{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T20:13:36Z","timestamp":1785528816351,"version":"3.56.0"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2007,6,15]],"date-time":"2007-06-15T00:00:00Z","timestamp":1181865600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Health Serv Res"],"published-print":{"date-parts":[[2007,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>In Malawi essential drugs are provided free of charge to patients at all public health facilities in order to ensure equitable access to health care. The country thereby spends about 30% of the national health budget on drugs. In order to investigate the level of drug shortages and eventually find the reasons for the drugs shortages in Malawi, we studied the management of the drug supplies for common and life threatening diseases such as pneumonia and malaria in a random selection of health centres.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>In July and August 2005 we visited eight out of a total of 37 health centres chosen at random in the Lilongwe District, Malawi. We recorded the logistics of eight essential and widely used drugs which according to the treatment guidelines should be available at all health centres. Five drugs are used regularly to treat pneumonia and three others to treat acute malaria. Out-of-stock situations in the course of one year were recorded retrospectively. We compared the quantity of each drug recorded on the Stock Cards with the actual stock of the drug on the shelves at the time of audit. We reviewed 8,968 Patient Records containing information on type and amount of drugs prescribed during one month.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>On average, drugs for treating pneumonia were out of stock for six months during one year of observation (median value 167 days); anti-malarial drugs were lacking for periods ranging from 42 to138 days. The cross-sectional audit was even more negative, but here too the situation was more positive for anti-malarial drugs. The main reason for the shortage of drugs was insufficient deliveries from the Regional Medical Store. Benzyl penicillin was in shortest supply (4% received). The median value for non-availability was 240 days in the course of a year. The supply was better for anti-malarial drugs, except for quinine injections (9 %). Only 66 % of Stock Card records of quantities received were reflected in Patient Records showing quantities dispensed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>We conclude that for the eight index drugs the levels of supply are unacceptable. The main reason for the observed shortage of drugs at the health centres was insufficient deliveries from the Regional Medical Store. A difference between the information recorded on the Stock Cards at the health centres and that recorded in the Patient Records may have contributed to the overall poor drug supply situation. In order to ensure equitable access to life saving drugs, logistics in general should be put in order before specific disease management programmes are initiated.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1472-6963-7-86","type":"journal-article","created":{"date-parts":[[2007,6,16]],"date-time":"2007-06-16T13:24:32Z","timestamp":1182000272000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Deficient supplies of drugs for life threatening diseases in an African community"],"prefix":"10.1186","volume":"7","author":[{"given":"Norman N","family":"Lufesi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marit","family":"Andrew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivar","family":"Aursnes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2007,6,15]]},"reference":[{"issue":"4","key":"427_CR1","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1016\/S0009-9236(03)00002-X","volume":"73","author":"JD Quick","year":"2003","unstructured":"Quick JD: Ensuring access to essential medicines in developing countries: a framework for action. Clinical Pharmacology & Therapeutics. 2003, 73 (4): 279-283.","journal-title":"Clinical Pharmacology & Therapeutics"},{"key":"427_CR2","volume-title":"Central Medical Stores' Catologue for the year 2005 \u2013 2006","author":"Malawi Central Medical Stores","year":"2005","unstructured":"Malawi Central Medical Stores: Central Medical Stores' Catologue for the year 2005 \u2013 2006. 2005"},{"key":"427_CR3","unstructured":"Malawi National Health Accounts: Sources of finance in the health sector, 1998\/9 financial year. Accessed 12-4-2007., [http:\/\/www.who.int\/nha\/docs\/en\/Malawi_NHA_report_english.pdf]"},{"key":"427_CR4","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1016\/S0168-8510(03)00003-4","volume":"65","author":"J Jitta","year":"2003","unstructured":"Jitta J, Whyte SR, Nshakira NT: The availability of drugs: what does it mean in Ugandan Primary Care. Health Policy. 2003, 65: 167-79. 10.1016\/S0168-8510(03)00003-4.","journal-title":"Health Policy"},{"issue":"11","key":"427_CR5","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1016\/0277-9536(91)90035-B","volume":"32","author":"S Foster","year":"1991","unstructured":"Foster S: Supply and use of essential drugs in Sub-Saharan Africa: Issues and possible solutions. Social Science and Medicine. 1991, 32 (11): 1201-1218. 10.1016\/0277-9536(91)90035-B.","journal-title":"Social Science and Medicine"},{"key":"427_CR6","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1093\/heapol\/15.1.59","volume":"15","author":"SV Qeest","year":"2000","unstructured":"Qeest SV, Macwan'gi M, Kamwanga J, Mulikelela D, Mazimba A, Mwangelwa M: User fees and drugs: What did the health reforms achieved in Zambia?. Health Policy and Planning. 2000, 15: 59-65. 10.1093\/heapol\/15.1.59.","journal-title":"Health Policy and Planning"},{"key":"427_CR7","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1093\/heapol\/14.2.89","volume":"14","author":"AL Grand","year":"1999","unstructured":"Grand AL, Hogerzeil HV, Haaijer-Ruskam FM: Intervention research in rational use of drugs: a review. Health Policy and Planning. 1999, 14: 89-102. 10.1093\/heapol\/14.2.89.","journal-title":"Health Policy and Planning"},{"key":"427_CR8","volume-title":"Malawi Population and Housing Census (1998) Final results","author":"National Statistic Office","year":"2000","unstructured":"National Statistic Office: Malawi Population and Housing Census (1998) Final results. 2000, Accessed 12-4-2007., [http:\/\/www.nso.malawi.net]"},{"key":"427_CR9","unstructured":"Research Randomizer. 2006, Accessed 12-4-2007., [http:\/\/www.randomizer.org]"},{"key":"427_CR10","first-page":"1","volume-title":"Malawi National Drug Policy","author":"Malawi Ministry of Health","year":"1999","unstructured":"Malawi Ministry of Health: Malawi National Drug Policy. 1999, 1-5."},{"key":"427_CR11","volume-title":"Annual review of the health sector 2005\u20132006 Financial year","author":"Malawi Ministry of Health","year":"2006","unstructured":"Malawi Ministry of Health: Annual review of the health sector 2005\u20132006 Financial year. 2006"},{"key":"427_CR12","volume-title":"Malawi: Health Commodities Logistics Management System Procedures Manual","author":"DELIVER","year":"2003","unstructured":"DELIVER: Calculating how much to order or issue. Malawi: Health Commodities Logistics Management System Procedures Manual. 2003, Arlington, Va.: John Snow, Inc\/DELIVER, for the U.S. Agency for International Development"},{"key":"427_CR13","unstructured":"Drug management for health facilities. Managing Drug Supply. 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