Assessment of Auditable Pharmaceutical Transactions at Public Hospitals in Gamo Gofa, Southern Ethiopia, a Comparative cross-sectional study, July 2017

Abstract Background Availability of essential medicines is necessary to maintain health of the community. In Ethiopia, availability of medicines was low (65%), with high expiry rate (8.24%), low patient knowledge on correct dosage (50.5%) and satisfaction on pharmacy services (74.5%). To avert these problems, the government had endorsed legislation on a system called “Auditable Pharmaceutical Transactions and Services (APTS)”. However, the outcomes and challenges in implementation of this system were not assessed. Objective To assess the implementation status of APTS and its challenges at public hospitals in Gamo Gofa Zone Southern Ethiopia, April 2017. Methods Facility based Cross sectional study was conducted in two APTS implementing hospitals in Gamo Gofa zone. Semi structured Self-administered questionnaire was distributed to all pharmacy staffs in selected hospitals. APTS reports of 12 months (with different characteristics) were reviewed. Four hundred patients were interviewed by data collectors about patient knowledge and satisfaction using WHO questionnaire. The data were entered and analyzed using Statistical package for social science students/SPSS version 20. T-test and linear regression was used to evaluate significant differences between two hospitals with level of significance pre-set at p-value ≤0.05. Results All dispensing units in primary hospital had six (75%) out of the eight essential equipment for dispensing practice. it was found that respondents in general hospital stated higher scores in general setting of outpatient pharmacy (4.58 Versus 4.25; P <0.001), but lower scores for availability and cost of medicines (4.24 vs 4.43; P<0.05) when compared with those in primary level hospital. There was no significant difference in instruction of medicine provided by dispenser (2.58 vs 2.59; P>0.05), dispenser client interaction (3.09 vs 4.08; P>0.05) and total satisfaction score (2.09 vs 2.02; P>0.05). Conclusion and recommendations In our study Quality of Auditable Pharmaceutical Transactions and Service was low, especially regarding patient knowledge about medicines, unaffordability of medicines, less availability of prescribed drugs, poor transparency of pharmaceutical transactions, insufficient counseling practice and limited facilities for dispensing such as, key medicines, formularies and standard guidelines. We therefore recommend the following measures responsible bodies to improve these gaps y taking administrative actions and providing continued education and training for dispensers.