu reference mrr0156001